首页|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

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

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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5 mg,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。
Clinical Efficacy of Tongtiao Xinshen Acupuncture Combined with Wenyang Bushen Moxibustion in the Treatment of Vascular Dementia and Its Effects on Cognitive Function
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 group decreased(P<0.05).No significant adverse reactions were observed in both groups.Conclusion Tongtiao Xinshen acupuncture combined with Wenyang Bushen moxibustion can enhance cognitive function and everyday life abilities.The mechanism may be related to the reduction of NSE and AChE levels,and event-related potential P300 is more sensitive than MMSE in determining VD and cognitive ability.

Tongtiao Xinshen acupunctureWenyang Bushen moxibustionvascular dementianeuron-specific enolaseacetylcholinesteraseevent-related potential P300

李蔚然、杨琪琪、周欣华、王克坡、李飞

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安徽中医药大学研究生院,安徽 合肥 230038

安徽中医药大学第二附属医院,安徽 合肥 230061

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

2025

中国中医药信息杂志
中国中医科学院中医药信息研究所

中国中医药信息杂志

影响因子:0.889
ISSN:1005-5304
年,卷(期):2025.32(1)