认知康复训练联合醒脑通督针刺疗法对脑卒中后认知功能障碍患者认知功能、脑血流动力学和血清神经损伤标志物的影响

Effects of Cognitive Rehabilitation Training Combined with Xingnaotongdu Acupuncture Therapy on Cognitive Function,Cerebral Hemodynamics and Serum Markers of Nerve Damage in Patients with Post-Stroke Cognitive Impairment

目的:探讨认知康复训练联合醒脑通督针刺疗法对脑卒中后认知功能障碍患者的影响。方法:按照随机数字表法,将2019年6月~2021年9月期间我院收治的脑卒中后认知功能障碍患者114例分为对照组(57例,接受常规药物治疗和认知康复训练)和研究组(57例,在对照组的基础上接受醒脑通督针刺疗法)。观察两组疗效、认知功能、脑血流动力学、血清神经损伤标志物及不良反应情况。结果:研究组84.21%(48/57)临床总有效率高于对照组64.91%(37/57)。研究组治疗4周后简易智能状态检查量表(MMSE)评分和大脑动脉平均流速(Vm)、血流最大峰值(Vs)高于对照组(P<0.05)。研究组治疗4周后神经元特异性烯醇化酶(NSE)、血管阻力指数(RI)、神经胶质原纤维酸性蛋白(GFAP)、泛素羧基末端水解酶-1(UCH-L1)、S100β蛋白(S100β)低于对照组(P<0.05)。治疗期间,两组不良反应发生率组间对比未见差异(P>0.05)。结论:认知康复训练联合醒脑通督针刺疗法可有效改善脑卒中后认知功能障碍患者的认知功能,可能与调节脑血流动力学和血清神经损伤标志物水平有关。

Objective:To investigate the effects of cognitive rehabilitation training combined with Xingnaotongdu acupuncture therapy on cognitive function,cerebral hemodynamics and serum markers of nerve damage in patients with post-stroke cognitive impairment.Methods:According to the random number table method,114 patients with post-stroke cognitive impairment who were treated in our hospital from June 2019 to September 2021 were divided into control group(57 cases,receiving routine drug treatment and cognitive rehabilitation training) and study group(57 cases,receiving Xingnaotongdu acupuncture therapy on the basis of the control group).The curative effect,cognitive function,cerebral hemodynamics,serum markers of nerve damage and adverse reactions in two groups were observed.Results:The total clinical effective rate in the study group was 84.21%(48/57) higher than 64.91%(37/57) in the control group.4 weeks after treatment,the Mini-Mental State Examination(MMSE) score and average velocity(Vm) of cerebral artery blood flow,the maximum peak value(Vs) in the study group was higher than that in the control group(P0.05).Conclusion:Cognitive rehabilitation training combined with Xingnaotongdu acupuncture therapy can effectively improve the cognitive function of patients with post-stroke cognitive impairment,which may be related to the regulation of cerebral hemodynamics and the level of serum markers of nerve injury.