“调心通督”针刺法联合艾灸治疗心脾两虚型遗忘型轻度认知障碍的疗效观察

Observation on the Clinical Efficacy of Acupuncture Method for Regulating Heart and Dredging Governor Vessel Combined with Moxibustion in the Treatment of Amnesic Mild Cognitive Impairment of Heart-Spleen Deficiency Type

【目的】观察“调心通督”针刺法联合艾灸疗法治疗心脾两虚型遗忘型轻度认知障碍(amnesic mild cognitive impairment,aMCI)的临床疗效。【方法】将60例心脾两虚型aMCI患者随机分为对照组和治疗组,每组各30例。2组患者均给予内科基础治疗,对照组同时给予艾灸治疗,治疗组在对照组的基础上加用“调心通督”针刺法治疗。隔天治疗1次,每周治疗3次,疗程为8周。观察2组患者治疗前后蒙特利尔认知评估量表(MoCA)评分、Rivermead行为记忆能力测验(RBMT)评分、神经精神症状问卷(NPI)评分和中医证候评分的变化情况,并评价2组患者的临床疗效。【结果】(1)治疗8周后,治疗组的总有效率为90.00%(27/30),对照组为83.33%(25/30);组间比较(秩和检验),治疗组的临床疗效明显优于对照组,差异有统计学意义(P<0.05)。(2)治疗后,2组患者的MoCA评分、RBMT评分、NPI评分和中医证候评分均较治疗前明显改善(P<0.05),且治疗组对MoCA评分、RBMT评分、NPI评分和中医证候评分的改善作用均明显优于对照组,差异均有统计学意义(P<0.05)。【结论】“调心通督”针刺法联合艾灸疗法能明显改善心脾两虚型aMCI患者临床症状,促进患者智力和记忆力的恢复,并能有效调节患者的精神行为和情绪状态,提高患者的生活质量。

Objective To observe the clinical efficacy of acupuncture method for regulating heart and dredging governor vessel combined with moxibustion in the treatment of amnesic mild cognitive impairment(aMCI)of heartspleen deficiency type.Methods Sixty aMCI patients with heart-spleen deficiency type were randomly divided into control group and treatment group,with 30 cases in each group.The patients in the two groups were given basic internal medicine treatment.Additionally,the control group was treated with moxibustion,and the treatment group was given acupuncture method for regulating heart and dredging governor vessel combined with moxibustion.The patients were treated once every other day and 3 times a week for 8 weeks.The Montreal Cognitive Assessment Scale(MoCA)scores,Rivermead Behavioral Memory Test(RBMT)scores,Neuropsychiatric Inventory(NPI)scores and traditional Chinese medicine(TCM)syndrome scores in the two groups were observed before and after treatment.After treatment,the clinical efficacy of the two groups was evaluated.Results(1)After 8 weeks of treatment,the overall effective rate of the treatment group was 90.00%(27/30)and that of the control group was 83.33%(25/30).The intergroup comparison(tested by rank sum test)showed that the clinical efficacy of the treatment group was significantly superior to that of the control group,and the difference was statistically significant(P<0.05).(2)After treatment,the MoCA scores,RBMT scores,NPI scores and TCM syndrome scores of patients in the two groups were all significantly improved compared with those before treatment(P<0.05),and the effect on improving MoCA scores,RBMT scores,NPI scores and TCM syndrome scores of the treatment group was significantly superior to that of the control group,the difference being statistically significant(P<0.05).Conclusion The acupuncture method for regulating heart and dredging governor vessel combined with moxibustion can significantly relieve the clinical symptoms of aMCI patients with heart-spleen deficiency type,promote the recovery of intelligence and memory,effectively regulate the mental behavior and emotional state of the patients,and improve the quality of life.