中医导引功法组方治疗血管性轻度认知障碍的疗效研究

doi:10.3760/cma.j.issn.1007-1245.2024.04.028

摘要/Abstract

摘要：

目的　探讨中医导引功法组方治疗血管性轻度认知功能障碍（vascular mild cognitive impairment，VaMCI）的疗效。方法　本研究为横断面研究。选取2017年1月至2019年1月在天津医科大学总医院康复医学科就诊的VaMCI患者50例作为研究对象，按随机数字表法将患者分为导引功法组25例［男12例、女13例，年龄（67.20±5.37）岁］和常规治疗组25例［男13例、女12例，年龄（67.36±5.38）岁］。另选取无疾病人群25例为正常组［男11例、女14例，年龄（67.04±4.36）岁］。常规治疗组给予基础治疗及常规运动功能康复训练，导引功法组在常规治疗组基础上经专业人员指导进行导引功法训练，疗程均为12周。对比3组治疗前后收缩压、舒张压及简易智力状态检查量表（MMSE）、蒙特利尔认知评估量表（MoCA）、洛文斯顿认知功能评定量表（LOTCA）及改良Barthel指数（MBI）评分。采用χ²检验、t检验、方差分析。结果　治疗12周后，导引功法组的MMSE评分、MoCA评分、MBI评分、注意力评分、视运动组织评分、思维操作评分及LOTCA总评分均高于常规治疗组［（23.64±2.90）分比（21.56±1.90）分、（23.72±2.42）分比（20.64±2.40）分、（75.80±7.31）分比（71.20±7.94）分、（3.12±0.73）分比（2.56±0.58）分、（21.96±1.90）分比（19.56±1.98）分、（26.16±1.89）分比（24.44±2.58）分、（96.20±4.25）比（90.44±6.58）分］，导引功法组的收缩压、舒张压均低于常规治疗组［（137.00±10.70）mmHg（1 mmHg=0.133 kPa）比（147.60±8.91）mmHg、（73.80±10.23）mmHg比（85.40±10.60）mmHg］，差异均有统计学意义（均P<0.05）。导引功法组治疗12周后的MMSE评分、收缩压、舒张压与正常组比较差异均无统计学意义［（23.64±2.90）分比（23.52±2.20）分、（137.00±10.70）mmHg比（138.80±7.94）mmHg、（73.80±10.23）mmHg比（73.40±10.08）mmHg］（均P>0.05）。导引功法组治疗前后MMSE、MoCA、MBI、注意力、定向力、视运动组织、思维操作评分、LOTCA总分、收缩压的差值均大于常规治疗组和正常组（均P<0.05）。结论　中医导引功法组方可以明显改善VaMCI患者的认知功能和日常生活活动能力，是VaMCI的有效治疗手段，值得在临床工作中进一步推广。

关键词:

中医, 导引, 血管性轻度认知功能障碍, 认知功能, 日常生活活动能力

Abstract:

Objective　To investigate the therapeutic effect of traditional Chinese medicine (TCM) Qigong prescription on vascular mild cognitive impairment (VaMCI). Methods　This was a cross-sectional study.Fifty VaMCI patients treated in Department of Rehabilitation Medicine, General Hospital of Tianjin Medical University from January 2017 to January 2019 were selected as the study objects, and were divided into a Qigong therapy group [25 cases, 12 males and 13 females, aged (67.20±5.37) years] and a conventional treatment group [25 cases, 13 males and 12 females, aged (67.36±5.38) years] according to the random number table method. Another 25 persons without diseases were selected as a normal group [11 males and 14 females, aged (67.04±4.36) years]. The conventional treatment group was given basic treatment and routine motor function rehabilitation training, and the Qigong therapy group was given Qigong prescription training on the basis of the conventional treatment group under the guidance of professionals. The overall course of treatment was 12 weeks. The systolic blood pressure (SBP), diastolic blood pressure (DBP), and scores of Mini-Mental State Examination (MMSE),Montreal Cognitive Assessment (MoCA), Loewenstein Occupational Therapy Cognitive Assessment (LOTCA), and modified Barthel index (MBI) were measured before and after treatment in the three groups. χ² test, t test, and variance analysis were used. Results　After 12 weeks of treatment, the MMSE score, MoCA score, MBI score, attention score, visual motor organization score, thinking operation score, and total LOTCA score of the Qigong therapy group were higher than those of the conventional treatment group [(23.64±2.90) points vs. (21.56±1.90) points, (23.72±2.42) points vs. (20.64±2.40) points, (75.80±7.31) points vs. (71.20±7.94) points, (3.12±0.73) points vs. (2.56±0.58) points, (21.96±1.90) points vs. (19.56±1.98) points, (26.16±1.89) points vs. (24.44±2.58) points, (96.20±4.25) points vs. (90.44±6.58) points]; the SBP and DBP of the Qigong therapy group were lower than those of the conventional treatment group [(137.00±10.70) mmHg (1 mmHg = 0.133 kPa) vs. (147.60±8.91) mmHg, (73.80±10.23) mmHg vs. (85.40±10.60) mmHg], with statistically significant differences (all P<0.05). After 12 weeks of treatment, there were no statistically significant differences in the MMSE score, SBP, and DBP between the Qigong therapy group and the normal group [(23.64±2.90) points vs. (23.52±2.20) points, (137.00±10.70) mmHg vs. (138.80±7.94) mmHg, (73.80±10.23) mmHg vs. (73.40±10.08) mmHg] (all P>0.05). The differences of MMSE, MoCA, MBI, attention, orientation, visual motor organization, and thinking operation scores and LOTCA total score and SBP before and after treatment in the Qigong therapy group were higher than those in the conventional treatment group and the normal group (all P<0.05). Conclusions　The TCM Qigong prescription can improve the cognitive function and the ability of daily living in VaMCI patients. It is an effective treatment of VaMCI and worthy of further promotion in clinical work.

Key words:

Traditional Chinese medicine, Qigong, Vascular mild cognitive impairment, Cognitive function, Ability of daily living

王婧蔡春茜陈晓娜王雪薛米娜牛亚利.

中医导引功法组方治疗血管性轻度认知障碍的疗效研究 [J]. 国际医药卫生导报, 2024, 30(4): 651-656.

Wang Jing, Cai Chunqian, Chen Xiaona, Wang Xue, Xue Mina, Niu Yali.

Study on the curative effect of traditional Chinese medicine Qigong prescription on vascular mild cognitive impairment [J]. International Medicine and Health Guidance News, 2024, 30(4): 651-656.

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