自拟补虚通窍方联合耳穴压豆治疗肾虚血瘀型缺血性卒中后轻中度血管性痴呆的疗效观察  

Therapeutic Effect of Buxu Tongqiao Decoction Combined with Auricular Points Plaster Therapy on Kidney Deficiency and Blood Stasis Syndrome of Vascular Dementia after Ischemic Stroke

作　　者：郭红 周嘉澄 GUO Hong;ZHOU Jiacheng(Guangdong Second Traditional Chinese Medicine Hospital(Guangdong Research Institute of Traditional Chinese Medicine Manuracturing Technology),Guangzhou,Guangdong 510095)

机构地区：[1]广东省第二中医院(广东省中医药工程技术研究院),广东广州510095

出　　处：《中医康复》2025年第4期59-65,共7页Traditional Chinese Medicine Rehabilitation

基　　金：广东省中医药管理局中医药科研项目(20221019);广东省第二中医院科研创新基金项目(SEZYY2023B14)。

摘　　要：目的:探讨补虚通窍方联合耳穴压豆治疗肾虚血瘀证卒中后血管性痴呆的临床疗效及对Hcy、LDL-C和hs-CRP的影响。方法:将2022年1月~2023年6月在广东省第二中医院脑病科、针灸康复科住院部接受治疗的肾虚血瘀型缺血性卒中后血管性痴呆患者67例,随机分组分为对照组34例和联合组33例。对照组采用内科疾病常规治疗+耳穴压豆,联合组在对照组基础上服用自拟补虚通窍方。对比两组患者临床疗效、治疗前后简易精神量表评分、血管性痴呆的中医辨证量表、临床痴呆评定量表评分、血同型半胱氨酸(Hcy)、低密度脂蛋白(LDL-C)、超敏C反应蛋白(hs-CRP)变化情况,监测治疗过程中发生的不良反应。结果:联合组总有效率高于对照组(P<0.05);治疗后,两组患者MMSE评分升高(P<0.05)、CDR评分降低(P<0.05),中医辨证量表评分降低(P<0.05),且联合组MMSE评分、CDR评分、中医辨证量表评分均优于对照组(P<0.05)。治疗后,两组患者Hcy、LDL-C、hs-CRP水平均有不同程度减低,两组Hcy、LDL-C组间对比差异有统计学意义(P<0.05),两组间hs-CRP差异无统计学意义(P>0.05)。两组治疗期间均无明显不良反应,不良反应发生率差异无统计学意义(P>0.05)。结论:补虚通窍法联合耳穴压豆可改善肾虚血瘀证缺血性卒中后血管性痴呆患者的临床症状,提高患者认知功能,降低痴呆程度,改善患者脂质代谢及炎症反应,无明显不良反应。Objective:To investigate the clinical efficacy and effect on Hcy,LDL-C and hs-CRP of BuxuTongqiao decoction combined with auricular points plaster therapy in the treatment of kidney deficiency and blood stasis syndrome of vascular dementia after ischemic stroke.Methods:Sixty-seven patients with kidney deficiency and blood stasis syndrome of vascular dementia after ischemic stroke who were treated in the inpatient departments of the Division of Encephalopathy and Acupuncture and Rehabilitation at our hospital from January 2022 to June 2023 were randomly grouped into control group(n=34)and combination group(n=33).The control group was treated with conventional treatment of internal diseases and auricular points plaster therapy,while combination group was given a self-proposed formula for Buxutongqiao Decoction on the basis of the control group.Compared the clinical efficacy of the two groups of patients,changes in the Simple Mental Scale score,Chinese Medicine Identification Scale for Vascular Dementia,Clinical Dementia Rating Scale score,blood homocysteine(Hcy),low-density lipoprotein(LDL-C),and ultrasensitive Creactive protein(hs-CRP)before and after the treatment,and monitored the adverse reactions that occur during the treatment process.Results:The effective rate of thecombination group was higher than that of the control group(P<0.05);After treatment,the MMSE scores of the patients in the two groups increased(P<0.05),the CDR scores decreased(P<0.05),the scores of the Chinese Medicine Identification Scale decreased(P<0.05),and the MMSE scores,CDR scores,and scores of the Chinese Medicine Identification Scale of the combination group were better than those of the control group(P<0.05).After treatment,Hcy,LDL-C and hs-CRP levels were reduced to different degrees in both groups,and the difference between the two groups in Hcy and LDL-C intergroup comparison was statistically significant(P<0.05),while the difference in hs-CRP between the two groups was not statistically significant(P>0.05).There were no significant

关 键 词：缺血性卒中 血管性痴呆 肾虚血瘀证 补虚通窍方 耳穴压豆 认知功能 炎症 

分 类 号：R592[医药卫生—老年医学]