针刺结合心理疗法治疗血管性认知障碍临床研究

Clinical Study on Acupuncture Combined with Psychotherapy for Vascular Cognitive Impairment

目的:探讨针刺与心理疗法对血管性认知障碍的治疗效果。方法:选取135例血管性认知障碍患者为研究对象,按随机数字表法分为3组,分别为药物组、针刺组、心理组,每组45例。药物组给予盐酸多奈哌齐治疗,针刺组在药物组基础上给予针刺疗法,心理组在针刺组基础上加用中医心理疗法。观察并记录3组患者治疗30天后临床疗效、精神状态、认知及生活能力、中医症状积分等情况。结果:药物组总有效率为60.00%,针刺组为82.22%,心理组为93.33%,针刺组、心理组高于药物组(χ^2=11.615、15.055,P <0.05),心理组高于针刺组(χ^2=12.862,P <0.05)。治疗后,3组患者精神状态及认知评分均较治疗前升高,生活能力评分较治疗前降低,差异均有统计学意义(P <0.05)。针刺组患者精神状态及认知评分高于药物组(P <0.05)。心理组患者精神状态及认知评分高于药物组和针刺组(P <0.05),生活能力评分低于药物组和针刺组(P <0.05)。治疗后,3组中医症状积分均较治疗前明显减少(P <0.05)。治疗后,心理组中医症状积分低于针刺组和药物组,针刺组低于药物组,差异均有统计学意义(P <0.05)。结论:应用药物、针刺和心理疗法治疗血管性认知障碍疗效显著,临床应用价值较大。

Objective:To explore the curative effect of acupuncture and psychotherapy for vascular cognitive impairment.Methods:Enrolled 135 cases of patients with vascular cognitive impairment in the study and divided them into three groups according to the random number table, which were the drug group, the acupuncture group and the psychotherapy group,with 45 cases in each group. The drug group was treated with donepezil hydrochloride, while the acupuncture group was additionally given acupuncture and the psychotherapy group was added with psychotherapy in Chinese medicine on the basis of the acupuncture group. Observed and recorded the clinical effect,mental state,cognition and living ability,and Chinese medicine symptom scores of patients in the three groups after 30 days of treatment. Results: The total effective rate was60.00% in the drug group, 82.22% in the acupuncture group and 93.33% in the psychotherapy group;the rates in the acupuncture group and the psychotherapy group were higher than that in the drug group(χ^2=11.615,15.055,P < 0.05);the rate in the psychotherapy group was higher than that in the acupuncture group(χ^2=12.862, P < 0.05). After treatment, the mental state and cognitive scores of the three groups were higher than those before treatment;the life ability score was lower than that before treatment,differences being significant(P < 0.05). The mental state and cognitive scores of patients in the acupuncture group were higher than those in the drug group(P < 0.05). The mental state and cognitive scores of patients in the psychotherapy group were higher than those in the drug group and the acupuncture group(P < 0.05);the life ability score was lower than that in the drug group and the acupuncture group(P < 0.05). After treatment,the scores of Chinese medicine symptom in the three groups were significantly lower than those before treatment(P < 0.05). After treatment,the scores of Chinese medicine symptom in the psychotherapy group were lower than those in the acupuncture group and the drug group;the score in the acupuncture group was lower than that in the drug group,differences being significant(P < 0.05). Conclusion:The application of drugs, acupuncture and psychotherapy for vascular cognitive impairment has obvious curative effect and great clinical application value.