Shi Guang-xia, Liu Cun-zhi, Guan Wei, Wang Zhan-kui, Wang Lei, Xiao Chuan, Li Zu-guang, Li Qian-qian, Wang Lin-peng
Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, Beijing, 100010, China.
Chin J Integr Med. 2014 Sep;20(9):661-6. doi: 10.1007/s11655-013-1323-4. Epub 2013 Oct 23.
To study the effects of acupuncture on Chinese medicine syndromes of vascular dementia (VaD).
Sixty-three VaD patients were divided into three groups. Those willing to be randomized were randomly assigned to receive either acupuncture (random acupuncture group, 24 cases) or rehabilitation training (guided rehabilitation group, 24 cases) for 6 weeks. Those unwilling to be randomized also received acupuncture for 6 weeks (non-random acupuncture group, 19 cases). Patient syndromes and their severity were evaluated before treatment (baseline), at the end of treatment, and at 4-week follow-up after the completion of treatment using a CM scoring system (scale of differentiation of syndromes of vascular dementia, SDSVD). The SDSVD scores of the random and non-random acupuncture groups, and of all patients who received acupuncture (combined acupuncture group, 43 cases), were compared with those in the guided rehabilitation group.
In the random, non-random, and combined acupuncture groups, SDSVD scores were significantly reduced at the end of treatment and at follow-up than at baseline. In the guided rehabilitation group, SDSVD scores were similar to baseline scores at the end of treatment and at follow-up. However, there were no significant differences in SDSVD scores among the three groups or between the combined acupuncture group and the guided rehabilitation group at any time points. In the non-random and combined acupuncture groups, SDSVD scores were significantly reduced at the end of treatment than at baseline in patients with hyperactivity of Liver (Gan)-yang or phlegm obstruction of the orifices.
Acupuncture reduced the severity of VaD. The improvement was the greatest in patients undergoing their treatment of choice. Treatments in this study were more effective for excess syndromes, such as Liver-yang hyperactivity or phlegm obstruction of the orifices than deficiency syndromes, such as Kidney (Shen)-essence deficiency.
研究针刺对血管性痴呆(VaD)中医证候的影响。
将63例VaD患者分为三组。愿意接受随机分组的患者被随机分配接受针刺治疗(随机针刺组,24例)或康复训练(引导康复组,24例),为期6周。不愿意接受随机分组的患者也接受针刺治疗6周(非随机针刺组,19例)。在治疗前(基线)、治疗结束时以及治疗完成后4周随访时,使用CM评分系统(血管性痴呆证候分化量表,SDSVD)评估患者的证候及其严重程度。将随机针刺组和非随机针刺组以及所有接受针刺治疗的患者(联合针刺组,43例)的SDSVD评分与引导康复组进行比较。
在随机针刺组、非随机针刺组和联合针刺组中,治疗结束时和随访时的SDSVD评分均较基线时显著降低。在引导康复组中,治疗结束时和随访时的SDSVD评分与基线评分相似。然而,在任何时间点,三组之间或联合针刺组与引导康复组之间的SDSVD评分均无显著差异。在非随机针刺组和联合针刺组中,肝阳上亢或痰蒙窍闭患者治疗结束时的SDSVD评分较基线时显著降低。
针刺降低了VaD的严重程度。在接受其选择治疗的患者中改善最为明显。本研究中的治疗对实证,如肝阳上亢或痰蒙窍闭,比虚证,如肾精亏虚,更有效。