“氧-针-康”综合方案治疗脑卒中后轻度认知功能障碍的临床研究  

Clinical study on“oxygen-acupuncture-rehabilitation”comprehensive regimen in the treatment of mild cognitive dysfunction after stroke

作　　者：罗琴[1] 石强[1] 龚清平[1] 王岗[1] LUO Qin;SHI Qiang;GONG Qingping;WANG Gang(The First People’s Hospital of Zigong,Zigong 643000,Sichuan,China)

机构地区：[1]四川省自贡市第一人民医院,四川自贡643000

出　　处：《现代中西医结合杂志》2020年第34期3790-3795,共6页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：四川省中医药管理局科学技术研究专项(2018QN073);自贡市市级重点科技计划项目(2018CXMZ04)。

摘　　要：目的观察“氧-针-康”综合方案治疗脑卒中后轻度认知功能障碍的临床疗效。方法采用随机单盲单中心的研究方法,从2017年1月—2019年1月自贡市第一人民医院收治的脑卒中后轻度认知功能障碍患者中选取120例,随机分为氧-针-康组、西药组、针康组各40例。氧-针-康组在高压氧舱治疗期间融入针刺、康复训练、五行音乐疗法多种干预手段,西药组给予盐酸多奈哌齐片、丁苯酞软胶囊口服,针康组给予头针结合认知康复训练治疗,3组均治疗4周。观察3组治疗后各量表评分(MMSE评分、WMS评分、Barthel指数)、实验室检查指标[总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、胰岛素样生长因子-1(IGF-1)、C反应蛋白(CRP)、同型半胱氨酸(Hcy)]、脑血流速度(左右椎动脉、大脑前动脉、大脑后动脉、双侧大脑中动脉)的变化,统计3组临床疗效。结果3组治疗后MMSE评分、WMS评分、Barthel指数及血清IGF1水平均明显升高(P均<0.05),血清TC、TG、LDL-C、CRP、Hcy水平均明显降低(P均<0.05),左右椎动脉、大脑前动脉、大脑后动脉、双侧大脑中动脉的血流速度均明显加快(P均<0.05)。氧-针-康组MMSE评分、WMS评分均明显高于西药组和针康组(P均<0.05);Barthel指数明显高于西药组(P均<0.05),但与针康组比较差异无统计学意义(P>0.05);氧-针-康组和西药组血清TC、TG、CRP、Hcy水平均明显低于针康组(P均<0.05),IGF-1水平均明显高于针康组(P均<0.05);氧-针-康组血清CRP水平明显低于西药组(P<0.05),血清TC、TG、IGF-1、Hcy水平与西药组比较差异均无统计学意义(P均>0.05);氧-针-康组各动脉血流速度明显快于西药组和针康组(P均<0.05),针康组左右椎动脉、大脑后动脉血流速度明显快于西药组(P均<0.05)。氧-针-康组总有效率明显高于西药组和针康组(P均<0.05),西药组和针康组比较差异无统计学意义(P>0.05)。结论“氧-针-康”Objective It is to observe the clinical efficacy of“oxygen-acupuncture-rehabilitation”comprehensive regimen in the treatment of mild cognitive dysfunction after stroke.Methods 120 patients with mild cognitive impairment after stroke admitted to the First People’s Hospital of Zigong from January 2017 to January 2019 were selected by a randomized single-blind single-center research method,they were randomly divided into oxygen-acupuncture-rehabilitation group(OAR group),western medicine group(WM group),and acupuncture-rehabilitation group(AR group).The OAR group was treated with many kinds of intervention such as acupuncture,rehabilitation training,and five-element music therapy during the hyperbaric oxygen chamber treatment.The WM group was treated with donepezil hydrochloride tablets and butylphthalide soft capsules,and the AR group was treated with scalp acupuncture combined with cognition rehabilitation training,all the 3 groups were treated for 4 weeks.The changes of scale scores(MMSE score,WMS score,Barthel index),laboratory examination indicators[total cholesterol(TC),triacylglycerol(TG),low-density lipoprotein cholesterol(LDL-C),insulin-like growth factor-1(IGF-1),C-reactive protein(CRP),homocysteine(Hcy)]and cerebral blood flow velocity(left and right vertebral artery,anterior cerebral artery,posterior cerebral artery,bilateral middle cerebral artery)after treatment were observed and the clinical efficacy was evaluated in the three groups.Results MMSE score,WMS score,Barthel index and serum IGF1 levels were significantly increased while the levels of serum TC,TG,LDL-C,CRP,and Hcy were significantly reduced(all P<0.05),the blood flow velocity of the left and right vertebral artery,anterior cerebral artery,posterior cerebral artery,and bilateral middle cerebral artery were significantly increased in the three groups(P<0.05).The MMSE score and WMS score of the OAR group were significantly higher than those of the WM group AR group(P<0.05),the Barthel index was significantly higher than that of the WM gr

关 键 词：脑卒中 轻度认知功能障碍 针刺疗法 康复训练 高压氧 

分 类 号：R743.3[医药卫生—神经病学与精神病学]