双乳突低频电刺激治疗对急性脑梗死后认知障碍的影响

Bilateral mastoid processes of low-frequency electrical stimulation on cognitive impairment in patients with acute cerebral infarction

目的探讨双乳突低频电刺激治疗对急性脑梗死后认知障碍的影响。方法以2012年1月至2014年10月廓坊市第四人民医院神经内科收治的98例急性脑梗死患者为研究对象,按入院顺序分组,奇数入对照组,偶数入电刺激组,每组49例。对照组患者给予脱水降颅压、抗血小板聚集、活血化淤、改善脑细胞代谢及预防并发症等常规药物治疗。电刺激组在药物常规治疗的基础上实施双乳突低频电刺激治疗。治疗前和治疗后采用蒙特利尔认知评测量表(Mo CA)、连线测验A型、词语流畅性测验、数字符号测验、数字广度分测验评定认知功能。结果对照组与电刺激组在性别、年龄、受教育年限、梗死灶位置及面积、伴其他疾病等方面比较差异无统计学意义(P>0.05);治疗后2周,电刺激组和对照组在各项认知测验评分较治疗前有改善,差异有统计学意义(P<0.05),两组在Mo CA评分、词语流畅测验、数字符号测验等方面比较,差异有统计学意义(P<0.05),电刺激组分数较对照组提高更明显;治疗后3个月,电刺激组在连线测验A方面均较治疗后2周有进一步改善(P<0.05),对照组在各项认知测验方面与治疗后2周相比均有下降(P<0.05),电刺激组在各项认知测验方面均明显好于对照组(P<0.05);治疗后6个月,电刺激组各项认知测验与治疗后3个月相比差异无统计学意义(P>0.05),对照组在各项认知测验分数均进一步下降,差异有统计学意义(P<0.05)。结论双乳突低频电刺激对急性脑梗死后认知障碍具有明显的治疗作用。

Objective To observe bilateral mastoid processes of low-frequency electrical stimulationon cognitive impairment in patients with acute cerebral infarction. Methods 98 cases of patients with acute cerebral infarction were chosen as the research objects in Department of Neurology,the Fourth People’s Hospital of Langfang City between January2012 and October 2014.According to admission order,all patients were divided into two groups,an odd number into the control group,even into the electric stimulation group,49 cases in each group.The patients were given the routine drug treatment as lowering the intracranial pressure,anti platelet aggregation, promoting blood circulation to remove blood stasis, improve the metabolism of brain cells and the prevention of complications in the control group;patients were implemented the double mastoid low-frequency electrical stimulationon the basis of medication in the electric stimulation group.The cognitive function was evaluated by Montreal Cognitive Assessment scale（Mo CA）,wired test（type A）,word fluency test, digit symbol test, digit span subtest before and after treatment. Results Gender, age, years of education,infarcts position and area and other diseases showed no statistical difference（P〉0.05） in two groups.The cognitive test scores were improved in 2 weeks after treatment in two groups;.the difference were statistically significant.（P 〈0.05）..The differences in Mo CA score,.word fluency test, digit symbol test were statistically significant.（P〈0.05）.between two group;the scores increased more obviously in the electric stimulation group than those in control group.After 3 months of treatment,the wired test score had further improved by comparing with that after 2 weeks of treatment（P〈0.05） in electric stimulation group,but were decreased significantly in control group（P 〈0.05）.The scores in various cognitive tests were significantly better in electric stimulation group than those in control group（P 〈0.05）.After 6 months of treatment,the scores in various cognitive testshad significant differences than those after 3 months of treatment（P〉0.05）;all scores were significantly decreased in the control group（P〈0.05）. Conclusion Double mastoid low-frequency electrical stimulation has obvious therapeutic effect on cognitive impairment after acute cerebral infarction.