补肾活血汤加减结合五神针治疗肝肾不足型血管性痴呆症临床观察

目的:观察补肾活血汤加减结合五神针治疗肝肾不足型血管性痴呆的临床疗效,并探讨其作用机制。方法:将180例肝肾不足型血管性痴呆患者随机分为补肾活血汤加减组、五神针组和针药结合组,每组各60例。补肾活血汤加减组给予补肾活血汤加减治疗,五神针组给予针刺百会、四神聪为主穴治疗,针药结合组同时给予补肾活血汤加减结合针刺百会、四神聪为主穴进行治疗,疗程均为28 d。比较各组治疗前后长谷川痴呆量表(HDS),日常生活能力量表(ADL)和简易精神状态量表(MMSE)评分;检测治疗前后超氧化物歧化酶(SOD),血浆降钙素基因相关肽(CGRP)和丙二醛(MDA)的变化。结果:治疗后针药结合组总有效率91.2%,显著高于补肾活血汤加减组的70.7%和五神针组的79.7%(P0.01);针药结合组HDS,ADL和MMSE评分较补肾活血汤加减组和五神针组改善更为明显(P0.05);针药结合组SOD,CGRP和MDA水平的改善优于补肾活血汤加减组和五神针组(P0.05)。结论:补肾活血汤加减结合五神针可显著提高肝肾不足型血管性痴呆患者的HDS,ADL和MMSE评分,改善SOD,CGRP和MDA水平,其临床疗效优于单用补肾活血汤加减和单用五神针。

Modified Bushen Huoxuetang Combined with Acupuncture for Treatment of Vascular Dementia of Relieving Delay Detention

Objective: To observe the therapeutic effect of modified Bushen Huoxuetang combined with acupuncture at Baihui and Sishencong points in treatment of vascular dementia of liver and kidney deficiency type. Method: A total of 180 cases of vascular dementia of liver and kidney deficiency type were randomly divided into the modified Bushen Huoxuetang group, the acupuncture group and the acupuncture combination with modified Bushen Huoxuetang group, with 60 cases in each one. Modified Bushen Huoxuetang was provided in the modified Bushen Huoxuetang group; the acupuncture at Baihui and Sishencong points group was applied the acupuncture group; the acupuncture combined with modified Bushen Huoxuetang was adopted in the acupuncture combination with traditional Chinese medicine (TCM) group. The course of treatment was 28 days. Hastgawa Dementia scale (HDS), activities of daily living (ADL) and mini-mental state examination (MMSE) were applied to compare the efficacy of the 3 groups before and after treatment. Superoxide dismutase (SOD), calcitonin gene-related peptide (CGRP) and serum levels of malondialdehyde (MDA) were detected. Result: The efficiency of modified Bushen Huoxuetang combination with acupuncture group was 91.2%, which was better than 79.7% of the acupuncture group and 70.7% of the modified Bushen Huoxuetang group (P<0.01). After treatment, the score of HDS, ADL and MMSE were improved significantly (P<0.05) in three groups. The acupuncture combination with TCM group was superior to the other groups; SOD, CGRP and MDA in the modified Bushen Huoxuetang combination with acupuncture group were better than those of the other two groups (P<0.05). Conclusion: Modified Bushen Huoxuetang combination with acupuncture at Baihui and Sishencong points could remarkably increase HDS, ADL and MMSE sores of vascular dementia of liver and kidney deficiency type, improve SOD, CGRP and MDA, with a superior clinical efficacy to single administration of modified Bushen Huoxuetang or acupuncture at Baihui and Sishencong points.