益智开窍针法联合认知训练治疗脑卒中后认知障碍的疗效及对血清IL-6、hs-CRP的影响  

Effect of Yizhi Kaiqiao Acupuncture Therapy Combined with Cognitive Training in Treatment of PSCI and Its Influence to Serum IL-6 and hs-CRP

作　　者：刘洋 刘飞[1] 吴成钢 LIU Yang;LIU Fei;WU Chenggang(East Hospital Zone,Shiyan Taihe Hospital,Shiyan 442000,China)

机构地区：[1]十堰市太和医院东院区,湖北十堰442000

出　　处：《针灸临床杂志》2023年第4期26-30,共5页Journal of Clinical Acupuncture and Moxibustion

基　　金：湖北省卫生健康委员会中医药科研项目,编号:ZY2021Q015。

摘　　要：目的:探讨益智开窍针法联合认知训练治疗脑卒中后认知障碍(PSCI)的疗效及对血清白细胞介素6(IL-6)、超敏C反应蛋白(hs-CRP)的影响。方法:按照随机数字表法将本院2019年9月—2021年9月期间收治的脑卒中后认知障碍患者116例分为两组。对照组58例采取常规治疗与认知训练,治疗组58例在对照组基础上联合益智开窍针法治疗。对比两组治疗前后简易智力状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)和日常生活活动能力Barthe指数、脑动脉血流动力学指标[脑动脉血流最大峰值(Vs)、平均流速(Vm)和血管阻力指数(RI)]、血清IL-6和hs-CRP变化,记录其临床疗效与不良反应情况。结果:与对照组比较,治疗组总有效率更高(χ^(2)=5.902,P=0.015);治疗前两组MMSE、MoCAt Barthe指数评分比较差异无统计学意义(P>0.05),治疗后两组MMSE、MoCA和Barthe指数评分均升高,且治疗组MMSE、MoCA和Barthe指数评分均高于对照组(P<0.05);两组治疗前脑动脉血流动力学指标比较差异无统计学意义(P>0.05);两组治疗后Vs、Vm水平升高,RI指标降低,且与对照组比较,治疗组Vs、Vm水平更高,RI指标更低(P<0.05);两组治疗前IL-6、hs-CRP水平比较差异无统计学意义(P>0.05);治疗后两组IL-6、hs-CRP水平均降低,且治疗组IL-6、hs-CRP水平低于对照组(P<0.05);治疗组不良反应发生率为5.17%(3/58),对照组为3.45%(2/58),两组比较差异无统计学意义(P=0.209,χ^(2)=0.648)。结论:益智开窍针法联合认知训练治疗PSCI患者疗效显著,能改善患者智力和脑血流动力学,提高认知功能与日常生活活动能力,且不良反应少,值得推广。Objective:To explore the effect of Yizhi Kaiqiao acupuncture therapy combined with cognitive training in treatment of post-stroke cognitive impairment(PSCI)and its influence to serum interleukin-6(IL-6)and high-sensitivity C-reactive protein(hs-CRP).Methods:A total of 116 patients with PSCI were randomly divided into the control group and the treatment group,with 58 cases in each group.The control group was treated with routine treatment and cognitive training;on which basis,the treatment group was also treated with Yizhi Kaiqiao acupuncture therapy.The scores of Mini-Mental State Examination(MMSE),Montreal Cognitive Assessment(MoCA),Barthe index of activities of daily living,and indexes of cerebral arterial hemodynamic(Vs,Vm,RI),as well as serum levels of IL-6 and hs-CRP were compared between before and after the treatment in the two groups.Clinical efficacy and adverse reactions were also compared between the two groups.Results:The total effective rate of the treatment group was significantly higher than that of the control group(χ^(2)=5.902,P=0.015).There were no statistical differences in the scores of MMSE,MoCA and Barthe index between the two groups before the treatment(P>0.05);the scores of MMSE,MoCA and Barthe index were all increased after the treatment in the two groups,and the increases were more significant in the treatment group(P<0.05).There were no statistical differences in the cerebral arterial hemodynamic indexes between the two groups before the treatment(P>0.05);the levels of Vs and Vm were increased,and the RI index was decreased after the treatment in the two groups,of which the improvements were more significant in the treatment group(P<0.05).There were no statistical differences in the levels of IL-6 and hs-CRP between the two groups before the treatment(P>0.05);the levels of IL-6 and hs-CRP were decreased after the treatment in the two groups,and the decreases were more significant in the treatment group(P<0.05).The incidence of adverse reactions was 5.17%(3/58)in the treatment group,and

关 键 词：益智开窍针法 认知训练 脑卒中 认知障碍 白细胞介素 超敏C反应蛋白 

分 类 号：R246.6[医药卫生—针灸推拿学]