健脑益智汤联合穴位注射脑蛋白水解物治疗老年血管性痴呆随机平行对照研究

Jiannaoyizhi Decoction Combined with Acupoint Injection of Cerebrolysin in Treatment of Senile Vascular Dementia Randomized Controlled Study

[目的]观察健脑益智汤联合穴位注射脑蛋白水解物治疗老年血管性痴呆疗效。[方法]使用随机平行对照方法,将180例住院及门诊患者按就诊顺序编号随机分为两组。对照组60例吡拉西坦,2片/次,3次/d。尼莫地平,1片/次,3次/d。治疗组120例1健脑益智汤（黄芪30g,熟地黄、制首乌各24g,山药12g,肉苁蓉15g,附子3g,当归、桃仁、红花、赤芍各12g,牛膝15g,丹参12g,僵蚕6g,益智仁、石菖蒲、天麻、远志、郁金、茯苓各12g等）,随证化裁,1剂/d,水煎300~400m L,早、晚温服;2穴位注射（第一组取风池、百会、悬钟、关元、足三里、曲池;第二组取风府、四神聪、神庭、太溪、肾俞、大椎）,两组穴位交替使用,第1疗程每日注射1次,第2疗程隔日注射1次;注射药物：脑蛋白水解物,8m L/次,0.1-2m L/穴。连续治疗4周为1疗程。观测临床症状、MMSE、CSS、ADL、智力障碍程度、血液流变学指标、不良反应。连续治疗2疗程,随访60d,判定疗效。[结果]治疗组显效59例,有效43例,无效18例,总有效率85.00%;对照组显效15例,有效24例,无效21例,总有效率65.00%;治疗组疗效优于对照组（P〈0.05）。智力障碍程度积分、MMSE、CSS、ADL评分、血液流变学治疗组优于对照组（P〈0.05）。[结论]健脑益智汤联合穴位注射脑蛋白水解物治疗老年血管性痴呆,疗效满意,无严重不良反应,值得推广。

[Objective] To observe the effect of Jiannao Yizhi Decoction Combined with acupoint injection of cerebrolysin treatment of senile vascular dementia. [Method] Using random parallel control method, 180 cases of inpatient and outpatient patients according to the order number were randomly divided into two groups. 60 cases in the control group piracetam, 2 tablets each time, 3 times/＆ nimodipine, 1 tablets each time, 3 times/ d. Treatment group of 120 patients.@ JiannaoYizhi Tang （Astragalus 30g, rehmannia, system Shouwu each 24g, Chinese yam 12g, Cistanche 15g, aconite 3g, angelica, peach kernel, safflower, red peony root 12g, Achyranthes 15g, Salvia 12g , silkworm 6g, treating diabetes, Shichangpu, Tianma, Polygala, turmeric, Poria 12g, etc.）, with the card of the CD, a/d, decoction of 300-400mL, morning and evening, warm clothes; @ point injection （the first group to take the wind pool, Baihui, hanging bell, Guan yuan, the full three years, Qu pool; the second group were wind House, Sishencong, the court of God, Taixi, Shenshu, Ojo）, two points are used interchangeably The first course of injections once a day, the second course of treatment every other day injection of 1; injectable drugs： brain protein hydrolyzate, 8 mL/second, 0.1 ~2mL/points. Continuous treatment for 4 weeks for a course of treatment. Observation of clinical symptoms, MMSE, CSS, ADL, the degree of mental retardation, blood theology, adverse reactions. Continuous treatment 2 courses, follow-60d, to determine efficacy. [Results] treatment group 59 cases, effective 43 cases, ineffective in 18 cases, the total efficiency of 85.00%; control group, 15 cases markedly effective in 24 cases, 21 cases ineffective, the total efficiency of 65.00%; the treatment group than the control group （P〈0.05）. Mental retardation degree of integration, MMSE, CSS, ADL score, hemorheology treatment group than the control group （P〈0.05）. [Conclusion] JiannaoYizhi soup and acupoint injection of brain protein hydrolyzate treatment of senile dementia, results were satisfactory, no serious adverse reactions, should be promoted.