耳穴压豆经皮耳迷走神经刺激治疗卒中后认知障碍临床研究

Clinical Study on Transcutaneous Auricular Vagus Nerve Stimulation with Auricular Point Seed-Pressing for Post-stroke Cognitive Dysfunction

目的:观察耳穴压豆经皮耳迷走神经刺激(taVNS)对卒中后认知障碍(PSCI)患者认知功能的影响。方法:选取84例PSCI患者,按随机数字表法分为干预组、对照组各42例。2组均接受基础药物治疗及认知康复训练,干预组心耳穴、肾耳穴予耳穴贴压,肘耳穴、肩耳穴予假磁疗贴治疗;对照组肘耳穴、肩耳穴予耳穴贴压,心耳穴、肾耳穴予假磁疗贴治疗。2组疗程均为12周。比较2组治疗前后简易智能状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)、改良Barthel指数(MBI)、神经精神问卷(NPI)评分的变化。结果:治疗后,2组MMSE、MoCA评分均较治疗前上升(P<0.05),干预组MMSE、MoCA评分均高于对照组(P<0.05)。治疗后,2组MBI评分均较治疗前上升(P<0.05),NPI-1、NPI-2评分均较治疗前下降(P<0.05);干预组MBI评分高于对照组,差异无统计学意义(P>0.05);干预组NPI-1、NPI-2评分均低于对照组(P<0.05)。结论:耳穴压豆taVNS可改善PSCI患者的全局认知功能及神经精神症状,降低照料者的苦恼程度。

Objective:To observe the effect of transcutaneous auricular vagus nerve stimulation(taVNS)with auricular point seed-pressing on patients with post-stroke cognitive dysfunction(PSCI).Methods:A total of 84 PSCI patients were selected and divided into the intervention group and the control group according to the random number table method,with 42 cases in each group.The two groups were treated with basic medicine and cognitive rehabilitation training;the intervention group was additionally given auricular points of heart and kidney seed-pressing,and the control group was additionally given auricular points of elbow and shoulder seed-pressing.The two groups were treated for 12 weeks.The changes of scores of Mini-Mental State Examination(MMSE),Montreal Cognitive Assessment(MoCA),Modified Barthel Index(MBI) and Neuropsychiatric Inventory(NPI) were compared before and after treatment between the two groups.Results:After treatment,the scores of MMSE and MoCA in the two groups were increased when compared with those before treatment(P<0.05),and the above scores in the intervention group were higher than those in the control group(P<0.05).After treatment,the MBI scores in the two groups were increased when compared with those before treatment(P<0.05),the scores of NPI-1 and NPI-2 were decreased when compared with those before treatment(P<0.05);the MBI score in the intervention group was higher than that in the control group,there being no significance in the difference(P>0.05);the scores of NPI-1 and NPI-2 in the intervention group were lower than those in the control group(P<0.05).Conclusion:The taVNS with auricular point seed-pressing can improve the global cognitive function and neuropsychiatric symptoms of PSCI patients and reduce the anxiety of caregivers.