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心脾不足证

张其镇; 苗雨; 王大力; 匡尧; 李华南

doi:10.13422/j.cnki.syfjx.20191526

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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心脾不足证

临床 | 更新时间：2021-02-09

- 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心脾不足证
- Effect of Modified Guipitang Combined with Xingnao Kaiqiao Acupuncture in Treatment of Heart and Spleen Insufficiency Syndrome of Non-dementia Vascular Cognitive Impairment
- 中国实验方剂学杂志 2019年25卷第21期页码：66-71
- 作者机构：
  
  天津中医药大学　第一附属医院，天津　 300193
- 作者简介：
  
  张其镇，主治医师，从事软组织损伤疾病及卒中后康复的治疗研究，E-mail：shuangsheq@163.com
- 基金信息：
  
  天津市教育委员会科学技术研究项目(TJJ160623)
- DOI：10.13422/j.cnki.syfjx.20191526
  中图分类号： R22; R242; R2-031; R287
- 收稿日期：2018-12-06，
  
  网络出版日期：2019-04-19，
  
  纸质出版日期：2019-11-05
- 稿件说明：
移动端阅览
张其镇, 苗雨, 王大力, 等. 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心脾不足证[J]. 中国实验方剂学杂志, 2019,25(21):66-71.

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, 2019, 25(21): 66-71.
张其镇, 苗雨, 王大力, 等. 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心脾不足证[J]. 中国实验方剂学杂志, 2019,25(21):66-71. DOI： 10.13422/j.cnki.syfjx.20191526.

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, 2019, 25(21): 66-71. DOI： 10.13422/j.cnki.syfjx.20191526.

摘要

目的：

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：

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：

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：

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。

Abstract

Objective:

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:

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:

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:

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.

关键词

Keywords

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