针灸治疗血管性痴呆及对患者血液流变学与血清炎性因子的影响  

Effect of Acupuncture and Moxibustion and Moxibustion on Vascular Dementia and Hemorheology and Serum Inflammatory Factors

作　　者：胡梦露 李飞[2] 邱帅辉 谷娜 韩舒煜 李蔚然 王克坡 周欣华 李申林[3] HU Menglu;LI Fei;QIU Shuaihui;GU Na;HAN Shuyu;LI Weiran;WANG Kepo;ZHOU Xinhua;LI Shenlin(Anhui University of Chinese Medicine,Anhui Hefei 230038,China;The Second Affiliated Hospital of Anhui University of Chinese Medicine,Anhui Hefei 230061,China;Tonghua County Hospital of Traditional Chinese Medicine,Jilin Tonghua 134199,China)

机构地区：[1]安徽中医药大学研究生院,安徽合肥230038 [2]安徽中医药大学第二附属医院,安徽合肥230061 [3]吉林省通化县中医院康复中心,吉林通化134199

出　　处：《中医药临床杂志》2024年第1期133-138,共6页Clinical Journal of Traditional Chinese Medicine

基　　金：安徽高校自然科学重点研究项目(KJ2021A0549);吉林省中医药管理局吉林省中医药科技项目(2021126)。

摘　　要：目的:观察针灸治疗对血管性痴呆(VD)患者的临床疗效及对血液流变学、白细胞介素1β(IL-1β)、白细胞介素10(IL-10)水平的影响。方法:收集确诊VD的患者90例,随机分为针刺组(辨经刺井针治疗)、艾灸组(化瘀通络灸治疗)及针灸组(辨经刺井结合化瘀通络灸治疗),每组各30例。3组患者均予以基础药物及康复训练、普通针刺治疗,每周6次,疗程8周。分别在治疗前、治疗8周后当天观察各组简易智力状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)、日常生活能力量表(ADL)及血液流变学、血清IL-1β、IL-10水平的变化。结果:与治疗前比较,3组患者MMSE、MoCA及ADL量表的评分均升高(P<0.05);全血高切黏度、全血低切黏度、血浆黏度水平及血清IL-1β水平均降低(P<0.05),而IL-10水平差异无统计学意义(P>0.05);与针刺组比较,艾灸组治疗后各指标无明显差异,针灸组治疗后各指标均有明显差异(P<0.05);与艾灸组相比,针灸组治疗后MMSE及ADL评分明显升高(P<0.05),全血高切黏度、全血低切黏度、血浆黏度水平及IL-1β水平明显下降(P<0.05)。结论:针灸结合治疗VD疗效肯定,能有效改善VD患者智能缺损、认知障碍及日常生活能力,其作用机制可能与调节血液流变学,减轻神经细胞炎性损伤有关。Objective:To observe the clinical efficacy of acupuncture treatment in patients with vascular dementia(VD)and its impact on hemorrheology,interleukin 1β(IL-1β),and interleukin 10(IL-10)levels.Methods:90 patients diagnosed with VD were collected and randomly divided into an acupuncture group(meridian differentiation and well acupuncture treatment),a moxibustion group(meridian differentiation and well acupuncture treatment),a moxibustion group(meridian differentiation acupuncture treatment combined with blood stasis and collaterals dredging moxibustion).treatment,30 cases in each group.Patients in the three groups were all given basic drugs,rehabilitation training,and ordinary acupuncture treatment,6 times a week for 8 weeks.The Mini-Mental State Examination(MMSE),Montreal Cognitive Assessment(MoCA),Daily Living Activities Scale(ADL),hemorrheology and serum IL in each group were observed before treatment and on the day after 8 weeks of treatment.Changes in 1β,IL-10 levels.Results:Compared with before treatment,the scores of MMSE,MoCA and ADL scales of patients in the three groups were all increased(P<0.05).Whole blood high shear viscosity,whole blood low shear viscosity,plasma viscosity level and serum IL-1β level were all reduced(P<0.05).The difference in IL-10 levels was not statistically significant(P>0.05).Compared with the acupuncture group,there was no significant difference in each index after treatment in the moxibustion group,while there was a significant difference in each index in the acupuncture group after treatment(P<0.05).Compared with the moxibustion group,the MMSE and ADL scores of the acupuncture group were significantly increased after treatment(P<0.05);the whole blood high-shear viscosity,whole blood low-shear viscosity,plasma viscosity level and IL-1β level were significantly decreased(P<0.05).Conclusion:The combination of acupuncture and moxibustion in the treatment of VD has positive effects and can effectively improve the intellectual impairment,cognitive impairment and daily living abi

关 键 词：血管性痴呆 辨经刺井针 化瘀通络灸 康复训练 血液流变学 IL-1β IL-10 

分 类 号：R246.1[医药卫生—针灸推拿学]