针刺对肾虚痰瘀型脑梗死后轻度认知障碍患者精神行为和记忆执行功能的影响

Effect of acupuncture on mental behavior,and memory and executive functions in patients with mild vascular cognitive impairment of kidney deficiency and phlegm stasis type after cerebral infarction

目的观察补肾活血调神针刺法对肾虚痰瘀型脑梗死后轻度认知障碍患者精神行为症状和记忆执行功能的影响。方法纳入86例脑梗死后轻度认知障碍患者,按随机数字表法分为两组,每组43例。对照组进行常规认知康复训练,观察组采用补肾活血调神针刺法联合常规认知康复训练进行治疗。比较两组治疗前后蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)评分、简易精神状态评价量表(mini-mental state examination,MMSE)评分、神经精神问卷(neuropsychiatric inventory,NPI)评分、Rivermead行为记忆量表(Rivermead behavioural memory test,RBMT)评分和执行缺陷综合征行为学评价测试(behavioral assessment of dysexecutive syndrome,BADS)评分的变化。比较两组治疗前后血清丙二醛(malondialdehyde,MDA)、晚期氧化蛋白产物(advanced oxidation protein products,AOPP)、白细胞介素-6(interleukin-6,IL-6)和白细胞介素-1β(interleukin-1β,IL-1β)水平。结果两组治疗后MMSE评分、MoCA评分、BADS评分和RBMT评分均较同组治疗前升高(P<0.05),NPI评分以及血清MDA、AOPP、IL-6和IL-1β水平均较同组治疗前降低(P<0.05)。观察组治疗后MMSE评分、MoCA评分、BADS评分和RBMT评分均高于对照组(P<0.05),NPI评分以及血清MDA、AOPP、IL-6和IL-1β水平均低于对照组(P<0.05)。结论在常规认知康复训练基础上,补肾活血调神针刺法可改善肾虚痰瘀型脑梗死后轻度认知障碍患者的认知、执行和记忆功能,降低精神行为症状,降低氧化应激和炎症反应。

Objective To observe the effect of Bu Shen Huo Xue Tiao Shen acupuncture on mental behavior,and memory and executive functions in patients with mild cognitive impairment of kidney deficiency and phlegm stasis type after cerebral infarction.Method Eighty-six patients with mild cognitive impairment after cerebral infarction were allocated,using a random number table,to two groups,with 43 cases in each group.The control group received conventional cognitive rehabilitation training and the observation group received Bu Shen Huo Xue Tiao Shen acupuncture in addition.The Montreal cognitive assessment(MoCA),the mini-mental state examination(MMSE),the Rivermead behavioural memory test(RBMT),the neuropsychiatric inventory(NPI)and the behavioral assessment of dysexecutive syndrome(BADS)scores were compared between the two groups before and after treatment.The serum malondialdehyde(MDA),advanced oxidation protein products(AOPP),interleukin-6(IL-6)and interleukin-1β(IL-1β)levels were also compared between two groups before and after treatment.Result After treatment,the MMSE,MoCA,BADS and RBMT scores increased(P<0.05)and the NPI score and serum MDA,AOPP,IL-6 and IL-1βlevels decreased(P<0.05)in the two groups compared with before.After treatment,the MMSE,MoCA,BADS and RBMT scores were higher(P<0.05)and the NPI score and serum MDA,AOPP,IL-6 and IL-1βlevels were lower(P<0.05)in the observation group than in the control group.Conclusion On the basis of conventional cognitive rehabilitation training,Bu Shen Huo Xue Tiao Shen acupuncture can improve cognitive,executive and memory functions,relieve psychobehavioral symptoms and reduce oxidative stress and inflammatory reactions in patients with mild cognitive impairment of kidney deficiency and phlegm stasis type after cerebral infarction.