针刺百会、四神聪联合化痰活血方治疗脑梗死后血管性认知障碍的研究分析  

Study on Clinical Effect of Acupuncture at Baihui(DU20) and Sishencong( EX-HN1) Combined with Huatan Huoxue Prescription in Treatment of Vascular Cognitive Impairment after Cerebral Infarction

作　　者：王磊[1] 师会 WANG Lei;SHI Hui(Encephalopathy Department,Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital,Tianjing 300120,China)

机构地区：[1]天津市中医药研究院附属医院脑病科,天津300120

出　　处：《辽宁中医杂志》2020年第12期161-164,共4页Liaoning Journal of Traditional Chinese Medicine

基　　金：天津市中医药管理局(13016)。

摘　　要：目的探讨针刺百会、四神聪联合化痰活血方治疗脑梗死后血管性认知障碍的临床研究。方法将2016年1月—2018年4月来诊的脑梗死后血管性认知障碍患者82例,随机分为两组,各41例,对照组采用盐酸多奈哌齐片,剂量5~10 mg/d口服;观察组采用针刺百会、四神聪联合化痰活血方治疗,连续治疗3个月。治疗前后评价患者简易精神检查量表(minimum mental state examination,MMSE)、脑卒中影响量表(stroke impact scale,SIS)、神经功能缺损积分(CCS)及大脑中动脉收缩期血流速度(Vs)、平均血流速率(Vm)及脉动指数(PI),记录不良反应状况。结果对照组有效率为80.49%(33/41),观察组有效率为95.12%(39/41),两组患者有效率比较,差异有统计学意义(P <0.05)。与治疗前比,两组治疗后MMSE、SIS升高,CCS评分降低;与对照组比,观察组治疗后MMSE、SIS升高,CCS评分降低,差异有统计学意义(P <0.05)。与治疗前比,两组治疗后大脑中动脉Vs、Vm及PI升高;与对照组比,观察组治疗后大脑中动脉Vs、Vm及PI较高,差异有统计学意义(P <0.05)。两组患者不良率比较,差异无统计学意义(P> 0.05)。结论针刺百会、四神聪联合化痰活血方治疗脑梗死后血管性认知障碍的疗效确切,提高认知和神经功能,改善脑血流动力学,且安全性高广。Objective To explore the clinical effect of acupuncture at Baihui( DU20) and Sishencong( EX-HN1) combined with Huatan Huoxue Prescription in the treatment of vascular cognitive impairment after cerebral infarction.Methods A total of 82 patients with vascular cognitive impairment after cerebral infarction were randomly divided into two groups,41 cases in each group.The control group received donepezil hydrochloride 5 mg to 10 mg orally.The observation group received acupuncture at Baihui( DU20) and Sishencong( EX-HN1) combined with Huatan Huoxue Prescription,and two groups were treated for 3 months.Minimum Mental State Examination( MMSE),stroke impact scale( SIS),neurological deficit score( CCS),systolic blood flow velocity( Vs),mean blood flow rate( Vm) and pulse index( PI) were evaluated before and after treatment,and adverse reactions were recorded.Results The effective rate of the control group was 80.49%( 33/41),and that of the observation group was95.12%( 39/41),and there was significant difference between the two groups( P < 0.05).Compared with those before treatment,the MMSE scale and SIS scale increased and CCS score decreased in the two groups after treatment.Compared with those of the control group,the MMSE scale and SIS scale increased and CCS score decreased in the observation group after treatment( P <0.05).Compared with those before treatment,Vs,Vmand PI of the middle cerebral artery in the two groups increased after treatment,while Vs,Vmand PI of the middle cerebral artery in the observation group were higher after treatment than those in the control group( P < 0.05).There was no significant difference in adverse rate between the two groups( P > 0.05).Conclusion Acupuncture at Baihui( DU20) and Sishencong( EX-HN1) combined with Huatan Huoxue Prescription is effective in the treatment of vascular cognitive impairment after cerebral infarction,which can improve cognitive,neurological functions and cerebral hemodynamics and has high safety.

关 键 词：针刺百会、四神聪 化痰活血方 脑梗死后血管性认知障碍 脑血流动力学 

分 类 号：R743[医药卫生—神经病学与精神病学]