通督醒神针刺法联合丁苯酞胶囊对血管性痴呆患者血清炎性因子及脑循环动力学的影响

Efficacy of the Tongdu Xingshen acupuncture plus butylphthalide capsules on serum inflammatory factors and cerebral circulation dynamics in patients with vascular dementia

目的:研究通督醒神针刺法联合丁苯酞胶囊对血管性痴呆患者血清炎性因子及脑循环动力学的影响,为临床提供更合理的综合治疗方案。方法:选取2021年1月-12月间广东医科大学附属湛江中心医院收治的血管性痴呆患者60例作为研究对象,随机分为研究组和对照组,每组30例患者。研究组在对照组常规治疗的基础上增加通督醒神针刺法及服用丁苯酞胶囊进行治疗。评价两组患者治疗后的情况,检测血清炎性因子和脑循环动力学相关指标,采用简易精神状态检查量表(Mini Mental Status Examination,MMSE)评价患者认知功能,采用日常生活能力评分量表(Barthel指数)评价患者日常生活能力,并统计两组患者治疗期间不良反应发生情况。结果:两组患者治疗后MMSE评分差异显著(P<0.05)。研究组患者治疗后血清同型半胱氨酸(Homocysteine,Hcy)、血清超敏C反应蛋白(Hypersensitive C-reactive Protein,hs-CRP)、肿瘤坏死因子-α(Tumor Necrosis Factor-α,TNF-α)及白细胞介素-6(Interleukin-6,IL-6)水平均低于对照组(P<0.05),而转化生长因子-β(Transforming Growth Factor-β,TGF-β)水平却明显高于对照组(P<0.05);研究组患者治疗后平均血流速度、平均血流量与对照组相比较无显著差异(P>0.05),而脑血管床特性阻抗及外周阻力均低于对照组(P<0.05);研究组患者治疗后认知功能MMSE评分及日常生活能力Barthel指数评分均高于对照组(P<0.05);两组患者不良反应发生率相近(P>0.05)。结论:通督醒神针刺法联合丁苯酞胶囊对血管性痴呆患者具有较好的疗效,且可以降低血清炎性因子水平、改善脑循环动力学相关指标。

Objective:To observe the effect of the Tongdu Xingshen acupuncture(通督醒神针刺法)combined with butylphthalide capsules on serum inflammatory factors and cerebral circulation dynamics in patients with vascular dementia,and to provide a more reasonable comprehensive treatment.Methods:Sixty patients admitted to Zhanjiang Central Hospital affiliated to Guangdong Medical University from January 2021 to December 2021 were randomly divided into two groups,the study group and the control group,with 30 patients in each group.On the basis of routine treatment in the control group,the study group was treated by the Tongdu Xingshen acupuncture and butylphthalide capsules.The curative effect in the two groups after treatment was evaluated.The serum inflammatory factors and cerebral circulation dynamics related indexes were detected.The Mini Mental Status Examination(MMSE)was used to evaluate the cognitive function of the patients.The daily living ability score scale(Barthel index)was used to evaluate the daily living ability of the patients,and the adverse reactions in the two groups during the treatment were counted.Results:There was a significant difference in MMSE score between the two groups after treatment(P<0.05).The levels of serum Hcy,hs-CRP,TNF-αand IL-6 in the study group were lower than those in the control group(P<0.05),while the level of TGF-βwas significantly higher than that in the control group(P<0.05).There was no significant difference in mean blood flow velocity and mean blood flow volume between the study group and the control group after treatment(P>0.05),while the cerebral vascular bed characteristic impedance and peripheral resistance were lower than those in the control group(P<0.05).The MMSE score of cognitive function and Barthel index score of daily living ability in the study group were higher than those in the control group(P<0.05).Conclusion:The Tongdu Xingshen acupuncture combined with butylphthalide capsules has a good effect on vascular dementia,and can reduce the level of serum inflammatory factors and improve cerebral circulation dynamics related indicators.