认知康复训练联合穴位电针对脑梗死后认知障碍患者的影响

Effect of Cognitive Rehabilitation Training Combined with AcupointElectroacupuncture on Patients with Post - stroke Cognitive Impairment

目的探讨认知康复训练联合穴位电针对脑梗死后认知障碍(PSCI)患者的影响。方法选取2020年5月至2023年5月河南省人民医院收治的60例PSCI患者,按随机数字表法分为对照组、试验组,各30例,对照组接受认知康复训练,试验组在对照组基础上联合穴位电针治疗。对比两组临床疗效,治疗前后中医证候积分、认知功能评分[蒙特利尔认知评估量表(MoCA)、简易神经状态检查表(MMSE)]、血清指标[白细胞介素-6(IL-6)、丙二醛(MDA)、同型半胱氨酸(Hcy)]。结果试验组总有效率高于对照组(P<0.05)。治疗前两组中医证候积分比较,差异无统计学意义(P>0.05),治疗后两组中医证候主症、次症积分均降低,试验组低于对照组(P<0.05)。治疗前两组MoCA、MMSE评分比较,差异无统计学意义(P>0.05),治疗后两组MoCA、MMSE评分均升高,试验组高于对照组(P<0.05)。治疗前两组血清IL-6、MDA、Hcy水平比较,差异无统计学意义(P>0.05),治疗后两组血清IL-6、MDA、Hcy水平均降低,试验组低于对照组(P<0.05)。结论认知康复训练联合穴位电针治疗PSCI可有效缓解中医证候,减轻炎症和应激氧化反应,改善认知功能,疗效显著。

Objective To investigate the effect of cognitive rehabilitation training combined with acupoint electroacupuncture on patients with post-stroke cognitive impairment(PSCI).Methods Sixty cases of PSCI patients admitted to Henan Provincial People’s Hospital from May 2020 to May 2023 were selected and divided into control group and experimental group according to the randomized numerical table method,each with 30 cases.The control group received cognitive rehabilitation training,and the experimental group was combined with acupoint electroacupuncture treatment on the basis of the control group.The clinical efficacy of the two groups,the TCM evidence points,cognitive function scores[Montreal cognitive assessment scale(MoCA),mini-mental state examination(MMSE)]and serum indexes[interleukin-6(IL-6),malondialdehyde(MDA),and homocysteine(Hcy)]before and after treatment were compared.Results The total effective rate in the test group was higher than that in the control group(P<0.05).Comparison of the points of Chinese medicine symptoms between the two groups before treatment,the difference was not statistically significant(P>0.05),and the points of primary and secondary symptoms of Chinese medicine symptoms were reduced in both groups after treatment,and the experimental group was lower than that of the control group(P<0.05).Comparison of MoCA and MMSE scores between the two groups before treatment,the difference was not statistically significant(P>0.05),and after treatment,MoCA and MMSE scores of the two groups increased,and the experimental group was higher than the control group(P<0.05).Comparison of serum IL-6,MDA and Hcy levels between the two groups before treatment showed no statistically significant difference(P>0.05),and serum IL-6,MDA and Hcy levels were reduced in both groups after treatment,with the experimental group lower than the control group(P<0.05).Conclusion Cognitive rehabilitation training combined with acupoint electroacupuncture for PSCI can effectively alleviate TCM symptoms,reduce inflammation and stress oxidative response,and improve cognitive function,with significant efficacy.