滋肾活血法治疗血管性痴呆肾阴虚血瘀证的临床研究

伍大华,姚 婷,蒋军林,龙华君,邓 谦,唐沛兰,周 慎

摘要:目的 观察滋肾活血法治疗血管性痴呆(VD)肾阴虚血瘀证的临床疗效。方法 按纳入标准选择50例VD肾阴虚血瘀证患者,根据随机、对照原则分为治疗组和对照组各25例,治疗组予滋肾活血法治疗,对照组予奥拉西坦胶囊治疗。治疗前后进行简易精神状态量表(MMSE)、日常生活活动量表(ADL)、中医证候、美国国立卫生院卒中量表(NIHSS)等评分。结果 最终纳入统计的病例为48例(治疗组与对照组各24例),脱落2例。治疗3个月后,治疗组疾病总有效率优于对照组(87.50%比70.83%,P<0.05)。治疗组治疗后MMSE积分、ADL积分、中医证候积分、NIHSS积分,较治疗前明显改善,差异有统计学意义(P<0.05或P<0.01),且治疗组后MMSE积分、ADL积分、中医证候改善程度优于对照组(P<0.05)。结论 滋肾活血法为治疗VD肾阴虚血瘀证的有效治法,疗效优于奥拉西坦胶囊。

关键词:血管性痴呆;滋肾活血法;肾阴虚血瘀证

中图分类号:R743 R289.5

文献标识码:A

doi:10.3969/j.issn.1672-1349.2015.12.005

文章编号:1672-1349(2015)12-1372-03

Abstract:Objective To observe the clinical effect of nourishing kidney and promoting blood circulation(NKPBC)therapy for treatment of vascular dementia(VD)with the syndrome of insufficiency of kidney yin and blood stasis(IKYBS)in TCM by the of.Methods Fifty patients with VD were randomized into two groups:Treatment group(n =25)treated by NKPBC and control group(n =25)treated with Oxiracetam capsule.The scores of Mini Mental State Examination(MMSE),Activity of Daily Living(ADL),NIHSS and Chinese medicine syndrome were observed before and after treatment.Results Forty eight cases were finally included in the statistics,2 cases were fallen off.After three months,the total effective rate was 87.50% in treatment group and 70.83% in control group(P< 0.05).We analyzed the TCM syndrome integral,MMSE,ADL and NIHSS,it suggested that the treat group was better than the control group,there were significant differences(P<0.05 or P<0.01).Conclusion The therapy of NKPBC had a certain effect for VD with the syndrome of IKYBS.

基金项目:湖南省科技厅项目(No.2013TZ2015)

收稿日期:(2015 01 01)

Clinical Observation of Nourishing Kidney and Promoting Blood Circulation Therapy for Treatment of Vascular Dementia

Wu Dahua,Yao Ting,Jiang Junlin,Long Huajun,Deng Qian,Tang Peilan,Zhou Shen Hunan Institute Affiliate Hospital of Traditional Chinese Medicine,Changsha 410006,Hunan,China

Key words:vascular dementia;nourishing kidney and promoting blood circulation;the syndrome of insufficiency of kidney yin and blood stasis

作者单位:湖南省中医药研究院附属医院(长沙410006),Email: wdh838692@sina.com.cn

血管性痴呆(vascular dementia,VD)是由一系列脑血管因素导致脑功能损害引起的以认知功能障碍为特征的痴呆综合征,是老年期痴呆的主要类型。近年来,由于世界人口老龄化及脑血管病发病率的不断攀升,VD的发病迅速上升,对社会造成了极大危害。国内外至今没有特效药物和治疗手段,防治VD是医学界面临的重大课题之一。本研究运用滋肾活血法治疗VD肾阴虚血瘀证,并与奥拉西坦胶囊作对照,观察其临床疗效,现报道如下。

1　资料与方法

1.1 诊断标准 VD的诊断采用《美国国立神经病与卒中研究所/瑞士神经科学研究国际会议(NINDS AIREN)》中“临床很可能血管性痴呆”诊断标准[1]。……