针灸对脑梗塞患者神经功能和认识功能的影响

Effect of Acupuncture Treatment of Cerebral Infarction on Patients′ Neurological Function and Cognitive Function

目的探讨中医针灸治疗急性脑梗塞后认知功能障碍患者的临床效果。方法选取该院神经内科收治的140例急性脑梗塞后并发认知功能障碍的患者进行前瞻性临床研究,采用随机数字表将患者分为针灸组与常规组各70例,两组均给予基础的西医治疗、康复理疗,针灸组同时给予通督养神针法治疗,连续进行康复治疗12周;对比治疗前后患者的国立卫生研究院卒中量表(NIHSS)评分、蒙特利尔认知评估量表(MoCA)评分、脑血流量灌注参数、大脑中动脉血流动力学参数、日常生活活动能力评分的变化。结果治疗前,针灸组和常规组的NIHSS评分、巴氏指数(BI指数)比较,差异均无统计学意义(P>0.05);治疗后,针灸组的NIHSS评分低于常规组(P<0.05),BI指数高于常规组(P<0.05);治疗前,针灸组和常规组的脑血容量(CBV)、达峰时间(TTP)、平均通过时间(MTT)、脑血流量(CBF)测定值比较,差异均无统计学意义(P>0.05);治疗后,针灸组的TTP低于常规组(P<0.05),CBF指数高于常规组(P<0.05);治疗前,针灸组和常规组的大脑中动脉血流平均速度(Vm)、收缩期峰值血流速度(Vs)、阻力指数(RI)、搏动指数(PI)测定值比较,差异均无统计学意义(P>0.05);治疗后,针灸组的RI、PI低于常规组(P<0.05),Vs高于常规组(P<0.05);治疗前,针灸组和常规组的MoCA评分比较,差异均无统计学意义(P>0.05);治疗后,针灸组的MoCA评分高于常规组(P<0.05)。结论通督养神针法联合基础的西医治疗、康复理疗治疗急性脑梗塞后认知功能障碍有利于患者神经功能康复及认知功能的恢复。

Objective To explore the clinical effect of traditional Chinese medicine acupuncture treatment on patients with cognitive dysfunction after acute cerebral infarction.Methods A prospective clinical study was conducted on 140 patients with cognitive dysfunction after acute cerebral infarction admitted to the Department of Neurology of our hospital.The random number table was used to divide them into an acupuncture group and a routine group with 70 cases in each.Both groups were given basic western medicine treatment and rehabilitation physiotherapy.The acupuncture group was given dredging Du meridian and nourishing the spirit acupuncture treatment at the same time,continuously for 12 weeks.The National Institutes of Health Stroke Scale(NIHSS)score,Montreal Cognitive Assessment Scale(MoCA)score,brain changes in blood flow perfusion parameters,middle cerebral artery hemodynamic parameters and activities of daily living were compared.Results Before treatment,there was no significant difference between the NIHSS score and BI index of the acupuncture group and the conventional group(P>0.05).After treatment,the NIHSS score of the acupuncture group was lower than that of the conventional group(P<0.05),and the BI index was higher than that of the conventional group(P<0.05).Before treatment,the comparison of the CBV,TTP,MTT and CBF between the acupuncture group and the conventional group showed no significant difference(P>0.05).After treatment,the TTP of the acupuncture group was lower than that of the conventional group group(P<0.05).The CBF index was higher compared with that of the conventional group(P<0.05).Before treatment,the acupuncture group and the conventional group had no significant difference in the measured values of Vm,Vs,RI and PI of the middle cerebral artery(P>0.05).After treatment,the RI and PI of the acupuncture group were lower than those of the conventional group(P<0.05),and the Vs was higher than that of the conventional group(P<0.05).Before treatment,there was no difference in the MoCA score between the acupuncture group and the conventional group(P>0.05).After treatment,the MoCA score of the acupuncture group was higher than that of the conventional group(P<0.05).ConclusionThe treatment of cognitive dysfunction after acute cerebral infarction with dredging Du meridian and nourishing the spirit acupuncture combined with basic western medical treatment and rehabilitation is beneficial to the rehabilitation of patients′neurological function and cognitive function.