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天津中医药大学 第一附属医院,天津 300193
Published:05 November 2019,
Published Online:19 April 2019,
Received:06 December 2018,
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Qi-zhen ZHANG, Yu MIAO, Da-li WANG, et al. Effect of Modified Guipitang Combined with Xingnao Kaiqiao Acupuncture in Treatment of Heart and Spleen Insufficiency Syndrome of Non-dementia Vascular Cognitive Impairment. [J]. Chinese Journal of Experimental Traditional Medical Formulae 25(21):66-71(2019)
Qi-zhen ZHANG, Yu MIAO, Da-li WANG, et al. Effect of Modified Guipitang Combined with Xingnao Kaiqiao Acupuncture in Treatment of Heart and Spleen Insufficiency Syndrome of Non-dementia Vascular Cognitive Impairment. [J]. Chinese Journal of Experimental Traditional Medical Formulae 25(21):66-71(2019) DOI: 10.13422/j.cnki.syfjx.20191526.
目的:
2
探究归脾汤加味联合醒脑开窍针法治疗非痴呆性血管认知障碍(VCIND)心脾不足证的疗效及部分作用机制。
方法:
2
选取天津中医药大学第一附属医院2017年5月至2018年10月收治的VCIND心脾不足证患者122例,随机分为归脾汤加味组(39例),针刺组(42例)和联合组(41例),3组患者均给予抗凝类药物及降脂类药物口服常规治疗;归脾汤加味组在常规治疗基础上给予归脾汤加味150 mL/次,2次/d口服;针刺组在常规治疗基础上采用醒脑开窍针法治疗,取水沟,内关(双侧),三阴交(双侧),四神聪,悬钟(双侧)及太溪(双侧),2次/d,每周治疗6 d;联合组在归脾汤加味组治疗基础上给予醒脑开窍针法治疗,3组患者均治疗8周。观察3组患者治疗前、治疗4,8周后蒙特利尔认知评估量表(MoCA量表,北京版)及日常生活能力(ADL)量表评分、中医症状积分结果及临床疗效;采用酶联免疫吸附测定法检测患者不同治疗时间血清降钙素基因相关肽(CGRP)及视锥蛋白样蛋白-1(VILIP-1)含量。
结果:
2
与归脾汤加味组及针刺组治疗4,8周比较,联合组患者MoCA,ADL及中医证候评分降低,且治疗4,8周总有效率均明显升高;血清CGRP含量升高,VILIP-1含量降低。
结论:
2
归脾汤加味联合醒脑开窍针法治疗VCIND心脾不足证有明确疗效,其机制可能与扩张血管、改善脑部血液供给,减少神经元损伤有关。
Objective:
2
To explore the curative effect and partial mechanism of modified Guipitang combined with Xingnao Kaiqiao acupuncture in the treatment of non-dementia vascular cognitive impairment (VCIND).
Method:
2
Totally 122 patients with VCIND admitted to the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine(TCM) from May 2017 to October 2018 were randomly divided into modified decoction group (39 cases)
acupuncture group (42 cases) and combination group (41 cases). All of the three groups were orally given routine anticoagulants and lipid-lowering drugs. The decoction group was orally given modified Guipitang 150 mL/times
2 times/day
in addition to the routine treatment
the acupuncture group was treated with Xingnao Kaiqiao acupuncture method in addition to the routine treatment
involving Shuigou
Neiguan (bilateral)
Sanyinjiao (bilateral)
Sishencong
Xuanzhong (bilateral) and Taixi (bilateral) acupoints
2 times/day
for six days a week
the combined group was treated with Xingnao Kaiqiao acupuncture in addition to modified Guipitang. All of the three groups were treated for 8 weeks. The Montreal cognitive assessment scale (MoCA scale
Beijing version) and activity of daily life (ADL) scale
TCM symptoms and clinical efficacy were scored before treatment
4 weeks after treatment and 8 weeks after treatment in three groups. Serum levels of calcitonin gene-related peptide (CGRP) and cone-like protein-1 (VILIP-1) were measured by enzyme-linked immunosorbent assay at different time points.
Result:
2
Compared with decoction group and acupuncture group
MoCA score
ADL score and TCM syndrome score of the combined group were decreased
the total effective rate was increased significantly after 4 and 8 weeks of treatment
the serum CGRP content was increased
and the VILIP-1 content was decreased.
Conclusion:
2
Modified Guipitang combined with Xingnao Kaiqiao acupuncture has a definite curative effect on VCIND with heart and spleen insufficiency syndrome. Its mechanism may be related to the expansion of blood vessels
the alleviation of blood supply of brain and the reduction of neuron injury.
归脾汤加味醒脑开窍针法非痴呆性血管认知障碍认知能力
modified GuipitangXingnao Kaiqiao acupuncturenon-dementia vascular cognitive impairmentcognitive ability
卜范艳,崔晓雪,王伊林,等.银杏叶软胶囊口服辅助治疗非痴呆性血管认知障碍的疗效及其作用机制[J].山东医药,2016,56(43):66-68.
张辽.醒脑开窍针法配合康复训练治疗脑梗塞后认知功能障碍的疗效观察[J].中国继续医学教育,2016,8(2):196-197.
刘建峰.醒脑开窍针刺法治疗中风病的临床效果[J].内蒙古中医药,2017,36(17):67-68.
路明,罗苓芝,蒙璐.醒脑开窍针法结合头皮针电刺激治疗卒中后丘脑痛40例临床观察[J].中医杂志,2018,59(10):861-865.
李雅洁,田浩,安丽,等.醒脑开窍针刺法治疗丘脑痛:随机对照研究[J].中国针灸,2017,37(1):14-18.
李正飞,卢燚,张洁瑛,等.加味通关汤配合推拿手法治疗中风后尿潴留的疗效机制[J].中国实验方剂学杂志,2018,24(5):155-159.
迟淑梅,王泽民,张利,等.经鼻靶向给予降钙素基因相关肽对蛛网膜下腔出血后海马区细胞凋亡的影响[J].中国现代应用药学,2018,35(6):793-796.
Wiley J W, Gross R A, Macdonald R L. The peptide CGRP increases a high-threshold Ca2+ current in rat nodose neurones via a pertussis toxin-sensitive pathway [J].J Physiology, 1992, 455(1): 367-381.
李斌,安中平,朱延霞,等.血清视锥蛋白样蛋白-1及其他因素与缺血性卒中后认知障碍的相关性[J].中国慢性病预防与控制,2014,22(6):687-690.
王茂松,王宏,李萌.卒中后认知功能障碍患者血清VILIP-1水平变化及其临床意义[J].实用临床使用医学,2016,17(6):1-4.
Bovin M J, Marx B P, Weathers F W, et al. Psychometric properties of the PTSD checklist for diagnostic and statistical manual of mental disorders-fifth edition (PCL-5) in eterans [J].Psychol Assess, 2016, 28(11): 1379-1391.
周仲英.中医内科学[M].北京:中国中医药出版社,2003:143.
中华人民共和国卫生部.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:93-96.
田金州,韩明向,涂晋文,等.血管性痴呆诊断、辨证及疗效评定标准(研究用)[J].中国老年学杂志,2002,22(5):329-331.
中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国缺血性脑卒中和短暂性脑缺血发作二级预防指南2014[J].中华神经科杂志,2015,48(4):258-273.
Ojeda N, Del Pino R, Ibarretxe-Bilbao N, et al. Montreal Cognitive Assessment Test: normalization and standardization for Spanish population [J].Rev Neurol, 2016, 63(11): 488-496.
Namdari S, Yaqnik G, Ebaugh D D, et al. Defining functional shoulder range of motion for activities of daily living [J].J Shoulder Elbow Surg, 2012, 21(9): 1177-1183.
Devine M E, Fonseca J A, Walker Z. Do cerebral white matter lesions influence the rate of progression from mild cognitive impairment to dementia? [J].Int Psychogeriatr, 2012, 25(1): 120-127.
Vasquez B P, Zakzanis K K. The neuropsychological profile of vascular cognitive impairment not demented: a Meta-analysis [J].J Neuropsychol, 2015, 9(1): 109-136.
CAO X, GUO Q, ZHAO Q, et al. The neuropsychological characteristics and regional cerebral blood flow of vascular cognitive impairment-nodementia [J].Int J Geriatr Psychiatry, 2010, 25(11): 1168-1176.
胡国强,王崇秀,周继增,等.醒脑开窍法针刺治疗急性中风病人的血液流变学变化及疗效观察[J].中国针灸,1987,7(1):13-16.
陈文,顾红卫,刘兴勤,等.针刺足三里、悬钟穴对缺血性脑卒中神经功能的影响及其临床意义[J].中国康复医学杂志,2007,22(12):1110-1111.
彭华,李贤,梁莉,等.补肾活血化痰方加醒脑开窍针法治疗血管性痴呆60例[J].湖南中医杂志,2013,29(12):51-53.
石新涛,赵霞,柴志坤.消栓通络颗粒对缺血性中风风痰瘀阻证的早期干预[J].中国实验方剂学杂志,2017,23(14):198-203.
Laterza O F, Modur V R, Crimmins D L, et al. Identification of novel brain biomarkers [J].Clin Chem, 2006, 52(9): 1713-1721.
Dasen J S. Master or servant? Emerging roles for motor neuron subtypes in the construction and evolution of locomotor circuits [J].Curr Opin Neurobiol, 2017, 42(2): 25-32.
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