针灸配合认知训练治疗颅脑外伤后认知障碍临床观察  

Clinical observation of cognitive impairment after traumatic brain injury treated with acupuncture and cognitive training

作　　者：梁慧英[1] 游国清[1] 廖琳[1] 黄营湘 

机构地区：[1]中山市人民医院康复医学科,广东中山528400

出　　处：《中国针灸》2015年第9期865-868,共4页Chinese Acupuncture & Moxibustion

基　　金：中山市科技计划项目:20132A090

摘　　要：目的:观察针灸配合认知训练对颅脑外伤(TBI)后认知障碍的临床疗效。方法:将60例患者随机分为观察组和对照组,每组30例,其中有5例患者提前出院中途退出,最终观察组患者28例,对照组患者27例完成治疗。对照组予认知训练与常规治疗,观察组在对照组基础上,行针灸治疗,穴取百会、风池、膈俞、丰隆,每天治疗1次,共治疗4周。治疗前后采用简明精神状态量表(MMSE)、蒙特利尔认知评估量表(MoCA)评定TBI后认知障碍患者的认知功能。结果:1两组治疗后MMSE总分及各分项评分较治疗前升高显著(均P<0.05),除外即刻记忆力项目评分外,观察组治疗后MMSE总分及各分项评分均较对照组明显升高(均P<0.05);2两组治疗后MoCA总分及各项评分较治疗前显著升高(均P<0.05),除命名子项目评分外,观察组治疗后MoCA总分及各子项目评分均高于对照组(均P<0.05)。结论:单纯认知训练、针灸配合认知训练均能提高MMSE和MoCA得分,改善TBI所致的认知障碍,但针灸配合认知训练疗效更佳。Objective To observe the clinical efficacy on cognitive impairment after traumatic brain injury（TBI）treated with acupuncture and cognitive training.Methods Sixty patients were randomized into an observation group and a control group,30 cases in each one,and 5cases of them were dropped out due to the earlier discharge.Finally,there were 28 cases in the observation group and 27 cases in the control group.In the control group,the cognitive training and conventional treatment were applied.In the observation group,on the basis of the treatment as the control group,acupuncture was applied to Baihui（GV 20）,Fengchi（GB 20）,Geshu（BL 17）and Fenglong（ST 40）,once a day,for 4weeks totally.The mini-mental state examination（MMSE）and Montreal cognitive assessment（MoCA）were adopted to evaluate the cognitive function in the patients of post-TBI cognitive impairment.Results 1After treatment,the total score in MMSE and the score of each item were increased significantly as compared with those before treatment in the two groups（allP〈0.05）.Except for the score of immediate recall,the score in MMSE and the score of each of the other items were increased significantly in the observation group as compared with those in the control group after treatment（allP〈0.05）.2After treatment,the total score in MoCA and the score of each item were increased significantly as compared with those before treatment in the two groups（allP〈0.05）.Except for the score of nomenclature item,the total score in MoCA and the score of each of the other items were increased significantly in the observation group as compared with those in the control group after treatment（allP〈0.05）.Conclusion Both the simple cognitive training and the combined therapy of acupuncture and cognitive training improve MMSE and MoCA scores and relieve the cognitive impairment induced by TBI.But the combined therapy achieves the much better efficacy.

关 键 词：颅脑外伤 认知障碍 针灸 认知训练 MMSE MOCA 

分 类 号：R246.6[医药卫生—针灸推拿学]