调神益智针法治疗髓海不足型轻度认知障碍随机对照研究  

A randomized controlled study on treating mild cognitive impairment of the marrow sea insufficiency type by the Tiaoshen Yizhi acupuncture

作　　者：史宗言 王栩[2] 张智龙[2] 吉学群[2] 卢轩[2] SHI Zongyan

机构地区：[1]天津中医药大学研究生院,天津300193 [2]天津市中医药研究院附属医院,天津300120

出　　处：《中医临床研究》2023年第29期82-86,共5页Clinical Journal Of Chinese Medicine

基　　金：天津市卫生健康委员会中医药重点领域科研课题项目(2020001)。

摘　　要：目的:轻度认知障碍是指患者表现出认知功能的损伤,且伴有个人的工具性日常生活能力轻度受损,其发病率在60~64岁为6.7%,若未经治疗将有30%~100%的患者进展为阿尔茨海默病。无高质量证据证明西医药物治疗轻度认知障碍的疗效,且长期服用药物存在一定的不良反应。因此,探索针灸治疗本病具有一定的临床意义。本研究主要观察调神益智针法治疗轻度认知障碍患者的临床疗效,并探索其作用机制。方法:将最终纳入的轻度认知障碍患者90例,按照随机数字表法分为观察组、对照组,每组45例。观察组采用调神益智针法,每日治疗1次,每周治疗5次,4周为一个疗程,共治疗3个疗程;对照组采用口服盐酸多奈哌齐片治疗,连续服用3个月。治疗前后采用蒙特利尔认知评估量表(Montreal Cognitive Assessment,MoCA)评分、简易精神状态检查量表(Mini-mental State Examination,MMSE)评分、临床疗效评定等指标评估疗效。结果:治疗后两组MoCA评分比较差异无统计学意义(P>0.05),两组治疗前后及治疗后组间MMSE评分、血清γ-氨基丁酸(Gamma Amino Butyric Acid,GABA)、血清Tau水平比较,差异均具有显著统计学意义(P<0.01),且观察组优于对照组;观察组临床总有效率为86.67%(39/45),对照组为71.11%(32/45),两组差异有统计学意义(P<0.05);两组安全性分级情况比较,差异无统计学意义(P>0.05)。结论:调神益智针法治疗轻度认知障碍患者临床疗效显著,可改善患者的认知功能。其作用机制可能为升高GABA含量、降低Tau水平。Objective:Mild cognitive impairment refers to patients showing cognitive impairment,accompanied by mild impairment of personal instrumental daily living ability,the incidence of which is 6.7%at the age of 60 to 64,and 30%to 100%of patients will progress to Alzheimer’s disease if untreated.There is no high-quality evidence of the efficacy of Western medicine in the treatment of mild cognitive impairment,and there are certain adverse effects of long-term medication.Therefore,exploring acupunctureO for the treatment of this disease has a certain clinical significance.The clinical effect of the Tiaoshen Yizhi acupuncture(调神益智针法)on mild cognitive impairments is observed in this paper,and its mechanism of action is explored.Methods:According to the random number table method,a total of 90 patients with mild cognitive impairment were randomly divided into the observation group and the control group,with 45 cases in each group.The observation group was treated by the Tiaoshen Yizhi acupuncture,once a day,five times a week,four weeks as a course,a total of three courses of treatment.The control group received oral donepezil hydrochloride tablets for 3 months.Before and after treatment,Montreal cognitive assessment scale(MoCA)score,simple mini-mental state examination(MMSE)score,clinical efficacy evaluation,serum gamma amino butyric acid(GABA),serum Tau protein were used to determine the efficacy.Results:After treatment,there were no significant differences in MoCA scores between the two groups(P>0.05),but there were significant differences in MMSE scores,GABA and serum Tau levels between the two groups after treatment(P<0.01),and those in the observation group were better than the control group.The total clinical efficiency was 86.67%(39/45)in the observation group and 71.11%(32/45)in the control group,and there was significant difference between the two groups(P<0.05).There was no significant difference in safety classification between the two groups(P>0.05).Conclusion:The Tiaoshen Yizhi acupuncture has a s

关 键 词：轻度认知障碍 调神益智针法 随机对照试验 临床机制 

分 类 号：R277.7[医药卫生—中医学]