卜刚 陆明 黄抒伟

[摘要] 目的 观察耳穴疗法对痰湿壅盛型高血压患者认知障碍的影响。 方法 选择2017年10月至2019年6月本院门诊及住院痰湿壅盛型高血压轻度认知障碍患者104例，随机分为观察组和对照组，观察组采用王不留行耳穴贴压治疗，对照组采用肤色胶布（不加王不留行籽）貼在无关耳穴上，治疗12周评估患者MMSE评分、脑功能指数（总功率、运动指数、兴奋抑制指数、血管舒缩指数）、中医证候积分、安全性。 结果 观察组治疗后与治疗前相比MMSE评分明显升高，差异有统计学意义（P<0.05），且观察组改善优于对照组（P<0.05）;观察组治疗后与治疗前相比脑功能指数总功率、运动指数、兴奋抑制指数、血管舒缩指数均明显升高，差异有统计学意义（P<0.05），且观察组改善优于对照组（P<0.05）;观察组治疗后各项中医证候积分均显著降低（P<0.05），且观察组改善优于对照组（P<0.05）。两组未出现不良反应。 结论 耳穴疗法可以改善痰湿壅盛型高血压患者认知障碍，提高脑功能指数。

[关键词] 高血压;认知障碍;耳穴疗法;证候积分

[中图分类号] R246.1          [文献标识码] B          [文章编号] 1673-9701（2021）08-0091-04

Effect of ear acupoint therapy on cognitive impairment in hypertensive patients with Tanshi Yongsheng type

BU Gang   LU Ming   HUANG Shuwei

Department of Cardiology， the Second Affiliated Hospital of Zhejiang Chinese Medical University， Hangzhou   310005， China

[Abstract] Objective To observe the effect of ear acupoint therapy on cognitive impairment in hypertensive patients with Tanshi Yongsheng type. Methods A total  of 104 patients with Tanshi Yongsheng hypertension and mild cognitive impairment in the outpatient and inpatient of our hospital from October 2017 to June 2019 were selected and randomly divided into observation group and control group. The observation group used Wangbuliuxing ear acupoint pressing treatment. The control group used skin color tape（without Wangbuliuxingzi） pasted on other ear acupoint. After 12 weeks of treatment， the patients′ MMSE score， brain function index（total power， exercise index， excitement inhibition index， vasomotor index）， TCM syndrome points and safety were evaluated. Results The MMSE score of the observation group after treatment was significantly higher than that before treatment， and the difference was statistically significant（P<0.05）. The improvement of the observation group was better than that of the control group（P<0.05）. The total power of brain function index， exercise index， excitability inhibition index， and vasomotor index in the observation group after treatment were higher than those before treatment， and the difference was statistically significant（P<0.05）. And the improvement of the observation group was better than that of the control group（P<0.05）. The scores of various TCM syndromes in the observation group were significantly reduced after treatment（P<0.05）， and the improvement in the observation group was better than that in the control group（P<0.05）. There was no adverse reaction in the two groups. Conclusion Ear acupoint therapy can improve the cognitive impairment of hypertensive patients with Tanshi Yongsheng and improve the brain function index.

[Key words] Hypertension; Cognitive impairment; Ear acupoint therapy; Symptom score

高血压是临床常见疾病，目前研究认为长期的高血压可能损伤脑血管，导致动脉粥样硬化，继发脑灌注改变，直接或间接地导致认知损害[1]。而痰湿是高血压和认知障碍的共同病机[2-3]。根据传统医学的现代研究显示，耳针治疗利用耳穴刺激，向机体反馈治疗信息，通过外周和中枢的神经体液传递，反馈信息和调节机体功能，唤起机体自身的修复，促使机体由病态向正常状态转化[4]。研究表明针刺大鼠“心肾脑”耳穴，通过调控细胞凋亡、保护缺血后神经元、调节神经介质含量与活性等作用，影响血管性痴呆模型大鼠海马区的结构和功能，影响中枢神经系统，改变脑缺血的状态，影响认知功能[5]。本研究通过比较治疗前后患者神经心理量表评分及脑涨落图的变化情况，探讨耳穴疗法对痰湿壅盛型高血压轻度认知障碍的临床疗效。……