头穴针刺结合耳穴压籽治疗对脑卒中后认知障碍患者血管内皮功能及认知水平的影响

Effect of Scalp Acupuncture Combined with Auricular Point Sticking on Vascular Endothelial Function and Cognitive Level for Patients with Post-stroke Cognitive Impairment

目的:观察头穴针刺与耳穴压籽联合应用于脑卒中后认知障碍患者的治疗中对血管内皮功能及认知水平的影响。方法:选取我院康复科2018年1月至2021年1月期间收治的脑卒中后认知障碍患者94例,按照随机数字法分为耳穴组和联合组每组47例,耳穴组给予耳穴压籽治疗,联合组采取头穴针刺配合耳穴压籽,治疗后观察内皮素-1(ET-1)、外周血清一氧化氮(NO)、血清神经元特异性烯醇化酶(NSE)的生化数据,观察洛文斯顿作业疗法认知评定量表(LOTCA)得分,智力状态检查量表(MMSE)及日常生活活动能力量表(Barthel)评分,中医核心症状评分情况。结果:(1)治疗后联合组NO高于耳穴组,血清ET-1、NSE低于耳穴组(P<0.05);(2)治疗后联合组LOTCA量表高于耳穴组(P<0.05);(3)治疗后联合组MMSE及Barthel得分高于耳穴组(P<0.05);(4)联合组治疗后中医症状得分低于耳穴组(P<0.05)。结论:头穴针刺与耳穴压籽有利于脑卒中后认知障碍患者血管内皮功能的改善及提高其认知水平。

Objective:To observe the effect of combined application of scalp acupuncture and auricular point sticking on vascular endothelial function and cognitive level for patients with post-stroke cognitive impairment.Methods:94 patients with post-stroke cognitive impairment who were treated in department of rehabilitation of the hospital were selected between January 2018 and January 2021,and were divided into a auricular point group and a combined group according to the random number method,with 47 cases in each group.The auricular point group was given auricular point sticking treatment,and the combined group was treated with scalp acupuncture combined with auricular point sticking.After treatment,the biochemical indicators such as endothelin-1(ET-1),peripheral serum nitric oxide(NO)and serum neuron-specific enolase(NSE)were observed.The scores of Lowenston Occupational Therapy Cognitive Assessment(LOTCA),Mini-Mental State Examination(MMSE)and Activity of Daily Living Scale(Barthel)and scores of TCM core symptoms were observed.Results:(1)After treatment,the NO level in the combined group was higher than that in the auricular point group while the levels of serum ET-1 and NSE were lower than those in the auricular point group(P<0.05).(2)The scores of LOTCA scale of the combined group after treatment were higher than those in the auricular point group(P<0.05).(3)After treatment,the scores of MMSE and Barthel were higher in the combined group than those in the auricular point group(P<0.05).(4)The scores of TCM symptoms in the combined group were lower compared with those in the auricular point group after treatment(P<0.05).Conclusion:Scalp acupuncture combined with auricular point sticking is beneficial to improve the vascular endothelial function and enhance the cognitive level of patients with post-stroke cognitive impairment.