通调心肾针刺法结合温阳补肾灸治疗血管性痴呆的疗效及对认知功能的影响  

Clinical Efficacy of Tongtiao Xinshen Acupuncture Combined with Wenyang Bushen Moxibustion in the Treatment of Vascular Dementia and Its Effects on Cognitive Function

作　　者：李蔚然 杨琪琪 周欣华 王克坡 李飞[2] LI Weiran;YANG Qiqi;ZHOU Xinhua;WANG Kepo;LI Fei(Graduate School of Anhui University of Chinese Medicine,Hefei 230038,China;Second Affiliated Hospital of Anhui University of Chinese Medicine,Hefei 230061,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

出　　处：《中国中医药信息杂志》2025年第1期158-163,共6页Chinese Journal of Information on Traditional Chinese Medicine

基　　金：国家青年岐黄学者支持项目(2022年);安徽省自然科学基金面上项目(2308085MH297);安徽高校自然科学重大研究项目(2023AH040099);安徽高校自然科学重点研究项目(KJ2021A0549)。

摘　　要：目的观察通调心肾针刺法结合温阳补肾灸治疗血管性痴呆(VD)的临床疗效及对事件相关电位P300、神经元特异性烯醇化酶(NSE)及乙酰胆碱酯酶(AChE)的影响。方法采用随机数字表法将60例VD患者分为针灸组和西药组各30例。2组均予调控血压、血糖、血脂等西医基础治疗;西药组予盐酸多奈哌齐片,每次5mg,每日1次,口服;针灸组在西药组治疗基础上,予通调心肾针刺法结合温阳补肾灸,每日1次,每周6次;2组均连续治疗4周。于治疗前后当日评估2组患者简易智力状态检查量表(MMSE)、日常生活能力量表(ADL)评分,检测血清NSE、AChE浓度,测定事件相关电位P300,并判定MMSE和P300的异常检出率变化。监测2组安全性指标。结果与本组治疗前比较,2组MMSE评分、ADL评分均显著提高(P<0.05),针灸组P300潜伏期下降、P300波幅升高(P<0.05),2组NSE、AChE水平降低(P<0.05);与西药组比较,针灸组治疗后MMSE评分、ADL评分及P300波幅升高,P300潜伏期下降,NSE、AChE水平下降(P<0.05)。患者P300潜伏期异常检出率明显高于MMSE评分异常检出率(P<0.05);与本组治疗前比较,针灸组患者P300潜伏期异常率和MMSE评分异常率降低(P<0.05)。2组均未见明显不良反应。结论通调心肾针刺法结合温阳补肾灸能提高患者认知功能及改善日常生活能力,其机制可能与降低NSE及AChE水平有关,事件相关电位P300在判断VD及认知能力方面较MMSE更为敏感。Objective To examine the clinical efficacy of Tongtiao Xinshen acupuncture combined with Wenyang Bushen moxibustion in the treatment of vascular dementia(VD),and its effects on event-related potential P300,neuron specific enolase(NSE),and acetylcholinesterase(AChE).Methods Totally 60 patients diagnosed with VD were divided into acupuncture and moxibustion group and the Western medicine group according to random number table method,with 30 patients in each group.Both groups received basic Western medicine treatments such as blood pressure regulation,blood glucose regulation,and blood lipid regulation;Western medicine group was given donepezil hydrochloride tablets,5 mg each time,once a day,orally;in the acupuncture and moxibustion group,on the basis of the treatment of the Western medicine group,Tongtiao Xinshen acupuncture was combined with Wenyang Bushen moxibustion,once a day,6 times a week;the treatment for both groups lasted for 4 weeks.The scores of Mini Mental State Examination(MMSE)and Activities of Daily Living(ADL)in two groups of patients were evaluated before and on the day after treatment.The event-related potential P300 was measured and the abnormal detection rate changes of MMSE and P300 were determined.Safety indicators of both groups were monitored.Results Compared with before treatment,the scores of MMSE and ADL in the two groups significantly increased(P<0.05),the latency of P300 in the acupuncture and moxibustion group decreased and the amplitude of P300 increased(P<0.05),and NSE and AChE levels decreased(P<0.05).Compared with the Western medicine group,after treatment,MMSE score,ADL score and the amplitude of P300 in the acupuncture and moxibustion group increased,the latency of P300 decreased,and the levels of NSE and AChE decreased(P<0.05).The detection rate of P300 latency abnormalities in patients was significantly higher than that of MMSE abnormalities(P<0.05);compared with before treatment,the abnormal rate of P300 latency and MMSE score of patients in the acupuncture and moxibustion gro

关 键 词：通调心肾针刺法 温阳补肾灸 血管性痴呆 神经元特异性烯醇化酶 乙酰胆碱酯酶 事件相关电位P300 

分 类 号：R259.4[医药卫生—中西医结合]