调神通督针法联合中西医结合卒中单元治疗血管性痴呆随机平行对照研究

The Avatar Overseers Acupuncture Combined Chinese and Western Medicine Combined with Stroke Unit Random Parallel Control Study Treatment of Vascular Dementia

[目的]观察调神通督针法联合中西医结合卒中单元治疗血管性痴呆疗效。[方法]使用随机平行对照方法,将60例住院患者按病志号抽签方法简单随机分两组。对照组30例中西医结合卒中单元联合辨证口服中药、现代功能康复及针灸等。治疗组30例调神通督针法（取神庭、百会）百会、神庭进针方向从前至后,针刺0.8-1寸,深度达到帽状腱膜下,捻转得气后,加电针,波形为连续波,强度以患者可耐受为度,15min后改变为疏密波,以防电适应;电针30min结束后去除电针及配穴,继续留头针1h;留针期间,每隔30min捻转1次,直至出针;留针期间进行认知功能训练,1次/d,周日休息1d;中西医结合卒中单元模式同对照组。连续治疗1周为1疗程。观测临床症状、蒙特利尔认知评估量表（MOCA）、改良Barthel指数评定量表（MBI）评分、不良反应。连续治疗4疗程（4周）,随访12周,判定疗效。[结果]Mo CA评分两组均有改善（P〈0.05）,治疗组改善优于对照组（P〈0.05）。MBI评分治疗组有改善（P〈0.05）,两组间无明显差异（P〉0.05）。[结论]调神通督针法联合中西医结合卒中单元治疗血管性痴呆,疗效满意,无严重不良反应,值得推广。

[Objective] To observe the avatar overseers acupuncture combined Chinese and western medicine treatment for vascular dementia combined stroke unit. [Methods] Using random parallel control method, 60 cases of hospitalized patients by pathography number the draw method is simple and randomly divided into two groups. Control group 30 cases of combine traditional Chinese and western medicine stroke unit combined oral Chinese medicine syndrome differentiation and function of modern rehabilitation and acupuncture and moxibustion, etc. Treatment group 30 cases of the avatar overseers stitch （division, best can take god） best, god court into the direction of the needle to the once upon a time, acupuncture 0.8-1 inch, depth to cap, with twisting, needling and cupping, waveform for continuous wave, strength in patients can be tolerated, for degrees, 15 min after the change of the density wave, in case of power adapt. Electric acupuncture 30 min after the removal of electric acupuncture and match point, to keep the head pin 1 h; Retaining needle, during every 30 min turning once, until the needle; Retaining needle during cognitive function training, l/d, 1 d rest Sunday; Combine traditional Chinese and western medicine stroke unit model with the control group. Continuous treatment for 1 week to 1 course of treatment. Observation of clinical symptoms, Montreal cognitive assessment scale （MOCA）, scale for assessment of modified Barthel index （MB1） score, adverse reactions. Continuous treatment 4 courses （4 weeks）, follow-up of 12 weeks, judge curative effect. [Results] The MoCA scores in the two groups were improved （P〈0.05）, the treatment group is better than that of control group （P〈0.05）. MBI score in treatment group improved （P〈0.05）, no obvious difference between the two groups （P〉0.05）. [Conclusion[ The avatar overseers acupuncture combined Chinese and western medicine combined with stroke unit treatment of vascular dementia, curative effect is satisfied, no serious adverse reactions, worthy of promotion.