Clinical Study On The Treatment Of Post-stroke Dementia With Tiaoshen Yizhi Acupuncture Based On Syndrome Investigation

Objective:To investigate the mechanism of the disease The distribution of PSD was determined by using the method of syndrome investigation;On this basis,the clinical efficacy and safety of the method of regulating the mind and promoting intelligence for the treatment of dementia after stroke were observed,so as to provide a safe and effective Chinese medicine treatment plan for the treatment of dementia after stroke.method:1.Syndrome investigation: This study,guided by the basic theory of traditional Chinese medicine,has developed the questionnaire of four diagnosis information of TCM for dementia after stroke,conducted syndrome investigation,and investigated the cases that meet the inclusion and exclusion criteria.The syndrome distribution of PSD patients was obtained by factor analysis,cluster analysis and secondary logistic regression analysis.2.Clinical study: 70 patients with stroke dementia with phlegm dampness block meeting the standard of nanogram were randomly divided into experimental group and control group respectively.On the basis of basic drug treatment,the control group determined the routine acupuncture treatment plan according to the ninth edition of textbook acupuncture therapy(2012),which was treated once a day,5 days a week and 4 weeks in a row.The experimental group was treated with the method of regulating the spirit and intelligence once a day,5 days a week and 4 weeks of continuous treatment.The cognitive function and daily life activity ability were assessed by mmse-r,moca-r and Cibic plus-r before and after treatment,and the scores of the above scales were compared,And observe whether the two groups of patients have adverse events during the whole treatment process.result:1.Syndrome investigation: 178 people were included.According to the basic methods and statistical analysis of syndrome investigation,the syndrome investigation scale and PSD clinical combination syndrome were developed,which were phlegm dampness block syndrome,Qi deficiency and blood stasis syndrome,kidney yin deficiency syndrome,Yang deficiency and water flooding syndrome,damp heat syndrome.The phlegm dampness block accounted for 27.52% of the total,so it was taken as the part of the second clinical study.2.Clinical study:(1)70 patients were included in this study,7 patients were lost during the treatment the rate of loss was 10.00%,which was in line with the planned loss rate),63 cases were actually completed,31 in the test group and 32 in the control group;(2)Baseline data comparison: before treatment,the two groups were compared in gender,age,course of disease,pathological nature,education,cognitive function and daily life activity ability.After statistical analysis,the difference was not significant(P > 0.05),which was comparable;(3)In terms of intelligence state: the scores of mmse-r and moca-r were improved after 4weeks of treatment,and the difference was significant(P < 0.01).The results showed that the mmse-r score in the control group and the experimental group were 43.75% and 70.96%respectively.The difference was significant(P < 0.05);The results showed that the efficacy of moca-r score in the control group and the experimental group was 46.88% and 70.96%respectively.The results showed that the moca-r score in the experimental group was better than that of the control group,and the difference was significant(P < 0.05);(4)Daily life ability: the adl-r score of the control group and the experimental group were improved after 4 weeks of treatment compared with that before treatment,and the difference was significant(P < 0.01);The total effective rate of adl-r score in control group and experimental group was 50.00% and 54.84%,respectively.The difference between the two groups was similar,and the difference was not significant(P > 0.05);(5)The overall efficacy of the control group was 62.50%,the total effective rate of the experimental group was 87.10%.Compared with the two groups,the latter was better than the former,the difference was significant(P < 0.05);(6)Safety: there was no obvious adverse reaction in the treatment of the two groups,and there was no significant difference in safety classification(P > 0.05).Conclusion:(1)Based on the investigation of 178 PSD patients,the five common syndromes of dementia after stroke are phlegm and damp block,Qi deficiency and blood stasis,deficiency of kidney yin,Yang deficiency and flood of water and syndrome of damp and heat.Phlegm dampness block is the most common clinical symptom.(2)The therapeutic effect of "regulating the spirit and improving intelligence" in the treatment of dementia patients with phlegm dampness block stroke is better than that of traditional acupuncture.The method is safe and reliable,and it is worth popularizing and applying in clinic.