中西医结合治疗血管性痴呆45例临床疗效分析  

Effect Analysis of Integrated Chinese and Western Medicine Therapy for 45 Cases of Vascular Dementia

作　　者：曲悦君 刘华锋 高玓 QU Yuejun;LIU Huafeng;GAO Di

机构地区：[1]浙江老年关怀医院,浙江杭州310015

出　　处：《新中医》2018年第3期57-60,共4页New Chinese Medicine

摘　　要：目的:观察中西医结合治疗血管性痴呆痰浊蒙窍证的疗效。方法:纳入90例血管性痴呆痰浊蒙窍证患者,随机分为对照组和治疗组各45例。2组均予常规干预,对照组口服盐酸多奈哌齐片,治疗组在对照组基础上予涤痰汤加味治疗。2组均连续治疗12周。比较2组患者治疗前后的Folstein简易精神状态检查表(MMSE)评分、日常生活能力量表(ADL)评分、痰浊蒙窍证症状评分、血清同型半胱氨酸(Hcy)、内皮素(ET)水平及治疗后的临床疗效。结果:治疗后,治疗组总有效率为91.11%,高于对照组的71.11%,差异有统计学意义(P<0.05)。2组ADL评分和MMSE评分均较治疗前升高,痰浊蒙窍证症状评分均较治疗前降低,差异均有统计学意义(P<0.01);治疗组ADL评分和MMSE评分均高于对照组,痰浊蒙窍证症状评分低于对照组,差异均有统计学意义(P<0.01)。2组血清Hcy和ET水平均较治疗前降低(P<0.01),治疗组血清Hcy和ET水平均低于对照组(P<0.01)。结论:涤痰汤加味联合常规西医治疗可明显改善血管性痴呆患者的生活能力和认知功能,提高临床疗效,效果优于单纯西医措施干预,其作用机制可能是通过改善神经毒作用,促进脑血液循环,进而有助于患者的康复。Objective：To observe the curative effect of integrated Chinese and western medicine therapy for patients with vascular dementia of syndrome of orifices confused by phlegm. Methods：Selected 90 cases of patients with vascular dementia of syndrome of orifices confused by phlegm,and divided them into the control group and the treatment group randomly,45 cases in each group. Both groups were given routine intervention,and the control group was given oral donepezil hydrochloride tablets,while the treatment group additionally received modified Ditan tang based on the treatment of the control group. The treatment of the two groups continuously lasted for 12 weeks. Compared scores of mini-mentalstate examination（MMSE） of Folstein,activity of daily living scale（ADL） and symptoms of syndrome of orifices confused by phlegm,levels of serum homocysteine（Hcy） and endothelin（ET） of patients as well as the post-treatment clinical effect before and after treatment. Results：After treatment,the total effective rate was 91.11% in the treatment group,being higher than 71.11%in the control group,the difference being significant（P〈0.05）. Scores of ADL and MMSE were increased when compared with those before treatment, while symptom scores of syndrome of orifices confused by phlegm were decreased,differences being significant（P〈0.01）. Scores of ADL and MMSE in the treatment group were higher than those in the control group,while symptom scores of syndrome of orifices confused by phlegm were lower,differences being significant（P〈0.01）. Levels of serum Hcy and ET in both groups were decreased when compared with those before treatment（P〈0.01）,while levels of those two indexes in the treatment group were lower than those in the control group（P〈0.01）. Conclusion：The therapy of modified Ditan tang combined with conventional western medicine therapy can obviously improve the living ability and cognitive function of patients with vascular dementia as well as the clinical efficacy,whose effect

关 键 词：血管性痴呆 痰浊蒙窍证 中西医结合疗法 涤痰汤 简易精神状态检查表(MMSE) 日常生活能力量表(ADL) 

分 类 号：R743[医药卫生—神经病学与精神病学]