补肾活血方联合子午流注纳支法穴位敷贴对轻度认知功能障碍患者事件相关电位P300的影响

Effect of Bushen Huoxue Prescription Combined with Midnight-Noon Ebb-Flow Earthly Branch-Prescription of Acupoint Sticking Method on Event-Related Potential P300 in Patients with Mild Cognitive Impairment

目的:观察子午流注纳支法穴位敷贴联合补肾活血方治疗轻度认知功能障碍的临床疗效。方法:将90例轻度认知功能障碍患者按111随机分为对照组、中药组及子午组各30例。对照组给予盐酸多奈哌齐片,中药组给予补肾活血方治疗,子午组在中药组治疗基础上给予子午流注纳支法穴位敷贴,3组均治疗12周。比较各组患者治疗前后中医证候积分、蒙特利尔认知评估(Montreal cognitive assessment,MoCA)量表评分、P300检测及临床疗效。结果:(1)治疗后,3组患者中医证候积分均显著降低(P<0.05),中药组、子午组中医证候积分显著低于同期对照组(P<0.05),子午组中医证候积分显著低于同期中药组(P<0.05)。(2)子午组有效率为93.33%,显著高于中药组的86.67%及对照组的76.67%,经Kruskal Wallis检验分析,差异有统计学意义(χ^(2)=11.34,P=0.003)。(3)治疗后,中药组视空间与执行能力、记忆与回忆以及总分高于同期对照组(P<0.05);子午组视空间与执行能力、记忆与回忆、注意与集中、定向力以及总分显著高于同期对照组(P<0.01、P<0.05、P<0.05、P<0.05、P<0.01);子午组的视空间与执行能力、记忆与回忆、注意与集中以及总分显著高于中药组(P<0.05、P<0.05、P<0.05、P<0.05)。(4)与治疗前比较,治疗后对照组顶区(Pz)潜伏期下降(P<0.05);中药组中央区(Cz)及顶区(Pz)均下降(P<0.05),Cz、Pz波幅增加(P<0.05);子午组Cz及Pz潜伏期显著下降(P<0.01),Cz、Pz波幅增加(P<0.05、P<0.01)。中药组和子午组治疗后的Cz、Pz潜伏期均低于对照组治疗后(P<0.05),子午组Cz、Pz波幅高于对照组治疗后(P<0.05、P<0.05)。子午组治疗后Cz、Pz潜伏期均低于中药组治疗后(P<0.05),Pz波幅高于中药组治疗后(P<0.05)。结论:子午流注纳支法穴位敷贴联合补肾活血方治疗轻度认知功能障碍疗效显著,可有效降低患者中医证候积分,提高MoCA量表评分,调节P300事件相关电位,干预轻度认知功能障碍。

Objective:To observe the clinical efficacy of Bushen Huoxue Prescription combined with midnight-noon ebb-flow earthly branch-prescription of acupoint sticking method on event related potential P300 in patients with mild cognitive impairment.Methods:120 patients with mild cognitive impairment were randomly divided into control group,Chinese medicine group and Ziwu group with 30 cases in each group.The control group was given donepezil hydrochloride tablets,the Chinese medicine group was given Bushen Huoxue Decoction,and the Ziwu group was given midnight-noon ebb-flow earthly branch-prescription of acupoint sticking method on the basis of the Chinese medicine group.All the three groups were treated for 12 weeks.TCM syndrome score,Montreal cognitive assessment(MoCA)score,P300 detection and clinical efficacy were compared before and after treatment.Results:(1)After treatment,TCM syndrome scores of three groups were significantly decreased(P<0.05),TCM syndrome scores of Chinese medicine group and Ziwu group were significantly lower than those of control group(P<0.05),and TCM syndrome scores of Ziwu group were significantly lower than those of Chinese medicine group(P<0.05).(2)The effective rate of Ziwu group was 93.33%,which was significantly higher than 86.67%of Chinese medicine group and 76.67%of control group(χ^(2)=11.34,P=0.003).(3)After treatment,the visual space and executive ability,memory and recall and total score of Chinese medicine group were higher than those of control group(P<0.05);the visual space and executive ability,memory and recall,attention and concentration,orientation and total score of Ziwu group were significantly higher than those of control group(P<0.01,P<0.05,P<0.05,P<0.05,P<0.01);the visual space and executive ability,memory and recall,attention and concentration and total score of Ziwu group were significantly higher than those of the Chinese medicine group(P<0.05,P<0.05,P<0.05,P<0.05).Compared with before treatment,the incubation period of the parietal zone(Pz)in control group decreased(P<0.05);the central zone(Cz)and the parietal zone(Pz)of Chinese medicine group decreased(P<0.05),and the amplitude of Cz and Pz increased(P<0.05);the latency of Cz and Pz in Ziwu group decreased significantly(both P<0.01),and the amplitude of Cz and Pz increased(P<0.05,P<0.01).The Cz and Pz latency of Chinese medicine group and Ziwu group after treatment were lower than those of the control group(P<0.05),and the Cz and Pz waves in Ziwu group were higher than those of control group(P<0.05,P<0.05).After treatment,the Cz and Pz latency of Ziwu group were lower than those of Chinese medicine group(P<0.05),and the Pz amplitude was higher than that of Chinese medicine group(P<0.05).Conclusion:Bushen Huoxue Prescription combined with midnight-noon ebb-flow earthly branch-prescription of acupoint sticking method has significant effect in the treatment of mild cognitive impairment,which can effectively reduce TCM syndrome score,improve MoCA scale score,regulate P300 event-related potential and intervene mild cognitive impairment.