靳三针疗法对基底核区脑卒中患者模糊决策能力的影响

The effect of Jin's 3 needling treatment on decision-making ability under ambiguity in patients with stroke in basal area

目的:探讨靳三针疗法对基底核区脑卒中患者模糊决策能力的影响。方法:采用爱荷华博弈任务分别对20例经常规治疗的基底核区脑卒中患者、20例经靳三针针刺治疗的基底核区脑卒中患者,以及20例年龄、性别及受教育程度匹配的健康对照组进行模糊风险决策能力测试。结果:与健康对照组相比,常规治疗组的脑卒中患者不仅存在数字广度(即倒序DS)(t=-15.4258,P<0.01)及stroop-3错误率(t=12.2369,P<0.01)测试的障碍,还存在模糊决策能力障碍,三组在博弈任务中总净剩值差异有显著性意义(P<0.05),靳三针治疗组的总净剩值高于常规治疗组(t=3.2264,P<0.01),靳三针治疗组与常规治疗组在5个Block中的净剩值两两比较显示,从Block1至Block5两组净剩值的差异逐渐增加,并且在Block4(t=2.2281,P<0.05)和Block5(t=2.2162 P<0.05)的净剩值差异有显著性意义。靳三针治疗组在5个Block的净剩值及总净剩值与正常组相比,差异无显著性意义。相关分析表明,常规治疗组的总净剩值与stroop-3错误率负相关(r=-0.691,P<0.05)。结论:基底核区脑卒中患者在风险概率不明确条件下存在决策能力受损,表现出主动趋利不能。当使用具有明智作用的靳三针治疗后,基底核区脑卒中患者的模糊风险决策能力得到明显改善。

Objective： To explore the effect of jin＇s 3 needling treatment on decision-making ability under ambiguity of patients with stroke in basal area. Method： The Iowa gambling task（IGT）was used to evaluated the decision-making ability for 20 stroke patients with lesion confined to the basal ganglia region receiving regular treatment,20 stroke patients with lesion confined to the basal ganglia region receiving jin＇s 3 needling treatment,and 20 healthy controls whose age, gender, and level of education match to stroke patients, respectively. Result： Compared with the healthy controls, the patients in the conventional treatment group showed impairments on digits span , stroop-3 and decision-making ability. There was a significant difference in IGT task scores among the three groups.The total net residual scores of the jin＇s 3 needling treatment group was higher than that of the conventional treatment group. The difference of net scores in Block1 to Block5 between the jin＇s 3 needling treatment group and the conventional treatment group was gradually increased, and the difference of net scores in Block4 and Block5 was significant. Compared with the healthy controls, the jin＇s 3 needling treatment group has no difference in the total net residual scores and net scores of the five Blocks. Correlation analysis showed that the total net residual scores of conventional treatment group was negative correlated with stroop-3 score. Conclusion： The patients with lesion confined to the basal ganglia region have impaired decision-making ability under uncertain risk probability, and displayed disability of obtaining profits actively,but this disability could be corrected by jin＇s 3 needling treatment.