灸治疗老年痴呆患者的疗效及对细胞因子和血脂代谢的影响

陈戴荣 郑义雄 陈敏庄

摘要 目的：探討针灸治疗老年痴呆患者的疗效及对患者细胞因子和血脂代谢的影响。方法：选取2014年9月至2017年3月南方医科大学第三附属医院收治的老年痴呆患者96例，按照随机表法分为观察组与对照组，各48例。对照组口服盐酸多奈哌齐片，观察组在对照组基础上结合针灸治疗。2组疗程均为3个月。比较2组治疗疗效，日常生活活动能力量表（ADL）评分、病理行为评分表（BEHAVE-AD）评分、简易智力状态检查（MMSE）评分、细胞因子和血脂代谢变化。结果：观察组治疗总有效率（85.42%）高于对照组（66.67%）（P<0.05）。2组治疗后ADL评分和BEHAVE-AD评分降低而MMSE评分增加（P<0.05）;观察组治疗后ADL评分和BEHAVE-AD评分低于对照组而MMSE评分高于对照组（P<0.05）。2组治疗后TNF-α、CRP和IL-6水平降低（P<0.05）;观察组治疗后TNF-α、CRP和IL-6水平低于对照组（P<0.05）。2组治疗后LDL-C、TG和TC水平降低（P<0.05）;观察组治疗后LDL-C、TG和TC水平低于对照组（P<0.05）。结论：针灸治疗老年痴呆患者疗效明显，且可改善患者细胞因子和血脂代谢，具有重要研究价值。

关键词 针灸;老年痴呆;疗效;肿瘤坏死因子-α、C反应蛋白;白介素-6;高密度脂蛋白胆固醇;低密度脂蛋白胆固醇;三酰甘油;总胆固醇

Therapeutic Effects of Acupuncture on Senile Dementia and Its Influence on Cytokine and Blood Lipid Metabolism

Chen Dairong1， Zheng Yixiong2， Chen Minzhuang3

（1 Second Outpatient Department of the Third Affiliated Hospital of Southern Medical University， Guangzhou 510060， China;

2 Department of Clinical Laboratory， Dongpu Branch of the First Affiliated Hospital of Jinan University， Guangzhou 510060，

China; 3 Department of Orthopedics， Liwan Hospital， Guangzhou Medical College， Guangzhou 510145， China）

Abstract Objective：To investigate the therapeutic effects of acupuncture on senile dementia and its influence on the metabolism of cytokines and blood lipids. Methods：A total of 96 cases of senile dementia admitted to the Third Affiliated Hospital of Southern Medical University， from September 2014 to March 2017 were randomly divided into the observation group （48 cases） and the control group （48 cases）. The control group was treated with Donepezil Hydrochloride Tablets， and the observation group was treated with acupuncture on the basis of the control group. The two groups were treated for 3 months and therapeutic effects of the two groups were compared in terms of the scores of ADL， BEHAVE-AD， MMSE， cytokine and blood lipid metabolism before and after treatment. Results：The total effective rate of the observation group （85.42%） was higher than that of the control group （66.67%） （P<0.05）. The ADL score and BEHAVE-AD score decreased in two groups after treatment while MMSE score increased （observation group： t=14.8483， 8.5707， 30.9352， the control group： t=8.5832， 4.2516， 16.6999， P<0.05）. The ADL score of the observation group after treatment and BEHAVE-AD score were lower than the control group while the MMSE score was higher than the control group （t=6.6985， 4.4386， 16.8574， P<0.05）. TNF-α and CRP and IL-6 levels decreased in two groups after treatment （observation group： t=19.1472， 14.5915， 28.8098， the control group： t=8.6531， 8.8128， 9.9875， P<0.05）. TNF-α， CRP and IL-6 levels after treatment in the observation group were lower than that in the control group （t=11.3943， 16.9391， 20.9811， P<0.05）. LDL-C， TG and TC levels decreased in two groups after treatment （observation group： t=15.3531， 24.3231， 13.0914， the control group： t=4.6533， 9.9162， 4.2570， P<0.05）. LDL-C， TG and TC levels after treatment in the observation group were lower than those in the control group （t=13.2004， 14.4374， 10.6958， P<0.05）. Conclusion：Acupuncture is effective in the treatment of Alzheimer′s disease and can improve the cytokine and blood lipid metabolism in patients with Alzheimer′s disease， and has important research value.

Key Words Acupuncture and moxibustion; Alzheimer′s disease; Efficacy; Tumor necrosis factor-α; C reactive protein; Interleukin-6; High density lipoprotein; Low density lipoprotein; Triglyceride; Total cholesterol

中图分类号：R245;R742文献标识码：Adoi：10.3969/j.issn.1673-7202.2018.03.044

老年痴呆是常见的一种威胁老年人身体健康的疾病，主要表现为以记忆力进行性衰退逐渐发展为高级认知功能障碍的一种中枢神经系统退行性疾病[1-4]。老年痴呆发病率呈不断增加趋势，严重影响老年人生命质量和认知功能[5-6]。目前，西医治疗老年痴呆尚无有效的治疗方法，且远期疗效并不十分理想。近年来研究证实针灸治疗老年痴呆患者取得了良好临床疗效[7]。故而，本研究探讨针灸治疗老年痴呆患者疗效及对患者细胞因子和血脂代谢影响。

1 资料与方法

1.1 一般资料

选取2014年9月至2017年3月期间收治的老年痴呆患者96例，按照随机表法分为观察组与对照组，各48例。观察组女19例，男29例，年龄65～84岁、平均年龄（74.36±5.47）岁，病程6个月至8年、平均病程（3.42±0.73）年;对照组女18例，男30例，年龄67～85岁、平均年龄（75.13±5.81）岁，病程8个月至7年、平均病程（3.29±0.68）年。……