石氏伤科针药联合高压氧治疗颅脑损伤后认知功能障碍患者40例临床研究

Clinical Study on SHI' s Traumatology-Based Acupuncture and Chinese Medicine Therapy Combined with Hyperbaric Oxygen in Treatment of 40 Cases of Cognitive Dysfunction after Brain Injury

目的观察石氏伤科针药联合高压氧治疗颅脑损伤后认知功能障碍患者的临床疗效。方法将116例颅脑损伤后认知功能障碍患者随机分为综合治疗组40例、中药组39例、针刺组37例。各组均给予高压氧及西医常规治疗。针刺组加石氏针刺治疗,每周5次,30次为1个疗程;中药组加石氏伤科中药,每日1剂,30剂为1个疗程;综合治疗组同时加石氏伤科中药口服和石氏针刺治疗,方法同中药组和针刺组。治疗前后采用中文版神经行为认知状况测试(NCSE)量表和简易精神状态检查表(MMSE)量表评价患者认知功能,采用功能独立性评测(FIM)评分评价患者日常生活活动能力的功能独立性。结果各组治疗后语言能力、推理能力、回忆能力、运动功能、认知功能评分及NCSE、MMSE、FIM总分均比治疗前明显提高(P<0.01);综合治疗组治疗后语言能力、推理能力、回忆能力评分及NCSE、MMSE总分均明显优于针刺组和中药组(P<0.01)。治疗后综合治疗组与针刺组的FIM总分、认知功能评分均明显优于中药组(P<0.05或P<0.01)。结论石氏伤科针药联合高压氧能明显改善颅脑损伤后认知功能障碍患者的语言能力、推理能力、回忆能力、认知功能,疗效优于单用石氏伤科针刺或者中药联合高压氧治疗。

Objective To observe the clinical efficacy of SHI＇ s traumatology-based acupuncture and Chinese medicine（ CM） therapy combined with hyperbaric oxygen in the treatment of cognitive dysfunction after brain injury.Methods Totally 116 patients with cognitive dysfunction after brain injury were randomly divided into integrated treatment group of 40 cases,CM group of 39 cases and acupuncture group of 37 cases. All groups were given hyperbaric oxygen therapy and routine western medicine,while the acupuncture group was added with SHI＇s traumatologybased acupuncture treatment,5 times a week,30 times as a course; the CM group was added with SHI＇s traumatologybased herbal decoction,1 dose per day,30 days as a course; the integrated treatment group was given both the same acupuncture and herbal decoction as the above. The Chinese version Neurobehavioral Cognitive Status Examination（ NCSE）,Mini-Mental State Examination（ MMSE）,Functional Independence Measure（ FIM） were scored before and after the treatment to evaluate function independency of activities of daily living. Results After treatment,scores of language ability,reasoning ability,memory ability,motor function and cognitive function and the total scores of MCSE,MMSE and FIM of all groups significantly increased（ P〈0. 01）. Scores of language ability,reasoning ability and memory ability and the total scores of NCSE and MMSE of the integrated treatment group were significantly superior to those of the acupuncture group and CM group（ P〈0. 01）. FIM total score and cognitive function score of the integrated treatment group and acupuncture group were significantly superior to those of the CM group（ P〈0. 05 or P〈0. 01）. Conclusion SHI＇s traumatology-based acupuncture and herbal decoction combined with hyperbaric oxygen therapy could significantly improve the language ability,reasoning ability,memory capacity and cognitive function in patients with cognitive dysfunction after brain injury,which was more effective than simply using acupuncture or CM.