颞三针治疗轻中度血管性痴呆及对血清血液流变学、ApoE、AchE的影响  

Treatment of mild to moderate vascular dementia with temporal three acupuncture and its effect on serum hemorheology,ApoE and AchE

作　　者：李卫民[1] 刘启[1] 洪洁 胡梦露 李飞[2] Li Weimin;Liu Qi;Hong Jie;Hu Menglu;Li Fei(Hefei vocational and technical college,Hefei,Anhui,238000,China;The second affiliated hospital of Anhui University of traditional Chinese Medicine,Hefei,Anhui,230061,China)

机构地区：[1]合肥职业技术学院,安徽合肥238000 [2]安徽中医药大学第二附属医院,安徽合肥230061

出　　处：《齐齐哈尔医学院学报》2023年第5期441-445,共5页Journal of Qiqihar Medical University

基　　金：安徽省教育厅自然科学重点项目(KJ2020A0982,KJ2020A0984);安徽省教育厅省级质量工程项目(2020kfkc466,2021jyxm1310)。

摘　　要：目的观察颞三针联合康复训练治疗血管性痴呆(VD)的临床疗效及对血液流变学、载脂蛋白E(ApoE)及乙酰胆碱酯酶(AchE)的影响。方法选择2019年9月—2021年9月本院收治的70例VD患者作为研究对象,按随机数表法分为治疗组和对照两组,每组各35例。治疗组在常规基础药物治疗上采取颞三针联合康复训练治疗,对照组在常规基础药物治疗上采取康复训练治疗。分别在治疗前后采用日常生活能力评定量表(ADL)、简易智能量表(MMSE)评价其临床疗效,并检测血液流变学、血清AChE和ApoE水平的变化。结果与治疗前比较,两组患者治疗后MMSE、ADL评分均明显升高(P<0.01),而血清AChE、ApoE水平均降低(P<0.01),全血高切黏度、全血低切黏度和血浆黏度水平有不同程度降低(P<0.01,P<0.05);治疗组治疗后ADL、MMSE评分高于对照组(P<0.01,P<0.05),血清AChE、ApoE水平低于对照组(P<0.01,P<0.05),全血高切黏度、全血低切黏度和血浆黏度水平明显低于对照组(P<0.01)。结论颞三针结合康复训练治疗VD疗效肯定,能明显改善患者的认知障碍,提高日常生活水平能力,改善生活的质量,其认知能力的提高可能与调节血液流变学、血清AChE、ApoE水平有关。Objective To observe the clinical efficacy of temporal three acupuncture combined with rehabilitation training in the treatment of vascular dementia(VD)and its effects on hemorheology,apolipoprotein E(ApoE)and acetylcholinesterase(AChE).Methods 70 patients with VD were randomly divided into treatment group and control group,with 35 cases in each group.The treatment group was treated with temporal three acupuncture combined with rehabilitation training on the basis of routine basic drug treatment,and the control group was treated with rehabilitation training on the basis of routine basic drug treatment.The clinical efficacy was evaluated by activity of daily living scale(ADL)and Mini-Mental State Examination(MMSE)before and after treatment,and the changes of hemorheology,serum AchE and ApoE were observed.Results Compared with those before treatment,the MMSE and ADL scores of the two groups increased significantly after treatment(P<0.01);while the levels of serum AchE and ApoE decreased(P<0.01);the levels of whole blood high shear viscosity,whole blood low shear viscosity and plasma viscosity decreased in varying degrees(P<0.01,P<0.05).After treatment,the scores of ADL and MMSE in the treatment group were higher than those in the control group(P<0.01,P<0.05);the levels of serum Ache and ApoE were lower than those in the control group(P<0.01,P<0.05);the levels of whole blood high shear viscosity,whole blood low shear viscosity and plasma viscosity were significantly lower than those in the control group(P<0.01).Conclusions Three temporal acupuncture combined with rehabilitation training is effective in the treatment of VD.It can significantly improve the cognitive impairment,improve the ability of daily living standard and improve the quality of life.The improvement of cognitive ability may be related to the regulation of hemorheology,serum Ache and ApoE levels.

关 键 词：颞三针 康复训练 血管性痴呆 血液流变学 载脂蛋白E 乙酰胆碱酯酶 

分 类 号：R245.31[医药卫生—针灸推拿学]