“调心通督”针刺法联合经颅直流电刺激对血管性痴呆的临床观察  

Clinical Observation on“Regulating Heart and Smoothing Du Meridian”Acupuncture Combined with Transcranial Direct Current Stimulation in the Treatment of Vascular Dementia

作　　者：李硕 倪伟 田浩梅[3] LI Shuo;NI Wei;TIAN Haomei(Changsha Hospital of Traditional Chinese Medicine,Changsha,Hunan 410100,China;Xiangya Hospital Central South University,Changsha,Hunan 410008,China;Hunan University of Chinese Medicine,Changsha,Hunan 410208,China)

机构地区：[1]长沙市中医医院,湖南长沙410100 [2]中南大学湘雅医院,湖南长沙410008 [3]湖南中医药大学,湖南长沙410208

出　　处：《湖南中医药大学学报》2020年第4期469-472,共4页Journal of Hunan University of Chinese Medicine

基　　金：湖南省自然科学基金项目(2015JJ4105)。

摘　　要：目的探讨"调心通督"针刺法联合经颅直流电刺激治疗血管性痴呆(vascular dementia,VD)的临床疗效。方法将2018年2月至2019年8月收治的64例VD患者随机分为观察组和对照组(每组32例),两组患者均运用经颅直流电刺激进行治疗,观察组在对照组基础上加做"调心通督"针刺法治疗,即针刺百会、神庭、水沟、内关、大陵、劳宫、神门等穴。两组患者均治疗8周,比较两组治疗前后蒙特利尔认知功能评估(montreal cognitive assessment,MoCA)量表、简易智能状态检查(mini-mental state examination,MMSE)量表评分及经颅多普勒超声(transcranial doppler,TCD)检查情况,对比两组治疗后临床疗效。结果每组均完成30例、脱落2例。与治疗前相比,两组治疗后MMSE、MoCA量表评分均升高(P<0.05);与对照组相比,观察组治疗后MMSE、MoCA量表评分更高(P<0.01),总有效率优于对照组(P<0.05)。TCD检查提示,两组治疗后脑血流速度(除对照组VA外)均较治疗前明显提高(P<0.05),且观察组高于对照组(P<0.05)。结论"调心通督"针刺法联合经颅直流电刺激可显著提升脑部血液循环,提高VD患者MMSE及MoCA评分,改善其认知智力状态,值得临床推广应用。Objective To investigate the clinical efficacy of"regulating heart and smoothing Du meridian"acupuncture combined with transcranial direct current stimulation in the treatment of vascular dementia(VD).Methods Sixty-four VD patients admitted from February 2018 to August 2019 were randomly divided into an observation group(n=32)and a control group(n=32).Both groups were treated with transcranial direct current stimulation.On the basis of the control group,the observation group was added"regulating heart and smoothing Du meridian"acupuncture,namely,acupuncture at Baihui(GV20),Shenting(GV24),Shuigou(GV26),Neiguan(PC6),Daling(PC7),Laogong(PC8),Shenmen(HT7)and other points.The two groups were treated for 8 weeks.The Montreal Cognitive Assessment scale(MoCA),the Mini-Mental State Examination scale(MMSE)score and transcranial Doppler ultrasound(TCD),as well as the clinical efficacy were compared before and after treatment.Results Totally 30 cases were completed in each group,with 2 cases falling off in each group.Compared with before treatment,the scores of MMSE and MoCA were increased after treatment(P<0.05).Compared with the control group,the scores of MMSE and MoCA were higher in the observation group after treatment(P<0.05).The total effective rate was better than the control group(P<0.05).TCD examination showed that the intracranial blood flow velocity was significantly increased in both groups(except control group VA),and the observation group was higher than the control group(P<0.05).Conclusion"Regulating heart and smoothing Du meridian"acupuncture combined with transcranial direct current stimulation can significantly improve the blood circulation of the brain,improve the MMSE and MoCA scores of patients with VD,and improve their cognitive intelligence status,which is worthy of clinical application.

关 键 词：血管性痴呆 调心通督 针刺 经颅直流电 认知功能评估量表 简易智能状态检查量表 经颅多普勒超声 

分 类 号：R246.6[医药卫生—针灸推拿学]