目的分析培元固本、化痰祛瘀法治疗缺血性脑卒中后血管性痴呆的临床效果。方法收集2018年11月至2020年12月南京中医药大学连云港附属医院康复科收治的缺血性脑卒中后血管性痴呆患者60例,男38例,女22例,年龄(54.8±12.6)岁。依据随...目的分析培元固本、化痰祛瘀法治疗缺血性脑卒中后血管性痴呆的临床效果。方法收集2018年11月至2020年12月南京中医药大学连云港附属医院康复科收治的缺血性脑卒中后血管性痴呆患者60例,男38例,女22例,年龄(54.8±12.6)岁。依据随机数字表法将其分为治疗组和对照组,各30例。对照组口服阿司匹林肠溶片0.1 g,每晚1粒,口服阿托伐他汀钙片20 mg,每晚1粒;治疗组在此基础上加用培元固本、化痰祛瘀的中药汤剂治疗;两组患者均进行一致的康复训练及基础疾病的治疗。治疗后1个月、6个月采用简易精神状态检查量表(Mini-Mental State Examination,MMSE)及蒙特利尔认知评估量表(Montreal Cognitive Assessment,MoCA)及日常生活能力评分量表(Activity of Daily Living Scale,ADL)评分,并比较两组中医症候临床有效率。两组患者在治疗前及治疗6个月均行磁共振磁敏感加权T2加权血管成像(T2 star weighted angiography,SWAN)序列检查,观察脑微出血(cerebral microbleeds,CMBs)数量变化。结果治疗组患者治疗后MMSE、MoCA、及ADL评分等明显优于对照组(均P<0.05)。治疗组痊愈4例,显效20例,有效5例,总有效率96.7%;对照组痊愈2例,显效10例,有效15例,总有效率90.0%;治疗组总有效率治疗组高于对照组(P<0.05);治疗组愈显率为80.0%,对照组为40.0%,差异有统计学意义(P<0.05)。SWAN序列检查显示,治疗组治疗前后CMBs数量差异无统计学意义(P>0.05),但对照组治疗后CMBs数量高于治疗前(P<0.05)。结论采用培元固本、化痰祛瘀法治疗缺血性脑卒中后血管性痴呆疗效确切,安全可靠,并能在一定程度上延缓脑小血管病变所致的CMBs。展开更多
Objective： To explore the effect of electroacupuncture （EA） on the pathomorphology of the sciatic nerve and the role of P2X3 receptors in EA analgesia. Methods： The chronic constriction injury （CCI） model was ad...Objective： To explore the effect of electroacupuncture （EA） on the pathomorphology of the sciatic nerve and the role of P2X3 receptors in EA analgesia. Methods： The chronic constriction injury （CCI） model was adopted in this study. A total of 32 rats were randomly divided into four groups： sham CCI, CCI, CCI plus contralateral EA （CCI ＋ conEA） and CCI plus ipsilateral EA （CCI ＋ ipsEA）. Mechanical withdrawal threshold （MWT） and thermal withdrawal latency OWL） were measured. EA began at day 7 after the CCI operation and was applied to the Zusanli （ST 36） and Yanglingquan acupoints （GB 34）. At day 14, the pathomorphologic changes of the operated sciatic nerve were demonstrated by hematoxylin and eosin staining. In addition, dorsal root ganglion （DRG） neurons isolated from rats were examined by electrophysiological recording to determine if the P2X3 receptor agonists, adenosine 5＇-tdphosphate disodium （ATP） and α, 13 -methylen-ATP （or, 13 -meATP） evoked inward currents. Results： Pain thresholds in the CCI group were obviously decreased post CCI surgery （P〈0.01）. In the EA groups, thermal and mechanical threshold values were increased after the last EA treatment （P〈0.05, P〈0.01）. There was no significant difference in light microscopic examination among the four groups （P〉0.05）. Current amplitude after application of ATP and or, 13 -meATP in DRG neurons were much larger in the CCI group compared to those obtained in sham CCI （P〈0.05）. ATP and α, 13 -meATP invoked amplitudes in the CCI ＋ EA groups were reduced. There was no significant difference between the CCI ＋ conEA group and the CCI ＋ ipsEA group （P〉0.05）. Conclusion： EA analgesia may be mediated by decreasing the response of P2X8 receptors to the agonists ATP and or, 13 -meATP in the DRG of rats with CCI. No pathological changes of the sciatic nerve of rats were observed after EA treatment.展开更多
文摘目的分析培元固本、化痰祛瘀法治疗缺血性脑卒中后血管性痴呆的临床效果。方法收集2018年11月至2020年12月南京中医药大学连云港附属医院康复科收治的缺血性脑卒中后血管性痴呆患者60例,男38例,女22例,年龄(54.8±12.6)岁。依据随机数字表法将其分为治疗组和对照组,各30例。对照组口服阿司匹林肠溶片0.1 g,每晚1粒,口服阿托伐他汀钙片20 mg,每晚1粒;治疗组在此基础上加用培元固本、化痰祛瘀的中药汤剂治疗;两组患者均进行一致的康复训练及基础疾病的治疗。治疗后1个月、6个月采用简易精神状态检查量表(Mini-Mental State Examination,MMSE)及蒙特利尔认知评估量表(Montreal Cognitive Assessment,MoCA)及日常生活能力评分量表(Activity of Daily Living Scale,ADL)评分,并比较两组中医症候临床有效率。两组患者在治疗前及治疗6个月均行磁共振磁敏感加权T2加权血管成像(T2 star weighted angiography,SWAN)序列检查,观察脑微出血(cerebral microbleeds,CMBs)数量变化。结果治疗组患者治疗后MMSE、MoCA、及ADL评分等明显优于对照组(均P<0.05)。治疗组痊愈4例,显效20例,有效5例,总有效率96.7%;对照组痊愈2例,显效10例,有效15例,总有效率90.0%;治疗组总有效率治疗组高于对照组(P<0.05);治疗组愈显率为80.0%,对照组为40.0%,差异有统计学意义(P<0.05)。SWAN序列检查显示,治疗组治疗前后CMBs数量差异无统计学意义(P>0.05),但对照组治疗后CMBs数量高于治疗前(P<0.05)。结论采用培元固本、化痰祛瘀法治疗缺血性脑卒中后血管性痴呆疗效确切,安全可靠,并能在一定程度上延缓脑小血管病变所致的CMBs。
基金Supported by the National Natural Science Foundation of China (No.30901924)
文摘Objective： To explore the effect of electroacupuncture （EA） on the pathomorphology of the sciatic nerve and the role of P2X3 receptors in EA analgesia. Methods： The chronic constriction injury （CCI） model was adopted in this study. A total of 32 rats were randomly divided into four groups： sham CCI, CCI, CCI plus contralateral EA （CCI ＋ conEA） and CCI plus ipsilateral EA （CCI ＋ ipsEA）. Mechanical withdrawal threshold （MWT） and thermal withdrawal latency OWL） were measured. EA began at day 7 after the CCI operation and was applied to the Zusanli （ST 36） and Yanglingquan acupoints （GB 34）. At day 14, the pathomorphologic changes of the operated sciatic nerve were demonstrated by hematoxylin and eosin staining. In addition, dorsal root ganglion （DRG） neurons isolated from rats were examined by electrophysiological recording to determine if the P2X3 receptor agonists, adenosine 5＇-tdphosphate disodium （ATP） and α, 13 -methylen-ATP （or, 13 -meATP） evoked inward currents. Results： Pain thresholds in the CCI group were obviously decreased post CCI surgery （P〈0.01）. In the EA groups, thermal and mechanical threshold values were increased after the last EA treatment （P〈0.05, P〈0.01）. There was no significant difference in light microscopic examination among the four groups （P〉0.05）. Current amplitude after application of ATP and or, 13 -meATP in DRG neurons were much larger in the CCI group compared to those obtained in sham CCI （P〈0.05）. ATP and α, 13 -meATP invoked amplitudes in the CCI ＋ EA groups were reduced. There was no significant difference between the CCI ＋ conEA group and the CCI ＋ ipsEA group （P〉0.05）. Conclusion： EA analgesia may be mediated by decreasing the response of P2X8 receptors to the agonists ATP and or, 13 -meATP in the DRG of rats with CCI. No pathological changes of the sciatic nerve of rats were observed after EA treatment.
