醒脑开窍针刺法治疗血管性痴呆患者的疗效

叶海森 武凯歌 张湘斌

摘要 目的：探究醒脑开窍针刺法对血管性痴呆（VD）患者的简易智能状态量表（MMSE）评分、Barthel指数及基质金属蛋白酶（MMP）的影响。方法：选取2017年1月至2018年1月湖南省脑科医院收治的血管性痴呆患者共110例作为研究对象，随机分为观察组和对照组，每组55例。对照组采用常规针刺疗法;观察组采用醒脑开窍针刺疗法，2组疗程均为4周。比较2组患者治疗后治疗有效率及治疗前后MMSE、Barthel指数及MMP水平。结果：观察组、对照组的治疗有效率分别为92.72%和78.18%，差异有统计学意义（P<0.05）;治疗后2组患者MMSE和Barthel指数均显著升高，差异有统计学意义（P<0.05），且观察组高于对照组，差异有统计学意义（P<0.05）;治疗后2组患者的MMP-2和MMP-9值均下降，差异有统计学意义（P<0.05），且观察者组患者的MMP-2和MMP-9低于对照组，差异有统计学意义（P<0.05）。结论：醒脑开窍针刺法对VD患者疗效显著，能够有效缓解痴呆症状。

关键词 醒脑开窍针;血管性痴呆;简易智能状态量表;基质金属蛋白酶

Abstract Objective：To explore the effects on MMSE scores， Barthel indexes and matrix metalloproteinase （MMP） in patients with vascular dementia （VD） by using acupuncture method of inducing resuscitation.Methods：A total of 110 patients with VD in Hunan Brain Hospital were randomly divided into an observation group （55 cases） and a control group （55 cases）.The control group was treated with routine acupuncture method while the observation group was treated with acupuncture method of inducing resuscitation.There were 2 weeks of treatment for the 2 groups.The total effective rates， MMSE scores， Barthel indexes and levels of MMP were compared between the 2 groups.Results：The total effective rates in the observation group and the control group were 92.72 % and 78.18 %， respectively， with significant difference （P<0.05）.After treatment， the MMSE scores and Barthel indexes in the 2 groups increased significantly （P<0.05）， and those in the observation group were higher than those in the control group， with significant difference （P<0.05）.After treatment， the levels of MMP-2 and MMP-9 in the 2 groups decreased significantly （P<0.05）; Moreover， those in the observation group were lower than those in the control group， with significant difference （P<0.05）.Conclusion：Acupuncture method of inducing resuscitation is an effective therapy in treating VD patients and can effectively relieve the symptoms of dementia， which is worthy for further promotion and application.

Keywords Acupuncture method of inducing resuscitation; VD; Barthel Indexes; MMP

隨着我国人口老龄化的加剧，脑血管病已经成为我国致死率首位疾病[1]。作为脑血管病的主要后遗症之一[2]，血管性痴呆（Vascular Dementia，VD）为缺血性或出血性脑血管病所引起的获得性认知功能障碍性疾病[3]，近年来发病率逐年升高。目前西医采用扩张脑血管、营养脑神经及相关降压调脂等保守治疗起效缓慢，难以恢复认知功能，耽误了VD的黄金治疗期，不利于患者预后[4]。如何在VD早期进行有效的干预以逆转痴呆进程，是近年来脑血管病领域的棘手问题。随着中医学的兴起，针灸对脑血管病及其并发症的疗效越来越受到肯定，具有无创经济，起效迅速，标本兼治等优点，本研究选用醒脑开窍针刺法治疗VD取得良好疗效。

1 资料与方法

1.1 一般资料

选取2017年1月至2018年1月湖南省脑科医院收治的VD患者110例作为研究对象，按随机数字表法分为观察组和对照组，每组55例。……