头穴丛刺长留针法联合认知功能训练治疗脑梗死后认知功能障碍临床研究

Clinical Study of Cluster Needling at Scalp Acupoints with Long-Time Needle-Retaining Combined with Cognitive Function Training in the Treatment of Cognitive Dysfunction After Cerebral Onfarction

目的观察头穴丛刺长留针法治疗脑梗死后认知功能障碍的临床疗效,初步探讨其作用机制。方法选取150例脑梗死后认知功能障碍患者,按照随机数字法分为观察组和对照组,各75例。对照组患者采取认知功能训练法,观察组患者采取头穴丛刺长留针法联合认知功能训练,疗程均为6周。比较2组患者治疗前后简易精神状态检查量表(mini mental status examination,MMSE)、蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)、改良Barthel指数(modified Barthel index,MBI)评分及血清降钙素基因相关肽(calcitonin gene-related peptide,CGRP)、5-羟色胺(5-hydroxytryptamine,5-HT)、游离三碘甲状腺原氨酸(free triiodothyronine,FT_(3))、甲状腺素(thyroxine,T_(4))水平。比较2组患者临床疗效。结果治疗后,观察组患者MMSE、MoCA、MBI评分及CGRP、5-HT、FT_(3)水平明显高于对照组(P<0.05)。观察组患者临床治疗总有效率明显高于对照组(P<0.05)。结论头穴丛刺长留针法联合认知功能训练能明显改善脑梗死后认知功能障碍患者认知功能,提高日常生活能力;其作用机制可能与提高血清CGRP、5-HT、FT_(3)水平有关。

Objective To observe the clinical effect of cluster needling at scalp acupoints with long-time needle-retaining on cognitive dysfunction after cerebral infarction,and preliminarily explore its mechanism.Methods One hundred and fifty patients with cognitive dysfunction after cerebral infarction were selected and divided into observation group and control group according to random number method,with 75 cases in each group.The patients in the control group were treated with cognitive function training,while the patients in the observation group were treated with cluster needling at scalp acupoints with long-time needle-retaining combined with cognitive function training,with the course of 6 weeks.The scores of mini mental status examination(MMSE),Montreal cognitive assessment(MoCA),modified Barthel index(MBI)and the levels of serum calcitonin gene-related peptide(CGRP),5-hydroxytryptamine(5-HT),free triiodothyronine(FT_(3)),thyroxine(T 4)were compared between the two groups before and after treatment.The clinical efficacy was compared between the two groups.Results After treatment,the scores of MMSE,MoCA,MBI and the levels of CGRP,5-HT and FT_(3) in the observation group were significantly higher than those in the control group(P<0.05).The total effective rate of clinical treatment in the observation group was significantly higher than that in the control group(P<0.05).Conclusion The cluster needling at scalp acupoints with long-time needle-retaining combined with cognitive function training could significantly improve the cognitive function of patients with cognitive dysfunction after cerebral infarction and improve the ability of daily life;its mechanism might be related to the increase of serum CGRP,5-HT and FT_(3) levels.