针刺督脉对一氧化碳中毒迟发性脑病认知功能障碍的影响

Effect of acupuncture at Du Meridian on cognitive dysfunction in delayed encephalopathy after acute carbon monoxide poisoning

目的观察针刺督脉治疗一氧化碳中毒迟发性脑病(DEACMP)认知功能障碍的临床疗效,为临床治疗该病提供新的方法。方法选取2011年10月至2014年4月该科收治的DEACMP患者50例,将其随机分为针刺治疗组和常规治疗组,各25例。对照组给予高压氧及激素、脑保护等常规治疗,针刺组在常规治疗基础上给予针刺督脉治疗,每周治疗6 d,休息1 d,连续8周;治疗前后分别对两组采用简易智力量表(MMSE)及蒙特利尔量表(MoCA)评分及事件相关电位(P300)评价其认知功能状况。结果两组患者治疗后均能提高MMSE和MoCA评分,差异均有统计学意义(P<0.05),且治疗组优于对照组,差异有统计学意义(P<0.05)。两组患者治疗后P300潜伏期明显缩短及波幅明显增高,差异均有统计学意义(P<0.05),且治疗组优于对照组,差异有统计学意义(P<0.05)。针刺组治疗总有效率为88.00%(22/25),对照组为68.00%(17/25),两组比较,差异有统计学意义(P<0.05)。结论针刺督脉能改善DEACMP认知功能障碍;P300可作为DEACMP认知功能障碍的评价指标,针刺督脉是一种简便、有效的治疗DEACMP认知功能障碍的方法,值得在临床上推广应用。

Objective To observe the clinical effect of acupuncture at Du Meridian on the cognitive dysfunction in de-layed encephalopathy after acute carbon monoxide poisoning （DEACMP） to provide a new method for treating this disease. Meth-ods Fifty cases of DEACMP in our hospital from October 2011 to April 2014 were selected and randomly divided into the treat-ment group and control group,25 cases in each group. The control group was treated with the routine therapy of hyperbaric oxy-gen,hormone and cerebral protection,while on this basis the treatment group was given the acupuncture at Du Meridian. The treatment in the two groups lasted for continuous 8 weeks ,with 6 d treatment and 1 d rest per week;the Mini-Mental State Exami-nation（MMSE）,Montreal Cognitive Assessment（MoCA） and latent period and amplitude of P300 were adopted to evaluate their cognition status after and before treatment. Results The scores of MMSE and MoCA after treatment in both groups were in-creased significantly,and the difference was statistically significant（P〈0.05）,moreover the treatment group was superior to the control group with statistical difference （P〈0.05）. The latent period of P300 after treatment in the two groups was significantly short ened,and the wave amplitude was significantly increased,the difference was statistically significant（P〈0.05）,moreover the treat-ment group was superior to the control group with statistical difference（P〈0.05）. The total effective rate in the acupuncture group was 88.00%（22/25）,which in the control group was 68.00%（17/25）,the difference between the two groups was statistically sig-nificant（P〈0.05）. Conclusion Acupuncture at Du Meridian can improve the cognitive dysfunction in DEACMP,P300 can serve as an evaluation index of cognitive dysfunction in DEACMP. Acupuncture at Du Meridian is a simple and effect method for treat-ing DEACMP and is worthy of being clinically promoted and applied.