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[目的]观察调神通督针法联合中西医结合卒中单元治疗血管性痴呆疗效。[方法]使用随机平行对照方法,将60例住院患者按病志号抽签方法简单随机分两组。对照组30例中西医结合卒中单元联合辨证口服中药、现代功能康复及针灸等。治疗组30例调神通督针法(取神庭、百会)百会、神庭进针方向从前至后,针刺0.8~1寸,深度达到帽状腱膜下,捻转得气后,加电针,波形为连续波,强度以患者可耐受为度,15min后改变为疏密波,以防电适应;电针30min结束后去除电针及配穴,继续留头针1h;留针期间,每隔30min捻转1次,直至出针;留针期间进行认知功能训练,1次/d,周日休息1d;中西医结合卒中单元模式同对照组。连续治疗1周为1疗程。观测临床症状、蒙特利尔认知评估量表(MOCA)、改良Barthel指数评定量表(MBI)评分、不良反应。连续治疗4疗程(4周),随访12周,判定疗效。[结果]Mo CA评分两组均有改善(P<0.05),治疗组改善优于对照组(P<0.05)。MBI评分治疗组有改善(P<0.05),两组间无明显差异(P>0.05)。[结论]调神通督针法联合中西医结合卒中单元治疗血管性痴呆,疗效满意,无严重不良反应,值得推广。
[Objective] To observe the curative effect of adjusting tone Shen Tong injection method combined with traditional Chinese and western medicine stroke unit on vascular dementia. [Method] Using randomized parallel control method, 60 inpatients were randomly divided into two groups randomly according to the method of lot drawing by disease symbol. The control group of 30 cases of integrated traditional Chinese and Western medicine unit of stroke combined oral TCM, modern functional rehabilitation and acupuncture and so on. In the treatment group, 30 cases were treated with the acupuncture anesthesia (taking Shenting, Baihui) Baihui and Shenting acupuncture points in the direction from anterior to posterior. Acupuncture was 0.8 to 1 inch in depth, Needle and waveforms were continuous wave, the intensity of the patient can tolerate the degree, after 15min to change the density wave to prevent electric adaptation; electroacupuncture 30min after the removal of electroacupuncture and matching points, continue to keep the first 1h; needle during the needle, Twirling once every 30min, until the needle; needle training during cognitive function, 1 / d, 1d on Sunday rest; Chinese and Western medicine stroke unit model with the control group. Continuous treatment for 1 week for a course of treatment. Observations of clinical symptoms, Montreal Cognitive Assessment Scale (MOCA), Modified Barthel Index Rating Scale (MBI) score, adverse reactions. Continuous treatment of 4 courses (4 weeks), followed up for 12 weeks to determine the efficacy. [Results] The Mo CA score improved in both groups (P <0.05), and the treatment group improved better than the control group (P <0.05). The MBI score improved in the treatment group (P <0.05), with no significant difference between the two groups (P> 0.05). [Conclusion] Tiaoshentongshu method combined with Chinese and Western medicine combined with stroke unit in treatment of vascular dementia has satisfactory curative effect and no serious adverse reactions, which deserves promotion.