奥拉西坦结合早期热针灸治疗脑梗死患者认知障碍的疗效观察

Efficacy of oxiracetam combined with heat acupuncture for the patients with cerebral infarction and cognitive impairment

目的观察奥拉西坦结合热针灸治疗脑梗死患者认知障碍的临床疗效。方法选取自2014年11月-2015年11月入住河北省沧州中西医结合医院神经内科的脑梗死患者240例,随机分为4组:奥拉西坦组、热针灸组、联合组和对照组各60例。对照组患者采用常规治疗、其他3组均在常规治疗基础上,奥拉西坦组加用奥拉西坦药物治疗、热针灸组加用早期热针灸中医治疗、联合组加用奥拉西坦结合热针灸中西医结合治疗;采用简单智能检查量表(MMSE)评分及相关生化指标来评价治疗前后临床效果。结果 MMSE评分组内比较:奥拉西坦组和热针灸组在3个疗程后出现明显疗效,与治疗前比较,差异均具有统计学意义(P<0.05);联合组在2个疗程后开始见疗效,并在3个疗程后患者MMSE分值已恢复到轻度认知障碍水平,差异均具有统计学意义(P<0.05);组间比较:2个疗程结束后,联合组患者MMSE分值开始明显高于其他组,差异具有统计学意义(P<0.05)。总有效率比较:通过3个疗程的治疗,联合组总有效率为95.0%,组间比较,联合组总有效率均高于其他3组,差异具有统计学意义(P<0.05)。治疗过程中联合组患者基本没有出现不良反应。结论采用奥拉西坦结合热针灸治疗脑梗死认知障碍有显著的临床疗效,体现了中西医结合治疗方法的优点。

Objective To observe the clinical efficacy of oxiracetam combined with acupuncture treatment for the patients with cerebral infarction and cognitive impairment. Methods From November 2014 to November 2015, 240 patients admitted to this hospital neurology with cerebral infarction were selected, and were randomly divided into four groups： group Oxiracetam（60 cases）, heat acupuncture group（ 60 cases） , the combination group（ 60 cases） and the control group （ 60 cases） . The control group were treated with conventional therapy, and the other three groups were on the basis of the conventional therapy, oxiracetam group with oxiracetam medication, heat acupuncture group with Chinese medicine acupuncture early, joint group with oxiracetam combined with heat acupuncture. MMSE score and biochemical parameters before and after treatment were used to evaluate clinical results. Results MMSE scores in the group：Oxiracetam group and acupuncture group showed significant effect after 3 courses, compared with before treatment, the difference were statistically significant （ P〈0.05）;the combination group began to see the efficacy of treatment after 2 courses and MMSE score had been restored to the level of mild cognitive impairment after 3 courses, and the difference were statistically significant （ P〈0.05） . Between the two groups：After two courses, MMSE scores of the combined group were significantly higher than other groups and the difference was statistically significant （ P〈0.05） . The total effective rate：through three courses of treatment, total effective rate of the combined group was 95. 0% which was higher than the other three groups, and the difference was statistically significant （ P〈0.05 ） . Combined group have no adverse reactions during treatment. Conclusion Oxiracetam combined heat acupuncture treatment of cerebral infarction cognitive impairment have a significant clinical effect, which reflects the advantages of chinese and western medicine treatment methods.