“填精益智”针刺法治疗轻度脑卒中后认知功能障碍的疗效及对血清同型半胱氨酸的影响

Clinical Effect of"Essence-filling and Intelligence-enhancing"Acupuncture in Patients with Mild Post-stroke Cognitive Impairment and Its Effect on Serum Homocysteine

目的探讨“填精益智”针刺法对轻度脑卒中后认知功能障碍(post-stroke cognitive impairment,PSCI)患者认知功能和血清同型半胱氨酸(homocysteine,Hcy)的影响。方法将116例轻度PSCI患者随机分为对照组(n=58,实际纳入研究55例)、针刺组(n=58,实际纳入研究54例)。两组患者均给予基础干预、康复训练,对照组另口服多奈哌齐5 mg,每晚1次,每周7次,连续治疗8周;针刺组在对照组治疗基础上予以“填精益智”针刺法治疗,每次治疗30 min,每日治疗1次,每周治疗6次,疗程为8周。观察和比较两组患者治疗前后蒙特利尔认知评估(Montreal cognitive assessment,MoCA)量表评分、简易精神状态检查(mini-mental state examination,MMSE)量表评分、Barthel指数(Barthel index,BI)、血清同型半胱氨酸(homocysteine,Hcy)水平,并基于MMSE量表评分进行疗效评价。结果治疗后两组患者MoCA量表评分、MMSE量表评分、BI均显著增加(P<0.05),血清Hcy水平显著降低(P<0.05),且针刺组MoCA量表评分、MMSE量表评分、BI增加程度,Hcy水平降低程度均显著大于对照组(P<0.05);针刺组临床疗效优于对照组(P<0.05)。结论“填精益智”针刺法可以明显改善轻度PSCI患者的认知功能以及日常生活能力,减轻Hcy对脑功能的损害,保护脑功能。

Objective To investigate the effect of"essence-filling and intelligence-enhancing"acupuncture on cognitive function and serum homocysteine(Hcy)in patients with mild post-stroke cognitive impairment(PSCI).Methods A total of 116 patients with mild PSCI were randomly divided into control group(58 patients,55 were actually included in the study)and acupuncture group(58 patients,54 were actually included in the study).The patients in the control group were given basic intervention,rehabilitation training,and oral administration of donepezil 5 mg once every night,seven times a week for 8 consecutive weeks,and those in the acupuncture group were given"essence-filling and intelligence-enhancing"acupuncture for 30 minutes each time,once a day and six times a week for 8 weeks,in addition to the treatment in the control group.The two groups were observed and compared in terms of Montreal Cognitive Assessment(MoCA)score,Mini-Mental State Examination(MMSE)score,Barthel Index(BI),and serum Hcy level before and after treatment,and treatment outcome was evaluated based on MMSE score.Results After treatment,both groups had significant increases in MoCA score,MMSE score,and BI(P<0.05)and a significant reduction in serum Hcy level(P<0.05),and compared with the control group,the acupuncture group had significantly greater changes in these indices(P<0.05).The acupuncture group had a significantly better clinical outcome than the control group(P<0.05).Conclusion For patients with mild PSCI,"essence-filling and intelligence-enhancing"acupuncture can significantly improve cognitive function and activities of daily living,alleviate the damage of Hcy to brain function,and protect the function of the brain.