头针治疗血管性痴呆随机对照临床研究

Clinical Randomized Controlled Trial of Scalp Acupuncture Treatment for Vascular Dementia

目的评价头针治疗血管性痴呆(肝肾亏虚兼痰瘀阻络证)的疗效。方法采用多中心随机对照的试验方法,将184例患者随机分配到头针组和体针组,治疗前后分别进行简易精神状态检查量表(MMSE)、社会行为能力量表(Blessed)、日常生活自理能力量表(ADL)和中医证候积分的测定。结果血管性痴呆患者认知功能疗效头针组的显效率、总有效率均优于体针组;社会行为能力疗效和中医证候疗效头针组的显效率优于体针组,但总有效率无明显差异;日常生活自理能力疗效两组总有效率无明显差异。MMSE量表评分和中医证候积分的改善均显示头针组显著优于体针组(P<0.01);而Blessed量表和ADL量表评分头针组与体针组无明显差异(P>0.05)。结论头针治疗血管性痴呆,可明显改善患者的智能状态、社会行为能力、日常生活功能及中医证候,而且具有安全、有效、取穴方便、操作简单、不受体位限制等优点,不失为一种有效的非药物疗法。

Objective To evaluate the therapeutic effect of scalp acupuncture on vascular dementia （liver-kidney insufficiency associated with phlegm-blood stasis obstructing the collaterals）. Methods A multicenter randomized controlled trial was designed. One hundred and eighty-four patients were randomly allocated to scalp acupuncture and body acupuncture groups. Evaluation was made using the Mini Mental State Examination （MMSE）, the Blesse Dementia Scale （Blessed）, the Activities of Daily living （ADL） and the Syndrome Score of Traditional Chinese Medicine before and after treatment. Results The MMSE evaluation of the therapeutic effects showed that the marked efficacy rate and the total efficacy rate were higher in the scalp acupuncture group than in the body acupuncture group of vascular dementia patients. The BBS and TCM Syndrome Score evaluations of the therapeutic effects showed that the marked efficacy rate was higher in the scalp acupuncture group than in the body acupuncture group but no significant difference in the total efficacy rate. The ADL evaluation of the therapeutic effects showed no significant difference in the total efficacy rate between the two groups. The MMSE score and the syndrome score of traditional Chinese medicine improved significantly more in the scalp acupuncture group than in the body acupuncture group （P〈0.01）. But there were no significant differences in the Blessed Scale score and ADL score between the scalp acupuncture and body acupuncture groups （P〉0.05）. Conclusion Scalp acupuncture treatment for vascular dementia can obviously improve the patient＇s intelligence, social behaviors, activities of daily living and syndrome of traditional Chinese medicine. It has the advantages of being safe, effective, easy to select points, simple to perform and no posture limitation and is an effective non-medicarnentous therapy.