针刺联合经颅直流电刺激治疗脑卒中后偏侧忽略疗效观察  

Observation on therapeutic effect of acupuncture combined with transcranial direct current stimulation on unilateral neglect after stroke

作　　者：成帅[1] 尹昱[2] 张少华 陈元武[2] 孙增鑫[2] 吕佩源[2] CHENG Shuai;YIN Yu;ZHANG Shaohua;CHEN Yuanwu;SUN Zengxin;LYU Peiyuan(Huanghua People’s Hospital,Huanghua 061100,Hebei,China;Hebei General Hospital,Shijiazhuang 050000,Hebei,China;The Eighth People’s Hospital of Hebei Province,Shijiazhuang 050000,Hebei,China)

机构地区：[1]黄骅市人民医院,河北黄骅061100 [2]河北省人民医院,河北石家庄050000 [3]河北省第八人民医院,河北石家庄050000

出　　处：《现代中西医结合杂志》2022年第14期1950-1956,共7页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：河北省中医药管理局科研计划项目(2021168)。

摘　　要：目的 观察针刺联合经颅直流电刺激治疗脑卒中后偏侧忽略的临床疗效。方法 选择2018年6月—2021年6月在黄骅市人民医院和河北省人民医院治疗的120例脑卒中后偏侧忽略患者,随机分为认知训练组、针刺组、针刺+单部位颅刺激组、针刺+多部位颅刺激组,每组30例。4组患者均接受改善忽略的常规认知训练,针刺+单部位颅刺激组、针刺+多部位颅刺激组患者接受15次不同刺激模式经颅直流电刺激治疗。观察4组患者治疗前后行为注意障碍测试(BIT-C)评分、线段二等分试验评分、划销实验评分、星星删除试验评分、画钟测试评分、临摹测试评分及事件相关电位检查(P300、N1和P1潜伏期、波幅)、DTI检查[各向异性分数(FA)和平均扩散系数(MD)]变化情况。结果 治疗后4组患者BIT-C评分、线段二等分试验评分、划销实验评分、星星删除试验评分、画钟测试评分、临摹测试评分均明显升高(P均<0.05);除临摹测试评分外,针刺组、针刺+单部位颅刺激组、针刺+多部位颅刺激组其余各项评分均明显高于认知训练组(P均<0.05),且针刺+单部位颅刺激组、针刺+多部位颅刺激组BIT-C评分、划销实验评分、画钟测试评分均明显高于针刺组(P均<0.05),针刺+单部位颅刺激组各项评分和针刺+多部位颅刺激组比较差异均无统计学意义(P均>0.05)。治疗后,针刺组、针刺+单部位颅刺激组、针刺+多部位颅刺激组患者P300、P1潜伏期及认知训练组P300潜伏期均明显缩短(P均<0.05),且针刺+多部位颅刺激组P300、P1潜伏期均明显短于其他组(P均<0.05);4组患者P300、N1、P1波幅均明显升高(P均<0.05),且针刺+单部位颅刺激组、针刺+多部位颅刺激组N1和P1波幅均明显高于针刺组(P均<0.05),但针刺+单部位颅刺激组N1和P1波幅与针刺+多部位颅刺激组比较差异均无统计学意义(P均>0.05)。治疗后4组患者FA和MD均明显升高(P均<0.05),针刺+Objective It is to observe the clinical effect of acupuncture combined with transcranial direct current stimulation in the treatment of unilateral neglect after stroke.Methods A total of 120 patients with unilateral neglect after stroke treated in Huanghua People's Hospital and Hebei General Hospital from June 2018 to June 2021 were selected and randomly divided into 4 groups:cognitive training group,acupuncture group,acupuncture+single-site cranial stimulation group and acupuncture+multiple-site cranial stimulation group,30 cases in each group.The patients in the four groups received routine cognitive training to improve neglect,the patients in the acupuncture+single-site cranial stimulation group and acupuncture+multiple-site cranial stimulation group received 15 times of transcranial direct current stimulation with different stimulation modes.The changes in the scores of Behavioral Inattention Test(BIT-C),line segment bisection test,cross-out test,star deletion test,clock drawing test,copy test and event-related potential examination(P300,N1 and P1 latency,amplitude),DTI examination[fractional anisotropy(FA)and mean diffusion coefficient(MD)]before and after treatment were observed in the four groups.Results After treatment,the scores of BIT-C,line segment bisection test,cancellation test,star deletion test,clock-drawing test,and copying test were all significantly increased in the four groups(all P<0.05).Except for the score of the copying test,the scores of the other test in the acupuncture group,acupuncture+single-site cranial stimulation group,and acupuncture+multi-site cranial stimulation group were significantly higher than those in the cognitive training group(all P<0.05),and the scores of BIT-C,cross-out test,and clock-drawing test in acupuncture+single-site cranial stimulation group and acupuncture+multi-site cranial stimulation group were significantly higher than those in the acupuncture group(all P<0.05),there was no significant difference in the scores between the acupuncture+single-site cranial s

关 键 词：针刺 经颅直流电刺激 偏侧忽略 

分 类 号：R743.33[医药卫生—神经病学与精神病学]