温阳补肾灸结合针刺治疗老年性痴呆临床研究

Clinical Study of Wenyang Bushen Moxibustion Combined with Acupuncture in Treating Senile Dementia

目的:通过观察温阳补肾灸结合针刺及口服西药治疗老年性痴呆的不同治疗效果,以期为临床治疗此病探索一种新型、有效的中医治疗手段。方法:选取60例在安徽中医药大学第二附属医院住院及门诊治疗的老年性痴呆患者随机分为观察组(温阳补肾灸结合针刺治疗)与对照组(口服西药盐酸多奈哌齐治疗)各30例,观察并比较各组治疗前后简易智能状态量表(MMSE)、日常生活活动能力量表(ADL)、阿尔茨海默病病理行为评定量表(BEHAVE-AD)评分和血浆Hcy水平及变化。结果:观察组治疗后的总有效率为93.33%(28/30),优于对照组的76.67%(23/30),差异有统计学意义(P<0.05)。治疗后两组患者各量表评分及血浆Hcy水平较治疗前均有明显改善(P<0.05),且观察组改善程度较对照组更明显(P<0.05)。结论:温阳补肾灸结合针刺及口服西药治疗对老年性痴呆均有效果,但温阳补肾灸结合针刺较口服西药更能改善老年性痴呆患者的认知功能和精神行为症状,提高患者日常生活活动能力,且具有不良反应少、更易被患者接受等优点,其作用的发挥可能是通过改善脑部血液循环、降低血浆Hcy水平以调控氧化应激、保护脑部神经元来实现的。

Objective:To observe the different therapeutic effects of Wenyang Bushen moxibustion combined with acupuncture and western medication in the treatment of senile dementia,so as to explore a new and effective TCM treatment for the disease.Methods:60 cases of senile dementia were randomly divided into the observation group and the control group,with 30 cases in each group.The observation group was treated with Wenyang Bushen moxibustion combined with acupuncture,whereas the control group was treated with oral Donepezil Hydrochloride.The scores of MMSE,ADL and BEHAVE-AD,as well as the level of Homocysteine(Hcy)were observed before and after the treatment in the two groups.Results:The total effective rate of the observation group was 93.33%(28/30),which was significantly higher than 76.67%(23/30)of the control group(P<0.05).The scores of MMSE,ADL and BEHAVE-AD,as well as the level of Hcy were significantly improved after the treatment compared to those before the treatment in the two groups(P<0.05);of which the improvements were more significant in the observation group(P<0.05).Conclusion:Wenyang Bushen moxibustion combined with acupuncture and western medication are effective for senile dementia,but Wenyang Bushen moxibustion combined with acupuncture has better effect.It can improve the cognitive function and mental behavior symptoms of senile dementia and improve the activities of daily living of the patients.The therapy has the advantages of less adverse reactions and easier to be accepted by the patients.The mechanism is related to improving brain blood circulation and decreasing Hcy level to regulate oxidative stress and protect brain neurons.