通督调神针刺法联合洗心汤化裁对血管源性轻度认知障碍患者认知功能及脑血流量的影响  

Efficacy of Tongdu Tiaoshen Acupuncture combined with Xixin Decoction on Cognitive Function and Cerebral Blood Flow in Patients with Vascular Mild Cognitive Impairment

作　　者：周嘉琪 魏立萍 陈丽萍[3,4] 卞海萍 祁晓 ZHOU Jia-qi;WEI Li-ping;CHEN Li-ping;BIAN Hai-ping;QI Xiao(Department of Traditional Chinese Medicine,Wujin Hospital,Jiangsu University,Changzhou Jiangsu 213017;Department of Traditional Chinese Medicine,Wujin Clinical College,Xuzhou Medical University,Changzhou Jiangsu 213017;Rehabilitation Department,Wujin Hospital,Jiangsu University,Changzhou Jiangsu 213017;Wujin,Xuzhou Medical University Department of Rehabilitation,Clinical College,Changzhou Jiangsu 213017)

机构地区：[1]江苏大学附属武进医院中医科,江苏常州213017 [2]徐州医科大学武进临床学院中医科,江苏常州213017 [3]江苏大学附属武进医院康复科,江苏常州213017 [4]徐州医科大学武进临床学院康复科,江苏常州213017

出　　处：《世界中西医结合杂志》2022年第2期368-374,共7页World Journal of Integrated Traditional and Western Medicine

基　　金：常州市武进区第三批科技计划项目(WS202017)。

摘　　要：目的探讨通督调神针刺法联合洗心汤化裁对血管源性轻度认知障碍(Vascular mild cognitive impairment,VMCI)患者认知功能及脑血流量的影响。方法选取2019年1月—2020年6月期间江苏大学附属武进医院门诊及住院的患者120例,采用随机数字表法将患者分为对照组、中药组、针灸组与针药联合组,每组各30例。对照组给予常规康复治疗,针灸组在对照组基础上给予通督调神针刺法治疗,中药组在对照组基础上给予洗心汤化裁治疗,针药联合组在对照组基础上给予通督调神针刺法联合洗心汤化裁治疗,疗程4周。治疗后比较4组患者神经心理评分[包括简易智力状态检查量表(Mini-mental state examination,MMSE)评分、蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)评分、巴塞尔指数(Barthel index,BI)评分、Zung焦虑自评量表(Zung self-rating anxiety scale,SAS)评分、Zung抑郁自评量表(Zung self-rating depression scale,SDS)评分]、中医证候评分、脑平均血流速度(Mean blood flow velocity,Vm)[包括大脑前动脉(Arteria cerebri anterior,ACA)、(Arteria cerebri media,MCA)、大脑后动脉(Posterior cerebral artery,PCA)]、临床疗效,中医症候疗效、不良反应的变化。结果治疗后4组患者MMSE、MoCA、BI评分均较治疗前明显升高,差异有统计学意义(P<0.05);且针药联合组明显高于其余3组,差异有统计学意义(P<0.05)。治疗后4组患者SAS、SDS、中医证候评分均较治疗前明显降低,差异有统计学意义(P<0.05);且针药联合组明显低于其余3组,差异有统计学意义(P<0.05)。治疗后对照组仅MCA的Vm均较治疗前明显升高,差异有统计学意义(P<0.05),其余3组ACA、MCA和PCA的Vm均较治疗前明显升高,差异有统计学意义(P<0.05);且针药联合组明显高于其余3组,差异有统计学意义(P<0.05)。治疗后针药联合组临床疗效总有效率为96.67%(29/30),明显高于对照组53.33%(16/30)、中药组76.67%(23/30)、针�Objective To explore the influence of Tongdu Tiaoshen Acupuncture combined with Xixin Decoction on cognitive function and cerebral blood flow in patients with vascular mild cognitive impairment(VMCI).Methods A total of 120 outpatient and inpatient patients in Wujin Hospital Affiliated to Jiangsu University from January 2019 to June 2020 were selected,and the patients were divided into control group,traditional Chinese medicine group,acupuncture group and acupuncture-medicine combination group by random number table method.30 cases each.The control group was given routine rehabilitation therapy,the acupuncture group was given acupuncture therapy based on the control group,the Chinese medicine group was given Xixin Decoction on the basis of the control group,and the acupuncture-medicine combination group was given acupuncture based on the control group.Tiaoshen acupuncture combined with Xixin decoction for treatment for 4 weeks.After treatment,the clinical efficacy of the four groups were compared,the Montreal Cognitive Assessment Scale(MoCA),Mini-Mental State Examination(MMSE),Barthel index(BI),Zung Self-rating Anxiety/Depression Scale(SAS,SDS)before and after treatment were evaluated.Cranial Doppler ultrasound(TCD)was used to detect the mean blood flow velocity(Vm)of the anterior cerebral artery(ACA),middle cerebral artery(MCA)and posterior cerebral artery(PCA).Results After treatment,the MMSE,MoCA and BI scores of the four groups were significantly higher than those before treatment,and the difference was statistically significant(P<0.05).After treatment,the SAS,SDS and TCM syndrome scores of the four groups were significantly lower than those before treatment,and the difference was statistically significant(P<0.05).After treatment,only the Vm of MCA in the control group was significantly higher than that before treatment,and the difference was statistically significant(P<0.05);and the acupuncture-medicine combination group was significantly higher than the other three groups,and the difference was statistically

关 键 词：血管源性轻度认知障碍 通督调神针 洗心汤 认知功能 脑血流量 

分 类 号：R749.1[医药卫生—神经病学与精神病学]