针刺配合西药治疗中风后轻度认知障碍:随机对照研究  

Acupuncture combined with western medication for mild cognitive disorder after stroke:a randomized controlled trial

作　　者：陈晓军[1] 方剑乔[1,2] 商越 马睿杰[1] 方针[1] 宣丽华[3] 吴翔[3] 包烨华[4] 陈顺喜[4] 

机构地区：[1]浙江中医药大学附属第三医院针灸科,杭州310005 [2]浙江中医药大学,杭州310053 [3]浙江省中医院 [4]杭州市中医院

出　　处：《中国针灸》2016年第4期337-341,共5页Chinese Acupuncture & Moxibustion

基　　金：国家中医临床研究基地业务建设科研专项课题:JDZX2012155

摘　　要：目的:验证督脉、膀胱经头部腧穴透刺法治疗中风后轻度认知障碍的临床疗效。方法:将110例患者随机分为观察组和对照组,每组55例。观察组采用督脉、膀胱经头部腧穴透刺,即五处透承光、通天透络却(均双侧),神庭透囟会、前顶透百会、后顶透强间,同时配合体针及常规西药治疗;对照组仅使用体针及常规西药治疗。针刺治疗1次/日,1周5次,共治疗8周,并于治疗前、治疗中(第4周)、治疗后(第8周)及治疗结束后3个月随访时分别比较两组的蒙特利尔认知评估量表(MoCA)、简易精神状态评价量表(MMSE)、抑郁自评量表(SDS)以及日常生活活动能力量表(Barthel指数)评分的变化情况。结果:治疗4周后、8周后及随访时,两组MoCA量表、MMSE量表、SDS量表以及Barthel指数评分均较治疗前明显改善(均P<0.01);与对照组比较,观察组在治疗8周后及随访时MoCA量表评分及SDS量表评分改善更为明显(P<0.01,P<0.05);观察组在各个时间点MMSE量表评分均较对照组改善明显(P<0.01,P<0.05);两组间Barthel指数评分的改善差异均无统计学意义(均P>0.05)。结论:督脉、膀胱经头部腧穴透刺法能显著改善中风后轻度认知障碍患者的认知功能,并对患者抑郁等不良情绪也具有一定的改善效果。Objective To verify the clinical effect of the penetration acupuncture at the acupoints of governor vessel（GV） and bladder meridian on head for mild cognitive disorder after stroke. Methods One hundred and ten patients were randomly divided into an observation group and a control group.55 cases in each one. Penetration acupuncture was used at the acupoints of GV and bladder meridian on head in the observation group,namely Wuchu （BL 5） to Chengguang（BI. 6） and Tongtian（BL 7） to Luoque（BI. 8） bilaterally,and Shenting（GV 24） to Xinhui （GV22）,Qianding（GV 21） to Baihui（GV 20）,Houding（GV 19） to Qiangjian（GV 18）. Body acupuncture and conventional western medication were applied in the both two groups. Acupuncture was adopted once a day, five times a week and eight weeks totally. The changes of Montreal Cognitive Assessment（ MoCA）, Mini mental state examination scale（MMSE）, self-rating depressive scale（SDS） and activities of daily living scale（Barthel index） were compared between the two groups before treatrnent,in the middle of treatment（at the forth week） ,after treat- ment（at the eighth week） and in three weeks after treatment（follow-up）. Results After treatment of four and eight weeks and at the time of follow-up,the results of MoCA, MMSE,SDS and Barthel index were apparently im- proved compared with those before treatment in the two groups（all P〈0.01）. After treatment of eight weeks and at the time of follow-up, the scores of MoCA and SDS were obviously improved in the observation group compared with those in the control group （P〈0.01,P〈0.05）. The improvements of MMSE in the observation group were more marked than those in the control group at all times（P〈0. 01 ,P〈0. 05）. But there was no statistical significance about the change of Barthel index between the two groups （all P〉0.05）. Conclusion Penetration acupuncture at the acupoints of GV and bladder meridian on head can remarkablely improve the cognitive function of

关 键 词：中风 轻度认知障碍 督脉 膀胱经 针刺 随机对照试验 

分 类 号：R246.6[医药卫生—针灸推拿学]