逐瘀活络艾灸干预联合双任务执行功能训练指导在脑出血后非痴呆性血管性认知功能障碍患者中的应用研究

Application of Moxibustion Intervention for Removing Blood Stasis and Activating Collaterals in Combination with Dual task Executive Function Training Guidance in Patients with Non dementia Vascular Cognitive Dysfunction after Cerebral Hemorrhage

目的:探讨逐瘀活络艾灸干预联合双任务执行功能训练指导在脑出血后非痴呆性血管性认知功能障碍患者中的应用价值。方法:选取我院2020年1月至2022年1月收治的422例脑出血后非痴呆性血管性认知功能障碍患者作为研究对象,按照干预方式不同分为观察组212例(采用逐瘀活络艾灸干预联合双任务执行功能训练指导干预)和对照组210例(采用单独双任务执行功能训练指导)。观察两组临床疗效、中医症状积分、精神状态[采用蒙特利尔认知评估量表(Montreal Cognitive Assessment,MoCA)评分]、认知功能评分以及日常生活能力。结果:干预后,观察组的临床总有效率为93.40%,高于对照组患者的85.71%(P<0.05)。干预后,观察组患者的智能减退、头重如裹、沉默少言、形体肥胖的中医证候积分,均低于对照组患者(P<0.05)。干预前,两组患者的定向力、语言、命名、视空间与执行力、注意力、抽象、延迟记忆评分比较(P>0.05);干预后,观察组患者各项评分,均高于对照组患者(P<0.05)。干预后1个月,2个月,观察组患者的认知功能评分,均高于对照组(P<0.05)。干预前,两组患者的日常生活能力比较(P>0.05);干预后1个月、2个月,观察组患者的日常生活能力的分值,均高于对照组(P<0.05)。结论:逐瘀活络艾灸干预联合双任务执行功能训练指导能够提高脑出血后非痴呆性血管性认知功能障碍患者的临床疗效,改善其临床症状,提高精神状态与认知功能,提高日常生活能力,值得临床推广。

Objective:To explore the application value of blood stasis removing and collateral activating moxibustion inter-vention combined with dual task executive function training guidance in patients with non dementia vascular cognitive dysfunction after cerebral hemorrhage.Methods:422patients with non dementia vascular cognitive impairment after intracerebral hemorrhage admitted in our hospital from January 2020to January 2022were selected as the research objects,and were divided into the observation group(212cases were treated with moxibustion for removing blood stasis and activating collaterals combined with dual task execution function training guidance intervention)and the control group(210cases were treated with dual task execution function training guidance alone)according to different intervention methods.Observe the clinical efficacy,TCM symptom score,mental state[using the Montreal Cognitive Assessment(MoCA)score],cognitive function score and daily living ability of the two groups.Results:After intervention,the total clinical effective rate in the observation group was 93.40%,which was higher than 85.71%in the control group(P<0.05).After treatment,the TCM symptom scores of the patients in the observation group were lower than those of the patients in the control group(P<0.05).Before intervention,the scores of orientation,language,naming,visual space and execution,attention,abstraction and delayed memory of the two groups were compared(P>0.05);After intervention,the scores of orientation,language,naming,visual space and executive power,attention,abstraction,and delayed memory of patients in the observation group were higher than those of patients in the control group(P<0.05).One month and two months after intervention,the cognitive function scores of patients in the observation group were higher than those of patients in the control group(P<0.05).Before intervention,the daily living ability of the two groups was compared(P>0.05);One month and two months after intervention,the values of ADL of patients in the observation group were higher than those of patients in the control group(P<0.05).Conclusion:Moxibustion intervention for removing blood stasis and activating collaterals combined with dual task executive function training guidance can improve the clinical efficacy of patients with non dementia vascular cognitive dysfunction after intracerebral hemorrhage,improve their clinical symptoms,improve their mental state and cognitive function,and improve their ability of daily life,which is worthy of clinical promotion.