耳针配合靳三针治疗非痴呆型血管性认知功能障碍的临床研究

Clinical Research of Non-dementia Vascular Cognitive Impairment Treated with Auricular Acupuncture Combined with Jin's Three-needle Therapy

【目的】比较耳针配合靳三针与单纯靳三针治疗非痴呆型血管性认知功能障碍的临床疗效。【方法】将100例非痴呆型血管性认知功能障碍患者随机分为试验组和对照组各50例。2组均予以内科基础治疗,试验组给予耳针配合靳三针治疗(耳针选取皮质下、心、肾、肝、耳中,每周一、三、五各治疗1次;靳三针选取颞三针、智三针、四神针,每日针刺1次),对照组给予靳三针治疗,共治疗4周。比较2组患者治疗前、治疗2周及4周后简易智能精神状态量表(MMSE量表)和日常生活活动能力量表(ADL量表)的评分情况,并评价其安全性。【结果】(1)治疗2周和治疗4周后,2组患者MMSE量表得分均较治疗前显著提高(P<0.05或P<0.01),ADL量表得分均较治疗前显著下降(P<0.01),且试验组对MMSE量表得分的提高作用及对ADL量表得分的下降作用均显著优于对照组(P<0.05或P<0.01)。而治疗4周与2周比较,2组患者MMSE量表得分均显著提高(P<0.01),以试验组提高作用较明显(P<0.05或P<0.01);2组患者ADL量表得分均有所下降(P<0.01),但组间差异无统计学意义(P>0.05)。(2)2组患者治疗期间均未发生明显与治疗相关的不良反应,具有较高的安全性。【结论】耳针配合靳三针治疗能有效提高非痴呆型血管性认知功能障碍患者的认知功能和日常生活活动能力,其疗效优于单纯靳三针治疗。

Objective To observe the clinical effect of auricular acupuncture combined with Jin＇s three-needle therapy（JTNT） on non-dementia vascular cognitive impairment. Methods Randomized controlled trial was adopted,and 100 non-dementia vascular cognitive impairment patients were randomly divided into combined group（50cases） and JTNT group（50 cases）. The two groups were treated with basic neurological therapies, and additionally, the combined group was given the auricular acupuncture on auricular points of Pizhixia（AT4）,Xin（CO15）,Shen（CO10）,Gan（CO12）,and Erzhong（HX1）,combined with JTNT on three temporal points,three intelligent points,and four mental points,once every Monday,Wednesday,and Friday. And JTNT group was given JTNT additionally. The treatment for the two groups covered 4 weeks. Before treatment and after treatment for 2,4 weeks, the scores of mini- mental state examination（MMSE） and activities of daily life（ADL）of both groups were compared, and the safety was also evaluated. Results（1）After treatment for 2and 4 weeks, MMSE scores of both groups were significantly increased（P〈0.05 or P〈0.01）and ADL scores were decreased as compared to those before treatment（P〈0.01）,and the combined group had better effect on improving MMSE and ADL scores（P〈0.05 or P〈0.01）. On treatment week 4,MMSE scores of both groups were higher and ADL scores were lower than those on treatment week 2（P〈0.01）, and the increase of MMSE scores of the combined group was superior to that of JTNT group（P〈0.05 or P〈0.01）,but the differences of ADL scores between the two groups were insignificant（P〈0.05）.（2）During the treatment,no obvious adverse reaction was found in both groups. Conclusion Auricular acupuncture combined with JTNT can obviously improve the cognitive dysfunction and ADL of patients with non-dementia vascular cognitive impairment,and its therapeutic effect is superior to that of JTNT alone.