影响相关井穴治疗血管性痴呆疗效的关键因素研究

Key factors research about influence on the effect of VD by acupuncture treatment of well points

目的研究分析影响井穴治疗血管性痴呆(VD)疗效差异的关键因素。方法选取80例VD患者,采用正交设计法,从不同刺激方法(针刺和点刺出血)、不同刺激频次(1次/天和2次/天)、不同疗程(1个和2个疗程)以及不同针刺治疗介入时机(发病一个月以内和一个月以后)角度设计实验方案,共分8组,每组10例观察病例。80例患者在治疗前后均接受简易精神状态检查量表(MMSE)积分评定、生活自理能力指数(ADL)量表积分评定及彩色经颅多普勒(TCD)检查,结果采取极差分析法。结果针刺方法对MMSE、ADL评分结果影响最大,疗程次之,针刺频次影响最小。针刺方法对TCD检查基底动脉平均脑血流量结果影响最大,发病后介入时间次之,针刺频次影响最小。结论不同方法,不同频次,不同的介入时间,不同疗程的治疗均对血管性痴呆的疗效有一定的影响;治疗方法对血管性痴呆疗效的影响最大,疗程次之,不同频次对其影响最小;最佳治疗方案组合为:发病一月内针刺井穴治疗,每日一次或者两次,治疗2个疗程。

Objective To explore the key factors of influence on the different effect of VD treated by acupuncture treatment of well points.Methods 80 befit tested patients were divided into 8 groups,10 patients each,according to the following key factors：different stimulating method（bleeding caused by needling and fast insertion）;different stimulating frequency（once and twice a day）;different treatment course（1 and 2 treatment courses） as well as different initiation time of acupuncture treatment（within and after one month of the onset）,orthogonality analyzing method was used.All the patients were treated with western medicine symptomatically,needling or fast insertion bleeding was used for different groups.All the 80 patients were evaluated before and after the treatment by MMSE and ADL and examined by TCD.The result of best therapeutic regimen was analyzed by using orthogonality design method and range analysis.Results Among the 4 factors,MMSE and ADL results have proved that it is the needling method which has the most significant influence on the evaluation score;the treatment course factor should be less,while treatment frequency factor has the least influence.TCD results of arteriae vertebralis＇ mean flow rate proved that,acupuncture method had the most remarkable influence on the evaluation score,followed by initiation time factor while acupuncture frequency had the least influence.Conclusion Different treatment methods,frequency,initiation time and treatment courses have certain influence on VD therapeutic effect.Treatment method has the most significant influence on VD effect.The treatment course factor is the second one,while the treatment frequency factor has the least influence.The best therapeutic regimen should be as follows：acupuncture treatment starts within one month of the onset,once or twice a day,and 2 treatment courses should be completed.