益肾活血中药联合电针穴位刺激治疗脑梗死后记忆功能障碍的疗效
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摘要
目的评价益肾活血中药联合电针穴位刺激治疗脑梗死后记忆功能障碍的疗效。方法将温州市龙湾第一人民医院2015年12月—2017年12月收治的84例脑梗死后记忆功能障碍患者采用随机数字表法分为对照组42例(给予脑梗死西医常规治疗)、联合治疗组42例(在对照组治疗的基础上加用益肾活血方联合电针灸)。比较2组治疗后中医证候积分,记忆量表评分、记忆商,血清MDA、SOD水平,大脑动脉的平均血流速度,临床疗效及不良反应等。结果 2组治疗后各项中医证候评分均较治疗前下降(均P<0.05),联合组治疗后的下降程度较对照组更明显(均P<0.05)。对照组治疗后记图、再认、再生得分、总分及记忆商较治疗前升高,差异有统计学意义(均P<0.05);联合组治疗后记图、再认、再生、计数1～100、背数、总分及记忆商较治疗前升高,差异有统计学意义(均P<0.05);且联合组在记图、再认、再生、计数1～100、背数、总分及记忆商的升高程度较对照组更明显,差异有统计学意义(均P<0.05)。2组治疗后MDA、SOD水平较同组治疗前比较差异有统计学意义(均P<0.05),联合组治疗后的变化程度较对照组更明显(均P<0.05)。2组治疗后MCA、ACA、PCA和BA的血流速度较治疗前均明显加快,联合组明显优于对照组(均P<0.05)。联合组治疗后临床有效率(92.86%)明显高于对照组(71.43%)。结论益肾活血中药联合电针穴位刺激治疗脑梗死后记忆功能障碍安全、有效。
Objective To investigate the efficacy of Yishen Huoxue decoction combined with electroacupuncture on memory dysfunction after cerebral infarction. Methods According to the digital table method, 84 patients with memory dysfunction after cerebral infarction were divided into control group(42 cases) treated with routine western medicine and donepezil, and combined group(42 cases) treated with Yishen Huoxue Decoction combined with electro-acupuncture on the basis of control group. The differences between TCM syndrome scores, memory scale score, memory quotient, serum MDA, SOD level, mean blood flow velocity of cerebral arteries, clinical efficacy and adverse reactions were compared between the two groups. Results The scores of TCM syndromes in the two groups were lower than those before treatment(all P<0.05), and the decrease in the combination group was more obvious than that in the control group(all P<0.05). After treatment, the scores, recognition, regeneration scores, total scores and memory quotient were significantly higher than those before treatment(all P<0.05). After treatment, the combined group was recorded, recognized, regenerated, counted 1-100, Back number, total score and memory quotient were higher than those before treatment, the difference was statistically significant(all P<0.05). In the combined group, the increase in the scores, recognition, regeneration, count 1-100, back number, total score and memory quotient was more significant than those in the control group(all P<0.05). The levels of MDA and SOD in the two groups were significantly different from those before treatment(all P<0.05). The difference in the changes after treatment in the combined group was more significant than that in the control group(all P<0.05). The blood flow velocity of MCA, ACA, PCA and BA in the combined group were significantly faster than those in the control group(all P<0.05). The clinical effective rate(92.86%) in the combined group was significantly better than that in the control group(71.43%). Conclusion Yishen Huoxue decoction combined with electroacupuncture is a safe and effective treatment for memory dysfunction after cerebral infarction.
Objective To investigate the efficacy of Yishen Huoxue decoction combined with electroacupuncture on memory dysfunction after cerebral infarction. Methods According to the digital table method, 84 patients with memory dysfunction after cerebral infarction were divided into control group(42 cases) treated with routine western medicine and donepezil, and combined group(42 cases) treated with Yishen Huoxue Decoction combined with electro-acupuncture on the basis of control group. The differences between TCM syndrome scores, memory scale score, memory quotient, serum MDA, SOD level, mean blood flow velocity of cerebral arteries, clinical efficacy and adverse reactions were compared between the two groups. Results The scores of TCM syndromes in the two groups were lower than those before treatment(all P<0.05), and the decrease in the combination group was more obvious than that in the control group(all P<0.05). After treatment, the scores, recognition, regeneration scores, total scores and memory quotient were significantly higher than those before treatment(all P<0.05). After treatment, the combined group was recorded, recognized, regenerated, counted 1-100, Back number, total score and memory quotient were higher than those before treatment, the difference was statistically significant(all P<0.05). In the combined group, the increase in the scores, recognition, regeneration, count 1-100, back number, total score and memory quotient was more significant than those in the control group(all P<0.05). The levels of MDA and SOD in the two groups were significantly different from those before treatment(all P<0.05). The difference in the changes after treatment in the combined group was more significant than that in the control group(all P<0.05). The blood flow velocity of MCA, ACA, PCA and BA in the combined group were significantly faster than those in the control group(all P<0.05). The clinical effective rate(92.86%) in the combined group was significantly better than that in the control group(71.43%). Conclusion Yishen Huoxue decoction combined with electroacupuncture is a safe and effective treatment for memory dysfunction after cerebral infarction.
引文
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[5] 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.
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[9] 林志诚,杨珊莉,薛偕华,等.针刺百会穴改善脑卒中患者记忆力的中枢机制[J].中国康复理论与实践,2015,21(2):184-188.
[10] YU T S,KIM A,KERNIE S G.Donepezil rescues spatial learning and memory deficits following traumatic brain injury independent of its effects on neurogenesis[J].PLoS One,2015,10(2):e0118793.
[11] 郭忠伟,陈杏丽.美金刚联合多奈哌齐治疗中重度阿尔茨海默病的研究[J].中华全科医学,2014,12(5):755-757.
[12] 潘燕.益肾活血中药+电针穴位刺激治疗脑梗死后记忆功能障碍疗效及对脑电位、氧化应激指标的影响[J].现代中西医结合杂志,2018,27(1):39-42.
[13] KRUK-SLOMKA M,BOGUSZEWSKA-CZUBARA A,SLOMKA T,et al.Correlations between the memory-related behavior and the level of oxidative stress biomarkers in the mice brain,provoked by an acute administration of CB receptor ligands[J].Neural Plast,2015,2016:9815092.
[14] LI X L,FAN N X,MENG H Z,et al.Specific neuroprotective effects of manual stimulation of real acupoints versus non-acupoints in rats after middle cerebral artery occlusion[J].Afr J Tradit Complement Altern Med,2013,10(4):186-195.
[15] YANG L,SUI J,SHI H.Control modeling and Chinese acupuncture treatment on cerebral circulation[J].Technol Health Care,2015,23(Suppl 1):S77-82.
[16] ZHANG C,WEN Y,FAN X N,et al.Therapeutic effects of different durations of acupuncture on rats with middle cerebral artery occlusion[J].Neural Regen Res,2015,10(1):159-164.
[2] WU C X,LIU R,GAO M,et al.Pinocembrin protects brain against ischemia/reperfusion injury by attenuating endoplasmic reticulum stress induced apoptosis[J].Neurosci Lett,2013,546:57-62.
[3] YU Q,LI X H,JIANG W,et al.Combined effects of electroacupuncture and behavioral training on learning-memory ability and event-related potential p300 in rats with mid/advanced cerebral infarction[J].Chin Med J (Engl),2018,131(18):2172-2178.
[4] 中华医学会神经病学分会痴呆与认知障碍学组写作组.血管性认知障碍诊治指南[J].中华神经科杂志,2011,44(2):142-147.
[5] 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.
[6] 中国中西医结合学会急救医学专业委员会.中国急性缺血性脑卒中中西医急诊诊治专家共识[J].中华危重病急救医学,2018,30(3):193-197.
[7] 中华医学会神经病学分会脑血管病学组急性缺血性脑卒中诊治指南撰写组.中国急性缺血性脑卒中诊治指南2010[J].中华神经科杂志,2010,43(2):146-153.
[8] 国家中医药管理局脑病急症科研协作组.中风病中医诊断疗效评定标准(试行)[J].北京中医药大学学报,1996,19(1):55-56.
[9] 林志诚,杨珊莉,薛偕华,等.针刺百会穴改善脑卒中患者记忆力的中枢机制[J].中国康复理论与实践,2015,21(2):184-188.
[10] YU T S,KIM A,KERNIE S G.Donepezil rescues spatial learning and memory deficits following traumatic brain injury independent of its effects on neurogenesis[J].PLoS One,2015,10(2):e0118793.
[11] 郭忠伟,陈杏丽.美金刚联合多奈哌齐治疗中重度阿尔茨海默病的研究[J].中华全科医学,2014,12(5):755-757.
[12] 潘燕.益肾活血中药+电针穴位刺激治疗脑梗死后记忆功能障碍疗效及对脑电位、氧化应激指标的影响[J].现代中西医结合杂志,2018,27(1):39-42.
[13] KRUK-SLOMKA M,BOGUSZEWSKA-CZUBARA A,SLOMKA T,et al.Correlations between the memory-related behavior and the level of oxidative stress biomarkers in the mice brain,provoked by an acute administration of CB receptor ligands[J].Neural Plast,2015,2016:9815092.
[14] LI X L,FAN N X,MENG H Z,et al.Specific neuroprotective effects of manual stimulation of real acupoints versus non-acupoints in rats after middle cerebral artery occlusion[J].Afr J Tradit Complement Altern Med,2013,10(4):186-195.
[15] YANG L,SUI J,SHI H.Control modeling and Chinese acupuncture treatment on cerebral circulation[J].Technol Health Care,2015,23(Suppl 1):S77-82.
[16] ZHANG C,WEN Y,FAN X N,et al.Therapeutic effects of different durations of acupuncture on rats with middle cerebral artery occlusion[J].Neural Regen Res,2015,10(1):159-164.