调任通督针刺法治疗脑梗死后轻度认知障碍疗效观察

Influence of Acupuncture Therapy of Regulating Conception Vessel and Unblocking Governor Vessel on Cerebral Hemodynamics Changes in Patients with Mild Cognitive Impairment After Cerebral Infarction

目的:观察调任通督针刺法对脑梗死后轻度认知障碍患者的脑血流动力学影响及其疗效。方法:将60例脑梗死后轻度认知障碍患者随机分为实验组(调任通督针刺组)和对照组(普通针刺组),治疗前采用MoCA评分,简易智能状态量表(MMSE),日常生活能力量表(Barthel)进行评价,并且使用TCD结合屏气试验的检查方法获取双侧大脑中动脉相应收缩峰血流速度(Vs)、舒张末血流速度(Vd)、平均血流速度(Vm)、搏动指数(PI)、阻力指数(RI),并计算出屏气指数(BHI)进行评价,治疗结束后进行量表复评和TCD复检,收集数据进行统计分析。结果:治疗后,实验组MMSE,MoCA量表评分改善较对照组明显(P<0.05)。实验组BHI值改变较对照组具有显著差异(P<0.05)。屏气指数BHI的变化值与MMSE量表评分,MoCA量表评分的变化值存在显著正相关性(P<0.01)。结论:调任通督针刺法与普通针刺法在治疗脑梗死后轻度认知障碍时疗效肯定,调任通督针刺法相比于普通针刺法能显著改善患者脑血流动力学水平,脑梗死后认知障碍水平的改善与脑血管反应性水平的升高存在一定联系,这可能是调任通督针刺法治疗认知功能障碍的潜在机制。

Objective： This research is to observe the clinical therapeutic efficacy of acupuncture therapy of Regulat- ing Conception Vessel and Unblocking Governor Vessel in the treatment of mild cognitive impairment（MCI） after cere- bral infarction, and detect the cerebral hemodynamic evaluated by Transcranial Doppler combined with breathless test, so to explore the therapeutic effect of acupuncture on cognitive function after stroke and its relationship with the change of the cerebral blood flow. Methods：In total sixty cases of patients with mild cognitive impairment after stroke which were in accordance with the inclusive criteria were randomized into treatment group and control group. In the treatment group, acupuncture therapy of Regulating Conception Vessel and Unblocking Governor Vessel was applied; in the con- trol group, routine acupuncture was used. Before the treatments, the Mini-Mental State Examination（MMSE）, Montreal cognitive assessment（MoCA）, the Barthel index of ADL（BI） were evaluated, and the both side of middle cerebral artery were detected by Transcranial Doppler combined with breathless test, collect and calculate the systole Velocity（Vs）, diastolic Velocity（Vd）, Mean Velocity（Vm）, Pulsatility Index（PI）, Resistance Index（RI）, Breathless Test Index（BHI）. After the treatments, all the assessment and TCD tests would be detected again. Finally, all the data were compared and analyzed statistically.Results：after the acupuncture therapy, Comparison between the two groups after treatment, on the MMSE scale score, MoCA rating scale to improve significant differences （P 〈0.05）, In the TCD inspection and breath- less test, Compared the two groups after treatment, BHI values were significantly different （P 〈0.05）; The change of BHI score and the changes value of MMSE scale, MoCA scale score have significant positive correlation （P〈0.01）. Conclusion： The acupuncture therapy of Regulating Conception Vessel and Unblocking Governor Vessel in the treatment of mild cognitive impairment after cerebral infarction curative effect affirmation, and compare to ordinary acupuncture method, this method can improve the cerebrovascular reactivity.The change of MMSE and MoCA score there is signifi- cant correlation between the change of BHI value.The level of mild cognitive impairment after cerebral infarction and Cerebrovascular reactivity level are in correlation.This may be a potential mechanisms of acupuncture therapy of Regu- lating Conception Vessel and Unblocking Governor Vessel treatment of cognitive dysfunction.