针刺联合耳穴贴压治疗血管性痴呆的疗效观察

Efficacy Observation of Acupuncture Combined with Auricular Point Sticking for Vascular Dementia

目的观察针刺联合耳穴贴压治疗血管性痴呆的临床疗效。方法将120例血管性痴呆患者随机分为对照组和观察组,每组60例。对照组给予常规治疗,观察组在对照组基础上给予针刺联合耳穴贴压治疗。观察两组治疗前后简易智能状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)、长谷川痴呆量表(HDS)积分变化,检测两组治疗前后脑血流速度及血清丙二醛(MDA)、超氧化物歧化酶(SOD)、同型半胱氨酸(Hcy)、谷胱甘肽过氧化物酶(GSH-Px)、神经相关蛋白高迁移率族蛋白B1(HMGBl)、神经调节蛋白1(NRG1)、微管相关蛋白(Tau)、神经元特异性烯醇化酶(NSE)水平,并比较两组临床疗效。结果观察组总有效率为94.9%,高于对照组的80.7%(P<0.05)。与治疗前比较,两组治疗后MMSE、MoCA、HDS积分升高,血清GSH-Px、SOD、NRGl水平和脑血流速度增加,血清MDA、Hcy、HMGBl、Tau、NSE水平降低,差异有统计学意义(P<0.05)。与对照组比较,观察组治疗后MMSE、MoCA、HDS积分升高,血清GSH-Px、SOD、NRGl水平和脑血流速度增加(P<0.05),血清MDA、Hcy、HMGBl、Tau、NSE水平降低,差异有统计学意义(P<0.05)。结论针刺联合耳穴贴压可明显提高血管性痴呆的智力和行为能力,改善神经相关蛋白的水平。

Objective To observe the clinical efficacy of acupuncture plus auricular point sticking in treating vascular dementia(VD).Method A total of 120 VD patients were randomized into a control group and an observation group,with 60 cases in each group.The control group received conventional treatment,and the observation group was given additional acupuncture and auricular point sticking therapies.Before and after the treatment,the scores of mini-mental state examination(MMSE),Montreal cognitive assessment(MoCA),and Hasegawa dementia scale(HDS)were observed for the two groups.The cerebral blood flow velocity and the levels of serum malondialdehyde(MDA),superoxide dismutase(SOD),homocysteine(Hcy),glutathione peroxidase(GSH-Px),high-mobility group box-1(HMGB1),neuregulin 1(NRG1),Tau,and neuron-specific enolase(NSE)were detected.The clinical efficacy was also compared.Result The total effective rate was 94.9%in the observation group,higher than 80.7%in the control group(P<0.05).After the treatment,the MMSE,MoCA,and HDS scores,the levels of serum GSH-Px,SOD,and NRG1,and cerebral blow velocity increased,and the levels of serum MDA,Hcy,HMGB1,Tau,and NSE decreased in both groups,and the changes were statistically significant(P<0.05).The scores of MMSE,MoCA,and HDS,the levels of serum GSH-Px,SOD,and NRG1,and cerebral blood flow velocity were significantly higher(P<0.05),and the levels of serum MDA,Hcy,HMGB1,Tau,and NSE were significantly lower(P<0.05)in the observation group than in the control group.Conclusion Acupuncture plus auricular point sticking can improve the intelligence and activities and the levels of nerve-associated proteins.