针刺治疗阿尔茨海默病临床观察

Clinical observation of Alzheimer's disease treated with acupuncture

目的:比较针刺与药物治疗阿尔茨海默病的临床疗效差异。方法:将141例患者随机分成针刺组(72例)和药物组(69例)。针刺组采用益气行血、调神益智针法,以神庭、百会、风池、完骨、膻中、中脘、气海、血海、足三里为主穴,依据证候体征加减配穴,每日1次,每周治疗6次;药物组予口服胆碱酯酶抑制剂多奈哌齐(安理申),每次1片(5mg),每晚1次,4周后加至每次2片(10mg)。两组均4周为一疗程,共治疗4个疗程。观察治疗前后简易精神状态检查量表(MMSE)、日常生活能力量表(ADL)、阿尔茨海默病评价量表-认知分量表(ADAS-cog)及数字广度测试(DS)评分的变化。结果:两组治疗后MMSE、DS评分较治疗前增加(均P<0.05),ADL、ADAS-cog量表评分较治疗前降低;两组MMSE、ADL、ADAS-cog量表和DS评分治疗前后差值组间比较差异均有统计学意义(均P<0.01),针刺组改善优于药物组。结论:益气行血、调神益智针法可以显著改善阿尔茨海默病患者的总体功能、认知障碍及日常生活能力,疗效优于口服多奈哌齐。

Objective To compare the differences in the clinical efficacy on Alzheimer’s disease between acupuncture and medicine.Methods One hundred and forty-one patients were randomized into an acupuncture group（72 cases）and a medicine group（69 cases）.In the acupuncture group,the needling technique for benefiting qi,promoting blood circulation,regulating mind and improving intelligence was used at Shenting（GV 24）,Baihui（GV 20）,Fengchi（GB 20）,Wangu（GB 12）,Danzhong（CV 17）,Zhangwan（CV 12）,Qihai（CV 6）,Xuehai（SP 10）and Zusanli（ST 36）.The supplementary acupoints were selected according to the symptoms and physical signs.Acupuncture was given once a day and 6 treatments were required for a week.In the medicine group,the choline sterase inhibitor,donepezil（aricept）was prescribed for oral administration,1 tablet（5 mg）each time,once every night.Four weeks later,the dose was increased to 2 tablets（10mg）each time.In the two groups,the treatment of 4 weeks made one session and 4sessions were required.The changes of scores before and after treatment in the minimum mental state examination（MMSE）,the activity of daily living scale（ADL）,Alzheimer’s disease assessment scale-cognition（ADAS-cog）and the digit span（DS）were observed.Results After treatment,scores of MMSE and DS were increased as compared with those before treatment（both P〈0.05）and scores of ADL and ADAS-cog were reduced as compared with those before treatment.The score differences in MMSE,ADL,ADAS-cog and DS before and after treatment were significant in the two groups（all P〈0.01）.Conclusion The needling technique for benefiting qi,promoting blood circulation,regulating mind and improving intelligence significantly improves the overall function,cognition and activity of daily life in the patients of Alzheimer’s disease and the efficacy is better than donepezil.