| 林杉.温针联合综合整体干预治疗阿尔茨海默病肾虚髓减证的临床研究[J].浙江中西医结合杂志,2026,36(4): |
| 温针联合综合整体干预治疗阿尔茨海默病肾虚髓减证的临床研究 |
| Clinical study on the combined treatment of warm needle and comprehensive holistic intervention for Alzheimer's disease with kidney deficiency and marrow depletion syndrome |
| 投稿时间：2025-09-10 修订日期：2025-11-17 |
| DOI： |
| 中文关键词: 阿尔茨海默病 温针 综合整体干预 肾虚髓减证 认知功能 生活质量 血清炎症因子 |
| 英文关键词:Alzheimer"s disease Warm needle Comprehensive overall intervention Kidney deficiency and marrow depletion syndrome Cognitive function Quality of life Brain-derived neurotrophic factor |
| 基金项目:舟山市科技计划项目(编号2024C31022) |
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| 中文摘要: |
| 目的 观察采用温针联合综合整体干预治疗阿尔茨海默病(AD)肾虚髓减证的临床效果。方法 本研究采取前瞻性、随机对照、单中心研究设计法。按随机数字表法将舟山市第二人民医院收治的123例AD肾虚髓减证患者分为对照组、观察1组、观察2组(各41例),最终完成研究对照组39例(剔除1例,脱落1例),观察1组40例(剔除1例),观察2组39例(剔除2例)。对照组给予常规西药+一般护理,观察1组在对照组基础上给予温针治疗,观察2组在观察1组基础上实施综合整体干预,治疗12周后比较3组临床疗效、中医证候积分、认知功能[简明精神状态量表(MMSE)、蒙特利尔认知评估量表(MoCA)]、生活质量[阿尔茨海默病生活质量量表(DQL-AD)]、血清实验室指标[白细胞介素-6(IL-6)、同型半胱氨酸(Hcy)]水平。结果? 治疗12周后,观察2组、观察1组总有效率94.87%、87.50%均高于对照组69.23%(P＜0.05),观察2组略高于观察1组(P＞0.05)；3组中医证候主症评分、次症评分及总积分较治疗前均降低,观察1组、观察2组均低于对照组(P＜0.05),观察1组与观察2组比较无显著差异(P＞0.05)；3组MMSE量表、MOCA量表及DQL-AD量表评分较治疗前均提高,观察2组MMSE量表、MOCA量表及DQL-AD量表评分高于对照组、观察1组(P＜0.05)；3组血清IL-6、Hcy水平较治疗前均降低,观察2组血清IL-6、Hcy水平低于对照组、观察1组(P＜0.05)。结论 采用温针联合综合整体干预治疗AD肾虚髓减证患者疗效显著,可有效减轻患者临床症状,改善认知功能,提高生活质量,减轻炎症反应,调节同型半胱氨酸水平,值得推广实施。 |
| 英文摘要: |
| Objective:Observation of the clinical effect of warm needle combined with comprehensive holistic intervention in the treatment of Alzheimer"s disease (AD) with kidney deficiency and marrow depletion syndrome. Method: This study adopts a prospective, randomized controlled, single center research design. According to the random number table method, 123 AD patients with kidney deficiency and marrow loss syndrome admitted to the Second People"s Hospital of Zhoushan City were divided into a control group, observation group 1, and observation group 2 (41 cases each). The final study included 39 patients in the control group (excluding 1 case and 1 dropout), 40 patients in observation group 1 (excluding 1 case), and 39 patients in observation group 2 (excluding 2 cases). The control group was given conventional Western medicine and general care. Observation group 1 received warm needle treatment on the basis of the control group, while observation group 2 received comprehensive overall intervention on the basis of observation group 1. After 12 weeks of treatment, the clinical efficacy, TCM syndrome scores, cognitive function [Mini Mental State Examination (MMSE), Montreal Cognitive Assessment Scale (MoCA)], quality of life [Alzheimer"s Disease Quality of Life Scale (DQL-AD)], and serum laboratory indicators [interleukin-6 (IL-6), homocysteine (Hcy)] levels were compared among the three groups. After 12 weeks of treatment, the total effective rates of observation group 2 and observation group 1 were 94.87% and 87.50%, respectively, which were higher than the control group"s 69.23% (P<0.05). Observation group 2 was slightly higher than observation group 1 (P>0.05); The main symptom score, secondary symptom score, and total score of the three groups of traditional Chinese medicine syndromes decreased compared to before treatment. Observation group 1 and observation group 2 were both lower than the control group (P<0.05), and there was no significant difference between observation group 1 and observation group 2 (P>0.05); The scores of the MMSE, MOCA, and DQL-AD scales in the three groups increased compared to before treatment. The scores of the MMSE, MOCA, and DQL-AD scales in the two groups were observed to be higher than those in the control group and observation group 1 (P<0.05); The levels of IL-6 and Hcy in the serum of all three groups decreased compared to before treatment. The levels of IL-6 and Hcy in the serum of two groups were observed to be lower than those in the control group and one group (P<0.05). Conclusion: The use of warm needle combined with comprehensive holistic intervention has significant therapeutic effects on patients with AD kidney deficiency and marrow deficiency syndrome. It can effectively alleviate clinical symptoms, improve cognitive function, enhance quality of life, alleviate inflammatory reactions, regulate homocysteine levels, and is worthy of promotion and implementation. |
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