艾灸督脉组穴治疗卒中后认知障碍的临床研究

Clinical Study of Du Meridian Moxibustion in Treating PSCI

目的:观察艾灸督脉组穴治疗卒中后认知障碍患者的临床疗效并探讨其可能的作用机制,以期为临床治疗此病探索一种新型、绿色的中医疗法。方法:将60例符合诊断标准的卒中后认知障碍患者纳入本研究,并按照随机数字表法将此60例患者随机分为观察组(予艾灸督脉组穴联合尼莫地平治疗)和对照组(单纯口服尼莫地平治疗),各30例,观察并比较两组治疗前和治疗8周后MMSE、MoCA、ADL量表评分变化及血清Cys-C水平的变化情况。结果:观察组患者治疗8周后的总有效率为86.67%(26/30),优于对照组的73.33%(22/30),差异有统计学意义(P<0.05);两组患者治疗结束后的MMSE、MoCA和ADL量表评分较治疗前均有提高,且观察组明显优于对照组,差异有统计学意义(P<0.05);治疗8周后观察组患者的血清Cys-C水平较治疗前明显下降,差异有统计学意义(P<0.05),而对照组变化不明显(P>0.05)。结论:艾灸督脉组穴治疗卒中后认知障碍效果明显,优于单纯口服西药,且具有副作用小、患者依从性高等优点,其机制可能是通过良性增加脑血流量、降低脑血管损伤和减少炎性因子释放进而保护脑部神经元来实现的。

Objective:To observe the clinical efficacy of moxibustion on Du Meridian group points in the treatment of post-stroke cognitive impairment(PSCI)and to explore its possible mechanism,so as to explore a new and green TCM therapy for the clinical treatment of the disease.Methods:60 patients with PSCI who met the diagnostic criteria were included in this study and randomly divided into the observation group and the control group,with 30 cases in each group.The control group was treated with Nimodipine Tablet;on which basis,the observation group was also treated with moxibustion on Du Meridian group points.The scores of MMSE,MoCA and ADL,as well as the serum level of Cys-C were observed and compared between the two groups before the treatment and after 8 weeks of the treatment.Results:The total effective rate of the observation group was 86.67%(26/30),which was significantly higher than 73.33%(22/30)of the control group after 8 weeks of the treatment(P<0.05).The scores of MMSE,MoCA and ADL were all improved after the treatment than those before the treatment in the two groups,of which the improvements were more significant in the observation group(P<0.05).After 8 weeks of the treatment,the serum level of Cys-C decreased significantly in the observation group(P<0.05);whereas there was no significant change in the control group(P>0.05).Conclusion:Moxibustion on Du Meridian group points has obvious effect on PSCI,which is better than simple oral western medication,and has the advantages of less side effects and higher patient compliance.Its mechanism may be achieved by increasing cerebral blood flow,reducing cerebrovascular injury,reducing the release of inflammatory factors and protecting brain neurons.