三焦针法结合计算机辅助认知训练治疗急性脑卒中后认知障碍疗效观察

Clinical Observation of Triple Energizer Acupuncture Combined with Computer Aided Cognitive Training in Treatment of Cognitive Impairment after Acute Stroke

目的:探讨三焦针法结合计算机辅助认知训练治疗患者急性脑卒中后认知障碍的疗效。方法:选取2017年4月至2018年1月在深圳市蛇口人民医院康复科住院患者70例,随机分为联合治疗组和康复训练组,联合治疗组采用三焦针法结合计算机辅助认知训练的方法进行治疗,康复训练组采用计算机辅助认知训练,每日治疗1次,每周6 d,共治疗8周,分别于入组时、治疗后4周、8周,及第10周、12周、16周后随访时,运用精神状态简易量表(MMSE)及改良Barthel指数(MBI)量表对患者进行认知功能及日常生活能力的评估,记录每个时间点的评分,并进行统计学分析。结果:①MMSE评分,从第8周起,每个时间点联合治疗组评分均高于康复训练组(P<0.05);两组患者MMSE评分分数随着时间的延长与治疗前比较,均有提高(P<0.05),且两组组内各时间点的两两比较,差异均有统计学意义(P<0.05);②MBI评分,在第4周及第16周时联合治疗组较康复训练组评分更高,差异有统计学意义(P<0.05);两组患者MBI评分分数随着时间的延长与治疗前比较,均有提高(均P<0.05);联合治疗组组内各时间点的两两比较,差异均有统计学意义(P<0.05),而康复训练组除第12周和第16周比较无统计学意义(P> 0.05)外,其余时间点两两比较差异均有统计学意义(P<0.05)。结论:三焦针法结合计算机辅助认知训练能有效改善脑卒中患者的认知功能,提高日常自理能力,较单纯计算机辅助认知训练疗效更好,且在提高日常生活能力方面较康复治疗组起效更快,远程疗效更佳。

Objective:To explore the efficacy of triple energizer acupuncture combined with computer aided cognitive training in the treatment of cognitive impairment after acute stroke. Methods:Seventy patients who were hospitalized from April 2017 to January 2018 in Shekou People’s Hospital of Shenzhen were randomly divided into combined treatment group and rehabilitation training group. The combined treatment group was treated with the method of triple energizer acupuncture combined with computer aided cognitive training. The patients of rehabilitation training group were trained by computer aided cognitive training. The two groups were treated 1 time a day and 6 days a week for 8 weeks. The patients were followed up 4,8,10,12 and 16 weeks after the treatment. The mini-mental state examination(MMSE) and the modified Barthel index(MBI) scales were used to evaluate the patients’ cognitive function and daily life ability on the first day of the experiment and during the follow up. The score at each time-point were analyzed statistically. Results:①MMSE score,Since the eighth week,the scores of the combined treatment group at each time-point was higher than those in the rehabilitation training group(P< 0.05). Compared with before treatment,MMSE scores in the two groups increased corresponding to the time duration,and the MMSE scores of the two groups showed difference at each time-point(P< 0.05);②MBI score:At the time-point of the 4 th and 16 th week,the combined treatment group had higher scores than the rehabilitation training group,with statistical difference(P< 0.05);compared with before the treatment,MBI scores in the two groups increased corresponding with time duration and the MBI scores in the combined treatment group varied at each time-point(P< 0.05),and in the rehabilitation training group,the MBI scores varied at each time-point except the 12 th and the 16 th week(P> 0.05).Conclusion:The triple acupuncture combined with computer aided cognitive training could effectively improve the cognitive function of stroke patients and improve their daily self-care ability. It is better than the computer aided cognitive training alone,and it could improve the daily living ability faster than the rehabilitation treatment,and the long-term effect is better.