留置头皮针下作业治疗对脑卒中后认知障碍的疗效

Effect of indwelling scalp acupuncture combined with occupational therapy on patients with cognitive dysfunction after stroke

目的:观察留置头皮针下作业治疗对脑卒中后认知障碍的疗效。方法:研究对象为2017年4月—2019年12月入组的60例脑卒中后认知障碍患者,随机分入研究组和对照组,每组各30例。研究组接受留置头皮针下作业治疗,对照组仅接受作业治疗,均连续治疗4周。使用蒙特利尔认知评估量表(Montreal Cognitive Assessment,MoCA)福州版、简易精神状态检查表(Mini-mental State Examination,MMSE)和改良Barthel指数评价康复治疗前后的认知功能和日常生活活动能力。结果:除对照组康复治疗前后的记忆及延迟回忆能力评分无显著变化以外,2组康复治疗后的MoCA福州版总评分以及其他单项评分均较康复治疗前显著提高(P<0.05)。康复治疗后,研究组的MoCA福州版总评分、视空间与执行功能、定向力、注意、记忆及延迟回忆能力和计算评分均显著高于对照组(P<0.05)。2组康复治疗后的改良Barthel指数和MMSE评分均较康复治疗前显著提高(P<0.05),并且研究组的改良Barthel指数和MMSE评分的改善程度均优于对照组(P<0.05)。结论:留置头皮针下作业治疗能够提高脑卒中后认知障碍患者的认知功能,改善其日常生活活动能力。

Objective:To observe the effect of indwelling scalp acupuncture combined with occupational therapy on cognitive dysfunction after stroke.Methods:Sixty patients with cognitive dysfunction after stroke were recruited from April 2017 to December 2019 and randomly divided into study group(n=30)and control group(n=30).The study group received indwelling scalp acupuncture combined with occupational therapy,while the control group only received occupational therapy.The patients were all treated for four weeks.Montreal Cognitive Assessment(MoCA)Fuzhou version,Mini-mental State Examination(MMSE)and Modified Barthel Index were used to evaluate the cognitive function and activities of daily living before and after rehabilitation treatment.Results:After rehabilitation,the overall score and the scores of each items in MoCA Fuzhou version of two groups were significantly higher than those before rehabilitation(P<0.05),except for the score of memory and delayed recall ability item of the control group.After rehabilitation,the overall score and the visual space and executive function,orientation,attention,memory and delayed recall ability and calculation scores in MoCA Fuzhou version of the study group were significantly higher than those of the control group(P<0.05).The Modified Barthel Index and the MMSE scores of the two groups after rehabilitation were significantly higher than those before rehabilitation(P<0.05),and the degree of improvement of the Modified Barthel Index and MMSE scores of the study group was better than that of the control group(P<0.05).Conclusion:Indwelling scalp acupuncture combined with occupational therapy can improve the cognitive function and activities of daily living of patients with cognitive dysfunction after stroke.