头穴丛刺长留针疗法治疗缺血性脑卒中后轻度认知障碍临床研究

Clinical Study of Cluster Needling of Scalp Point Long Needle Retention Method on Mild Cognitive Dysfunction After Ischemic Stroke

目的:观察头穴丛刺长留针疗法治疗缺血性脑卒中后轻度认知障碍的临床疗效。方法:采用随机数字表法将160例缺血性脑卒中后轻度认知障碍患者分为观察组、对照组各80例。2组给予常规西药、认知功能训练治疗,对照组加用普通头针疗法治疗,观察组加用头穴丛刺长留针疗法治疗,2组连续治疗6周。比较2组临床疗效及治疗前后血管性痴呆评定量表认知分量表(VADAS-cog)、蒙特利尔认知评估量表(MoCA)、简易智能精神状态量表(MMSE)、日常生活能力量表(ADL)、总体衰退量表(GDS)、血管性痴呆中医辨证量表(SDSVD)评分及血浆多巴胺(DA)、去甲肾上腺素(NE)、5-羟色胺(5-HT)和降钙素原基因肽(CGRP)水平。结果:观察组总有效率95.00%,高于对照组81.25%(P<0.05)。治疗后,2组MMSE、MoCA、ADL评分及血浆DA、 NE、 5-HT、 CGRP水平均较治疗前升高(P<0.05), VADAS-cog、 GDS、 SDSVD评分降低(P<0.05),且观察组治疗后MMSE、MoCA、ADL评分及血浆DA、NE、5-HT、CGRP水平均高于对照组(P<0.05),VADAS-cog、GDS、SDSVD评分低于对照组(P<0.05)。结论:头穴丛刺长留针疗法治疗缺血性脑卒中后轻度认知障碍疗效确切,能够调节患者神经递质水平,改善患者认知功能,提高生活质量。

Objective:To observe the clinical efficacy of cluster needling of scalp point long needle retention method on mild cognitive dysfunction after ischemic stroke.Methods:Using a random number table method,a total of 160 cases of patients with mild cognitive dysfunction after ischemic stroke were divided into the observation group and the control group,with 80 cases in each group.Two groups were given conventional western medicines and cognitive function training treatment.The control group was treated with ordinary scalp acupuncture therapy,while the observation group was treated with cluster needling at scalp acupoints with long needle retention therapy.Both groups were treated continuously for six weeks.Compared the scores of the Vascular Dementia Assessment Scale-Cognitive Subscale(VADAS-cog),Montreal Cognitive Assessment Scale(MoCA),Mini-Mental State Examination(MMSE),Activities of Daily Living Scale(ADL),Global Decline Scale(GDS),Scale for the Differentiation of Syndromes of Vascular Dementia(SDSVD),and levels of plasma dopamine(DA),norepinephrine(NE),serotonin(5-HT),and calcitonin gene-related peptide(CGRP)before and after treatment between the two groups.Results:The total effective rate was 95.00%in the observation group,which was higher than that of 81.25%in the control group(P<0.05).After treatment,the scores of MMSE,MoCA,and ADL,as well as the levels of plasma DA,NE,5-HT,and CGRP in both groups were higher than those before treatment(P<0.05).The scores of VADAS-cog,GDS,and SDSVD were decreased(P<0.05);the scores of MMSE,MoCA,ADL,and levels of plasma DA,NE,5-HT,and CGRP in the observation group were higher than those in the control group after treatment(P<0.05),and the scores of VADAS-cog,GDS,and SDSVD were lower than those in the control group(P<0.05).Conclusion:Cluster needling of scalp point long needle retention method has a definite therapeutic effect in treating mild cognitive dysfunction after ischemic stroke,which can regulate the level of neurotransmitter,improve the cognitive function and improve the quality of life in patients.