头穴丛刺联合认知康复对脑梗死后认知障碍的影响  

Effect of Cluster Needling of Scalp Acupuncture Combined With Cognitive Rehabilitation on Cognitive Impairment after Cerebral Infarction

作　　者：王永新[1] 苗维[2] 张红顺[2] 王利春[2] 刘冀[1] 马向阳[1] 吴晓华[1] WANG Yong-xin;MIAO Wei;ZHANG Hong-shun;WANG Li-chun;LIU Ji;MA Xiang-yang;WU Xiao-hua(Cangzhou Medical College,Cangzhou Hebei 061001,China;Hospital of Integrated Traditional and Western Medicine,Cangzhou Hebei 061001,China)

机构地区：[1]沧州医学高等专科学校,河北沧州061001 [2]河北省沧州中西医结合医院,河北沧州061001

出　　处：《中医药导报》2018年第17期84-86,93,共4页Guiding Journal of Traditional Chinese Medicine and Pharmacy

基　　金：沧州市科技计划项目(151302004);项目名称:头穴丛刺联合认知康复对脑卒中患者轻度认知功能障碍的影响

摘　　要：目的:探究头穴丛刺与认知康复对脑梗死后认知功能障碍的影响。方法:将120例脑梗死伴认知障碍患者随机分成3组,每组40例。头穴丛刺组(A组)给予于氏头针治疗,认知训练组(B组)给予认知康复训练,联合治疗组(C组)给予上述两种方案联合治疗。每周6次,共治疗4周。治疗前后评价简易精神状态量表(MMSE)、事件相关电位(P300)潜伏期,并检测血清同型半胱氨酸水平。结果:3组MMSE均上升,其中C组评分显著高于A组和B组(P<0.01),且B组较A组对认知改善明显(P<0.05);治疗前各组P300潜伏期比较,差异无统计学意义,治疗后比较,差异均有统计学意义(P<0.05)。A、B两组与C组比较,P300潜伏期长且显著(P<0.01),A组和B组比较差异有统计学意义(P<0.05),但总体比较C组疗效最佳;治疗前各组血同型半胱氨酸水平比较,差异无统计学意义,A组、C组治疗前后比较,同型半胱氨酸水平降低,而B组治疗前后比较,差异无统计学意义(P>0.05)。A组、C组疗效比较,差异无统计学意义(P>0.05),而与B组比较,差异有统计学意义(P<0.01)。结论:头穴丛刺联合认知康复训练对脑卒中后认知功能障碍有改善作用,可缩短P300潜伏期,降低同型半胱氨酸水平,但是单纯认知康复对同型半胱氨酸水平无影响。Objectives： To explore the effect of cluster needling of scalp acupuncture combined with cognitive rehabilitation on cognitive impairment after cerebral infarction. Methods： A total of 120 patients with cerebral infarction and cognitive impairment were randomly divided into three groups, 40 patients in each group.The scalp acupuncture group（group A） was treated with cluster needling of scalp acupuncture. Cognitive training group（group B） was given cognitive rehabilitation training. The combined treatment group（group C） received the above two therapies for combined treatment. Patients were treated 6 times a week for 4 weeks. The MMSE and P300 incubation period were evaluated before and after treatment, and serum homocysteine levels were measured.Results： The MMSE of the three groups increased. The score of group C was significantly higher than that of group A and group B（P〈0.01）, and the cognitive improvement of group B was significantly higher than that of group A（P〈0.05）. There was no significant difference in the incubation period of P300 in each group before treatment. After treatment, the differences were statistically significant（P〈0.05）. The incubation period of P300 in group A and group B was longer and significant than that in group C（P〈0.01）. The difference between group A and group B was statistically significant（P〈0.05）, but the curative effect of group C was the best. There was no significant difference in level of homocysteine of each group before treatment. After treatment, the level of homocysteine in group A and C was lower than before, but there was no significant difference in group B before and after treatment（P〈0.05）. There was no significant difference in the curative effect between group A and group C（P〈0.05）. Compared with group B, the difference was statistically significant（P〈0.01）. Conclusion： Cluster needling of scalp acupuncture combined with cognitive rehabilitation training can improve the condition of the patient wi

关 键 词：脑梗死 认知功能障碍 头穴丛刺 MMSE P300 血清同型半胱氨酸 

分 类 号：R245[医药卫生—针灸推拿学]