通督调神针刺法联合多奈哌齐治疗血管性轻度认知障碍的临床效果

Clinical effect of Tongdu Tiaoshen acupuncture combined with Donepezil in the treatment of vascular mild cognitive impairment

目的观察通督调神针刺法联合多奈哌齐治疗血管性轻度认知障碍(VMCI)患者的临床效果。方法纳入2017年9月至2019年9月安徽中医药大学第二附属医院脑病科的VMCI患者64例为研究对象,按随机数字表法将其分为对照组(多奈哌齐+常规针刺)和观察组(多奈哌齐+通督调神针刺),每组32例,两组均予以常规对症治疗。持续治疗8周,比较两组临床疗效。依据简易精神状态检查(MMSE)、蒙特利尔认知量表(MoCA)评分评估两组认知能力,根据日常生活活动能力量表(ADL)、神经功能缺损量表(NFDS)评分评估两组生活行为能力,并观察两组治疗前后血清半胱氨酸蛋白酶抑制剂C(CysC)、血浆同型半胱氨酸(Hcy)水平的变化。结果两组各脱落2例,最终各纳入30例。观察组临床总有效率高于对照组,差异有统计学意义(P<0.05)。治疗后,两组MMSE、MoCA及ADL评分均高于治疗前,NFDS评分低于治疗前,且观察组MMSE、MoCA及ADL评分高于对照组,NFDS评分低于对照组,差异有统计学意义(P<0.05)。治疗后,两组CysC、Hcy水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。结论通督调神针刺法联合多奈哌齐治疗VMCI效果较好,能够改善VMCI患者认知能力及行为能力,调节CysC、Hcy水平。

Objective To observe the clinical effect of Tongdu Tiaoshen acupuncture combined with Donepezil in the treatment of patients with vascular mild cognitive impairment(VMCI).Methods Sixty four patients with VMCI admitted to the Department of Encephalopathy in Second Affiliated Hospital of Anhui University of Chinese Medicine from September 2017 to September 2019 were included as the study subjects.According to the random number table method,they were divided into control group(Donepezil+conventional acupuncture)and observation group(Donepezil+Tongdu Tiaosen acupuncture),with 32 cases in each group,both groups were given conventional treatment.The treatment lasted for eight weeks,and the clinical efficacy of the two groups was compared.The cognitive ability of the two groups was assessed by mini mental status examination(MMSE)and Montreal cognitive assessment(MoCA).The activity of daily living scale(ADL)and neurological function defect scale(NFDS)were used to evaluate the living ability of the two groups,and the changes of serum cystatin C(CysC)and plasma homocysteine(Hcy)levels were observed before and after treatment.Results Two cases fell off in each group,and 30 cases were finally included in each group.The total clinical effective rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).After treatment,the MMSE,MoCA,and ADL scores of two groups were higher than those before treatment,and the NFDS score was lower than that before treatment.The MMSE,MoCA,and ADL scores of the observation group were higher than those of the control group,and the NFDS score was lower than that of the control group,with statistical significance(P<0.05).After treatment,the levels of CysC and Hcy in two groups were lower than before,and the observation group was lower than the control group,with statistical significance(P<0.05).Conclusion Tongdu Tiaoshen acupuncture combined with Donepezil has a good effect in the treatment of VMCI,which can improve the cognitive ability and behavioral ability of VMCI patients,and regulate the levels of CysC and Hcy.