针刺井穴治疗血管性痴呆的特异性研究

Specific Study on Puncturing Jing-well Points for Vascular Dementia

目的选用不同井穴治疗血管性痴呆(VD),观察其疗效及差异。方法选取合格受试患者140例,按入院顺序,随机纳入井穴组、药物组和非经穴组,并给予相应处理,针刺治疗每次留针30 min,留针期间每10 min行针1次,每日治疗1次,连续10次为1个疗程,共治疗2个疗程;药物选用茴拉西坦0.2 g/次,口服,每日3次,连服20 d。治疗前后均接受MMSE、ADL量表积分评定及TCD检查。结果治疗后十二井穴各组在改善MMSE、ADL与脑血管平均血流速度上均优于非经穴组(P<0.05)。与药物组比较,在改善MMSE评分疗效上商阳组、少冲组、中冲组、至阴组、大敦组有统计学差异(P<0.05);在改善ADL评分效果上,少冲组、中冲组与其他井穴组比较效果更明显(P<0.05);在改善各条脑血管平均流速效果上,少冲组、中冲组及大敦组均有7条以上脑血管平均流速改善幅度大于药物组。结论不同井穴治疗VD效果有一定的差异性,手少阴心经井穴少冲穴和手厥阴心包经井穴中冲穴疗效较为优越。

Objective To observe the therapeutic effect and difference of acupuncture with different Jing-well points in treating vascular dementia（VD）.Method A hundred and forty patients were recruited and randomized into a Jing-well point group,a medication group,and a non-acupoint group,and then received corresponding treatment.The needles were retained for 30 min each time,while the needles were manipulated every 10 min during retaining.The treatment was given once a day,successive 10 treatments for a treatment course,and 2 courses were given in total.The medication selected for the study was Aniracetam,0.2 g each time,three times a day,orally administered for successive 20 d.MMSE,ADL and TCD were adopted for evaluation before and after treatment.Result It found that after treatment,the improvements of MMSE,ADL and the mean cerebrovascular velocity in the Jing-well point group were superior to that in the non-acupoint group（P0.05）.In comparing the improvement of MMSE,the results in Shangyang（LI 1） group,Shaochong（HT 9） group,Zhongchong（PC 9） group,Zhiyin（BL 67） group,and Dadun（LR 1） group were respectively different from that in the medication group（P0.05）.Shaochong（HT 9） group and Zhongchong（PC 9） group both obtained better result in improving ADL score compared with other Jing-well groups（P0.05）.Regarding the mean cerebrovascular velocity,Shaochong（HT 9） group,Zhongchong（PC 9） group and Dadun（LR 1） group each had 7 cerebral vessels with better improvement compared with the medication group.Conclusion There is deviation among different Jing-well points in treating VD.Of all the Jing-well points,Shaochong（HT 9）,the Jing-well point of the Heart Meridian of Hand Shaoyin,and Zhongchong（PC 9）,the Jing-well point of the Pericardium Meridian of Hand Jueyin,can obtain comparatively better result in treating VD.