研究疾病:
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血管性痴呆
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研究疾病代码:
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Target disease:
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Vascular dementia
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Target disease code:
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研究类型:
Study type:
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干预性研究
Interventional study
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研究设计:
Study design:
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随机平行对照
randomized controlled trial(parallel group design)
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研究所处阶段:
Study phase:
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探索性研究/预试验
Pilot clinical trial
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研究目的:
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利用相关精神量表,比较头针治疗前后量表评分的变化,评价头针治疗VD的疗效。利用DTI及头针专用线圈,比较治疗前后DTI各参数的变化,探讨头针治疗VD的脑效应机制。
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Objectives of Study:
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To evaluate the therapeutic effect of scalp acupuncture on VD by comparing the changes of scale scores before and after scalp acupuncture treatment. To compare The changes of DTI parameters before and after treatment and explore the brain effect mechanism of scalp acupuncture on VD by using DTI and special coil for scalp needle.
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药物成份或治疗方案详述:
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血管性痴呆受试者完成评估后,药物组给安理申,每天1次,每次1片,服用12周。针灸+药物组使用相同药物,同时在治疗开始时进行每周三次的头针治疗,每次持续30分钟,共维持4周的治疗,总计12次,穴位采用百会、神庭、印堂、四神聪、风池、水沟六个穴位。在治疗之前、治疗后即刻、治疗后4周、治疗后12周的日常生活和行为症状进行评估,并同时进行MRI扫描,包括T1结构相、BOLD-fMRI及DTI。
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Description for medicine or protocol of treatment in detail:
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After the vascular dementia subjects complete the evaluation, the drug group will be given Anlishen 1 tablet once a day for 12 weeks. The acupuncture + drug group will be treated with the same drug, and scalp acupuncture will be given three times a week at the beginning of the treatment, each lasting for 30 minutes for 4 weeks. Six acupoints are used: Baihui, Shenting, Yintang, Sishen Cong, Fengchi and Shuigou. The symptoms of daily life and behavior will be evaluated before treatment, immediately after treatment, 4 weeks after treatment and 12 weeks after treatment, and MRI scans will be performed at the same time, including T1 structural phase, BOLD-fMRI and DTI.
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纳入标准:
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(1)右利手,年龄40-80岁,性别不限;
(2)MRI和/或CT支持存在缺血性脑血管病,符合NINDS-AIREN影像诊断标准;
(3)小学以上文化程度(含小学);
(4)符合《精神疾病诊断与统计学手册》第4版 (Diagnostic and Statistical Manual of Mental Disorders-4th Edition, DSM-IV)痴呆诊断标准;
(5)符合美国国立神经病与卒中研究所/瑞士神经科学研究国际协会(NINDS-AIREN)很可能的VaD诊断标准(1993);
(6)改良Hachinski缺血量表(modified Hachinski ischemic scale,MHIS)总分≥4 ;
(7)病情程度为轻、中度的患者:10≤MMSE≤26 及1≤CDR≤2 ;
(8)汉密尔顿抑郁量表(Hamilton depression scale, HAMD)总分≤17;
(9)无MRI扫描禁忌。
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Inclusion criteria
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1. Right-handed, aged40-80 years, regardless of gender;
2. MRI and / or CT support the existence of ischemic cerebrovascular disease, which accords with the diagnostic criteria of NINDS-AIREN;
3. The education level above primary school (including primary school);
4. Meets the diagnostic criteria of dementia (DSM-IV);
5. Meeting the probable VaD diagnostic criteria of NINDS-AIREN;
6. Modified Hachinski Ischemia scale (MHIS), total score >= 4;
7. Patients with mild or moderate severity: 10 <= MMSE <= 26 and 1 <= CDR <= 2;
8. Hamilton depression scale, HAMD total score of Hamilton Depression scale <= 17;
9. There is no taboo on MRI scanning.
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排除标准:
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(1)既往有记忆力或其他认知功能障碍但影像上没有明显的缺血性病灶;
(2)由创伤肿瘤感染、甲状腺功能异常、酗酒等引起的认知功能障碍;
(3)严重视力、听力障碍以及失语,影响检查或不能配合完成痴呆量表评定或不能配合进行头部制动;
(4)伴焦虑、抑郁、精神障碍及意识障碍;
(5)存在异常实验室指标:Hb、Plt小于正常下限;APTT超过正常对照值10秒以上,PT超过正常对照值3秒以上;Cr超过正常值上限的1.5倍;ALT、AST或ALP、γ-GT超过正常值上限的2倍,TBiL超过正常值上限的1.5倍;
(6)严重的循环、呼吸、泌尿、消化、造血系统疾病(如不稳定心绞痛、不能控制的哮喘、活动性胃出血等)以及癌症;
(7)妊娠或哺乳期妇女;
(8)近1月内有脑外伤或脑出血病史;
(9)存在MR检查禁忌症;
(10)过去的4周内接受过针灸治疗;
(11)不能完成基本的治疗疗程,依从性可能不好者(即不能坚持治疗)及日后难以随访者。
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Exclusion criteria:
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1. There was memory or other cognitive dysfunction in the past, but no obvious ischemic focus on the image;
2. With cognitive impairment caused by trauma, tumor, infection, thyroid dysfunction, alcoholism, etc;
3. With severe vision, hearing impairment and aphasia, affect the examination or can not cooperate with the dementia scale evaluation or can not cooperate with the head immobilization; 4. With anxiety, depression, mental disorder and disturbance of consciousness;
5. With abnormal laboratory indexes;
6. With severe circulatory, respiratory, urinary, digestive, hematopoietic diseases (such as unstable angina pectoris, uncontrollable asthma, active gastric hemorrhage, etc.) and cancer;
7. Pregnant or lactating women;
8. With history of brain trauma or cerebral hemorrhage within 1 month;
9 With contraindications for MR examination;
10. Taken a acupuncture treatment in the past 4 weeks;
11. Unable to complete the basic course of treatment, poor compliance (that is, unable to adhere to treatment) and difficult to follow up in the future.
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研究实施时间:
Study execute time:
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从From
2020-01-01
至To
2021-12-31
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征募观察对象时间:
Recruiting time:
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从From
2020-03-01
至To
2021-03-01
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