脑电仿生电刺激神门穴、乳突穴对皮质下动脉硬化性脑病患者的影响

Electroencephalographic Bionic Electrical Stimulation of Otopoint Ear-shenmen and Rutu Point on Patients with Subcortical Arteriosclerotic Encephalopathy

目的探讨脑电仿生电刺激神门穴、乳突穴对皮质下动脉硬化性脑病(SAE)患者的影响。方法选取2015年2月—2017年6月苏州市吴江区中医医院内科收治的SAE患者124例,采用随机数字表法分为对照组和研究组,每组62例。对照组患者给予盐酸多奈哌齐治疗,研究组患者在对照组治疗基础上给予脑电仿生电刺激神门穴、乳突穴治疗;两组患者均连续治疗6周。比较两组患者临床疗效,治疗前后中文版蒙特利尔认知评估量表(MoCA)、长谷川痴呆量表(HDS)评分、脑部血流速度、同型半胱氨酸(Hcy)、D-二聚体及血液流变学指标(包括全血高切黏度、全血低切黏度、血浆黏度、红细胞聚集指数),并观察两组患者治疗期间不良反应发生情况。结果 (1)研究组患者临床疗效优于对照组(P<0.05)。(2)治疗前两组患者中文版MoCA评分、HDS评分比较,差异无统计学意义(P>0.05);治疗后研究组患者中文版MoCA评分、HDS评分高于对照组(P<0.05)。(3)治疗前两组患者左椎动脉、右椎动脉、基底动脉血流速度比较,差异无统计学意义(P>0.05);治疗后研究组患者左椎动脉、右椎动脉、基底动脉血流速度快于对照组(P<0.05)。(4)两组患者治疗前血浆Hcy、D-二聚体水平比较,差异无统计学意义(P>0.05);治疗后研究组患者血浆Hcy、D-二聚体水平低于对照组(P<0.05)。(5)两组患者治疗前全血高切黏度、全血低切黏度、血浆黏度、红细胞聚集指数比较,差异均无统计学意义(P>0.05);治疗后研究组患者全血高切黏度、全血低切黏度、血浆黏度、红细胞聚集指数均低于对照组(P<0.05)。(6)两组患者治疗期间均未发生严重不良反应。结论脑电仿生电刺激神门穴、乳突穴可有效减轻SAE患者痴呆程度,改善患者神经功能、认知功能,加快脑部血流速度,降低血液黏稠度,且安全性较高。

Objective To investigate the impact of electroencephalographic bionic electrical stimulation of otopoint ear-shenmen and rutu point on patients with subcortical arteriosclerotic encephalopathy(SAE).Methods From February 2015 to June 2017,a total of 124 patients with SAE were selected in the Department of Internal Medicine,the Traditional Chinese Medicine Hospital of Wujiang District,Suzhou,and they were divided into control group and study group according to random number table method,with 62 cases in each group.Patients in control group received donepezil,while patients in study group received electroencephalographic bionic electrical stimulation of otopoint ear-shenmen and rutu point based on that of control group;both group continuously treated for 6 weeks.Clinical effect,Chinese version Montreal Cognitive Assessment Scale(MoCA)score,Hasegawa Dementia Scale(HDS)score,cerebral blood flow velocity,Hcy,D-dimer and hemorheological index(including whole blood high shear viscosity,whole blood low shear viscosity,plasma viscosity and erythrocyte aggregation index)before and after treatment were compared between the two groups,and incidence of adverse reactions was observed during treatment.Results(1)Clinical effect in study group was statistically significantly better than that in control group(P<0.05).(2)No statistically significant difference of Chinese version MoCA score or HDS score was found between the two groups before treatment(P>0.05),while Chinese version MoCA score and HDS score in observation group were statistically significantly higher than those in control group after treatment(P<0.05).(3)No statistically significant difference of blood flow velocity of left vertebral artery,right vertebral artery or basilar artery was found between the two groups before treatment(P>0.05);while blood flow velocity of left vertebral artery,right vertebral artery and basilar artery in study group was statistically significantly faster than those in control group after treatment,respectively(P<0.05).(4)No statistically significant difference of plasma levels of Hcy or D-dimer was found between the two groups before treatment(P>0.05),while plasma levels of Hcy and D-dimer in study group were statistically significantly lower than those in control group after treatment(P<0.05).(5)No statistically significant difference of whole blood high shear viscosity,whole blood low shear viscosity,plasma viscosity or erythrocyte aggregation index was found between the two groups before treatment(P>0.05),while whole blood high shear viscosity,whole blood low shear viscosity,plasma viscosity and erythrocyte aggregation index in study group were statistically significantly lower than those in control group after treatment(P<0.05).(6)No one in the two groups occurred any serious adverse reactions during treatment.Conclusion In patients with SAE,electroencephalographic bionic electrical stimulation of otopoint ear-shenmen and rutu point can effectively relieve the severity of dementia,improve the neurological function and cognitive function,quicken the cerebral blood flow velocity,reduce the blood viscosity,with relatively high safety.