“通元法”治疗血管性痴呆临床疗效及对BDNF、VEGF、MMP-9神经免疫影响  

Clinical efficacy of“Tongyuan Method”in treating vascular dementia and its neuroimmune effects on BDNF,VEGF and MMP-9

作　　者：张现豪 刘丽平 黄少鹏 袁玉梅 王玉妹 Zhang Xianhao;Liu Liping;Huang Shaopeng;Yuan Yumei;Wang Yumei(Baoan Hospital of Traditional Chinese Medicine,Shenzhen,Guangdong 518000,China)

机构地区：[1]广东省深圳市宝安中医院,广东深圳518000

出　　处：《首都食品与医药》2024年第11期165-168,共4页Capital Food Medicine

基　　金：国家重点基础研究发展计划(973计划)项目(NO.2012CB518504);国家自然科学基金项目(NO.81173349,81473600,81173350);全国名老中医药专家传承工作室建设项目(NO.201420)。

摘　　要：目的观察“通元法”治疗血管性痴呆(VaD)临床疗效及对BDNF、VEGF、MMP-9神经免疫影响。方法将104例VaD患者随机分为观察组与对照组各52例。两组均给予VaD基础治疗(常规西药治疗、康复训练)和常规针刺治疗;观察组在此基础上予通元针法,取穴以百会、前顶、后顶、人中、天枢、关元、气海为主,配穴太溪(双)、曲池(双)、血海(双)等。治疗前后对简易精神状态量表(MMSE)、长谷川痴呆量表(HDS)、日常生活自理能力量表(ADL)进行评分,并检测血清脑源性神经生长因子(BDNF)、血管内皮生长因子(VEGF)、基质金属蛋白酶-9(MMP-9)水平。结果与同组治疗前比较,治疗后两组患者的MMSE、ADL、HDS评分均提高(P<0.05),治疗后两组患者的血清BDNF、VEGF、MMP-9水平均降低(P<0.05),且观察组各项指标改善明显优于对照组(P<0.05)。两组不良反应总发生率对比,无显著性差异(P>0.05)。结论通元针法联合常规西药治疗、康复训练及常规针刺可显著改善VaD患者的认知功能、日常生活自理能力,优于常规西药治疗、康复训练及常规针刺,其可能通过调节血清BDNF、VEGF、MMP-9水平发挥治疗作用。Objective To observe the clinical efficacy of"Tongyuan Method"in the treatment of vascular dementia(VaD)and its neuroimmune effects on BDNF,VEGF,and MMP-9.Methods 104 VaD patients were randomly divided into observation group and control group,52 cases in each group.Both groups were given VaD basic treatment(conventional western medicine treatment,rehabilitation training)and conventional acupuncture treatment;on this basis,the observation group was given Tongyuan acupuncture,and the acupoints were Baihui,Qianding,Houding,Renzhong,Tianshu,Guanyuan and Qihai are the main points,with Taixi(double),Quchi(double),Xuehai(double),etc.The Mini-Mental State Examination(MMSE),Modified Hasegawa Dementia Scale(HDS),and Daily Living Ability Scale(ADL)were scored before and after treatment,and serum brain-derived nerve growth factor(BDNF),vascular endothelial growth factor(VEGF),matrix metalloproteinase-9(MMP-9)levels were detected.Results Compared with this group before treatment,the MMSE,ADL,and HDS scores of the two groups of patients after treatment were all improved(P<0.05),and the serum BDNF,VEGF,and MMP9 levels of the two groups of patients were reduced after treatment(P<0.05),and the improvement of various indicators in the observation group was significantly better than that in the control group(P<0.05).There was no significant difference in the incidence of total adverse reactions between the two groups(P>0.05).Conclusion Tongyuan acupuncture combined with conventional Western medicine treatment,rehabilitation training and conventional acupuncture can significantly improve the cognitive function and daily self-care ability of VaD patients,which is better than conventional Western medicine treatment,rehabilitation training and conventional acupuncture.This may be through regulating serum BDNF,VEGF,and MMP-9 levels exert therapeutic effects.

关 键 词：血管性痴呆 通元疗法 临床疗效 神经免疫 赖新生 

分 类 号：R743[医药卫生—神经病学与精神病学]