不同梗死部位与脑卒中后认知功能障碍的关系及针刺治疗脑卒中后认知功能障碍的临床研究

The Relationship between Different Infarction Sites and Post-stroke Cognitive Dysfunction and the Clinical Study on Acupuncture in the Treatment of Post-stroke Cognitive Dysfunction

目的探讨不同梗死部位与脑卒中后认知功能障碍的关系及针刺治疗脑卒中后认知功能障碍的临床效果。方法本研究选取2016年4月—2018年6月收治的70例脑梗死患者。对70例患者梗死发生部位等资料进行分析。采取随机数字表法均分为2组。其中观察组35例患者采用针刺治疗联合康复训练。对照组35例采用康复训练。对脑梗死患者的康复效果进行总结。结果观察组35例患者简易智能精神状态检查量表评分、最佳智力测验DS评分明显优于对照组,差异有统计学意义(P <0. 05)。卒中后认知功能障碍患者RBANS评分均与健康体检者有明显差异(P <0. 05)。与健康体检者相比,左额叶、左丘脑的视觉空间结构评分下降尤为显著(P <0. 05)。与健康体检者相比,左额叶中的语言(图片命名、语言流畅度)评分下降尤为显著(P <0. 05)。相较于健康体检者,注意功能均明显下降,其中尤以左额叶最为明显(P <0. 05)。结论大脑左半球发生脑梗死容易影响认知功能中的语言、注意力以及相关记忆等高级功能,利用针刺治疗可提升卒中后认知功能的康复效果,值得临床重视。

Objective To explore the relationship between different infarct sites and cognitive impairment after stroke and the clinical effect of acupuncture on cognitive impairment after stroke.Methods 70 patients with cerebral infarction from April 2016 to June 2018 were selected for this study.The location of infarction in 70 patients was analyzed.They were divided into two groups by random number table method.In the observation group,35 patients were treated with acupuncture combined with rehabilitation training.70 cases in the control group received rehabilitation training.The rehabilitation effect of cerebral infarction patients was summarized.Results 35 patients in the observation group were significantly better than those in the control group in the scores of the Simple Mental State Examination Scale and the DS scores of the Best Intelligence Test(P<0.05).The RBANS scores of patients with cognitive impairment after stroke were significantly different from those of healthy people(P<0.05).Compared with healthy subjects,the visual spatial structure scores of left frontal lobe and left thalamus decreased significantly(P<0.05).Compared with healthy subjects,the scores of language(picture naming,language fluency)in left frontal lobe decreased significantly(P<0.05).Compared with healthy people,attention function decreased significantly,especially in the left frontal lobe(P<0.05).Conclusion Cerebral infarction in the left hemisphere of the brain can easily affect the advanced functions of language,attention and related memory in cognitive function.Acupuncture treatment can improve the rehabilitation effect of cognitive function love after stroke,which deserves clinical attention.