艾灸督脉组穴联合认知功能训练治疗脑卒中后认知障碍临床观察

Clinical Effect of Moxibustion at Paired Acupoints of the Governor Vessel Combined with Cognitive Function Training in Treatment of Post-stroke Cognitive Impairment

目的观察艾灸督脉组穴联合认知功能训练对脑卒中后认知障碍(post-stroke cognitive impairment,PSCI)患者认知功能的影响。方法将60例PSCI患者随机分为观察组和对照组,每组30例。对照组予认知功能训练,观察组在对照组基础上采用艾灸督脉疗法。采用蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)、简易精神状态评价量表(mini-mental state examination,MMSE)评价患者的认知功能,采用功能独立性评定量表(functional independence measure,FIM)评价患者的功能与生活能力,监测患者血清神经细胞特异性烯醇化酶(neuron-specific enolase,NSE)、同型半胱氨酸(homocysteine,Hcy)水平及观察血管性痴呆辨证量表(the scale for the differentiation of syndromes of vascular dementia,SDSVD)评分情况。结果两组基于MMSE评分的疗效比较,差异具有统计学意义(P<0.05),观察组临床疗效显著优于对照组。与治疗前比较,两组患者治疗后MoCA、MMSE、FIM评分均显著升高(P<0.05),且观察组升高程度显著大于对照组(P<0.05)。与治疗前比较,观察组患者治疗后SDSVD积分显著降低(P<0.05)。与治疗前比较,两组患者治疗后血清NSE、Hcy水平均明显降低(P<0.05),且观察组降低程度明显大于对照组(P<0.05)。结论艾灸督脉组穴联合认知功能训练能保护血管内皮细胞,修复中枢神经损伤,有效提高PSCI患者的认知功能及日常生活能力。

Objective To investigate the effect of moxibustion at paired acupoints of the governor vessel combined with cognitive function training on the cognitive function of patients with post-stroke cognitive impairment(PSCI).Methods A total of 60 patients with PSCI were randomly divided into observation group and control group,with 30 patients in each group.The patients in the control group were given cognitive function training,and those in the observation group were given moxibustion at the governor vessel in addition to the treatment in the control group.Montreal Cognitive Assessment(MoCA)and Mini-Mental State Examination(MMSE)were used to evaluate cognitive function;Functional Independence Measure(FIM)was used to evaluate function and living abilities;the serum levels of neuron-specific enolase(NSE)and homocysteine(Hcy)were monitored,and the improvement in Scale for the Differentiation of Syndromes of Vascular Dementia(SDSVD)was evaluated.Results There was a significant difference in MMSE score between the two groups(P<0.05),and the observation group had a significantly better clinical outcome than the control group.After treatment,both groups had significant increases in MoCA,MMSE,and FIM scores(P<0.05),and the observation group had significantly greater increases than the control group(P<0.05).The observation group had a significant reduction in SDSVD score after treatment(P<0.05).After treatment,both groups had significant reductions in the serum levels of NSE and Hcy(P<0.05),and the observation group had significantly greater reductions than the control group(P<0.05).Conclusion Moxibustion at paired acupoints of the governor vessel combined with cognitive function training can protect vascular endothelial cells,repair central nervous injury,and effectively improve cognitive function and activities of daily living in patients with PSCI.