针药结合对脑卒中后轻度认知功能障碍的影响

Observation on therapeutic effect of acupuncture combined with medicine on mild cognition disorders in patients with post-stroke

目的:探讨针刺对脑卒中后轻度认知功能障碍的疗效和安全性。方法:采用随机对照试验研究的设计方案,按随机数字表法将100例符合标准的患者随机分为针药组和药物组,每组50例。所有患者均在脑血管病治疗的基础上,针药组给予针刺结合口服尼莫地平,穴取百会、神庭、曲差等;药物组给予口服尼莫地平,共治疗3个月。治疗前后分别用简易智能状态检查表(Mini-Mental State Examination,MMSE)、改良长谷川痴呆量表(HDS-R)、日常生活能力评定量表(Barthel Index,BI)对患者进行疗效评定。结果:针药组总有效率为66.7%(32/48),优于药物组的30.4%(14/46),差异有统计学意义(P<0.05);治疗后两组MMSE评分、HDS-R评分和日常生活能力BI评分均有明显提高(均P<0.01),且针药组优于药物组(均P<0.05)。针刺治疗未见明显不良反应。结论:针药结合能改善患者的日常生活能力,对脑卒中后轻度认知功能障碍的改善作用明确,安全有效。

Objective To explore the curative effect and safety of acupuncture for mild cognitive disorders after stroke.Methods Randomized controlled trial was adopted and one hundred cases conforming to criteria were divided into a combined acupuncture and medication group（group A）and a medication group（group B）,50 cases in each group.The basic treatment of cerebrovascular disease was applied in two groups.The group A was treated with acupuncture at Baihui（GV 20）,Shenting（GV 24） and Qucha（BL 4） etc.and oral administration of Nimodipine.In group B,Nimodipine was taken orally.The treatment lasted for 3 months,the scores of Mini-Mental State Examination（MMSE）,modified Hasegawa Dementia Scale（HDS-R） and Barthel Index（BI） were observed before and after treatment in two groups.Results The total effective rate in group A was 66.7%（32/48）,which was superior to 30.4%（14/46） in group B（P0.05）.The scores of MMSE,HDS-R and BI after treatment were apparently improved as compared with those before treatment in two groups（all P0.01）.The improvements in group A were superior to those in group B（all P0.05）.There was no adverse event reported during the treatment in two groups.Conclusion Acupuncture can improve activity of daily living and has significant effect in treating mild cognition disorders after stroke without adverse reactions.