针刺颈夹脊穴联合推拿对主观认知下降患者认知功能的影响  

Effect of acupuncture at neck-Jiaji(EX-B 2)and tuina on the cognitive function in the patients with subjective cognitive decline

作　　者：张宇 尹曦[1] 刘朝阳 杨清峰[1] 韩蓄 徐祎迪 卢笑晖[1] ZHANG Yu;YIN Xi;LIU Zhao-yang;YANG Qing-feng;HAN Xu;XU Yi-di;LU Xiao-hui(Center of Geriatric Medicine,Affiliated Hospital of Shandong University of TCM,Jinan 250014,China;Clinic of Healthcare and Tuina,Affiliated Hospital of Shandong University of TCM,Jinan 250014,China;First Clinical College,Shandong University of TCM)

机构地区：[1]山东中医药大学附属医院老年医学中心,济南250014 [2]山东中医药大学附属医院保健推拿门诊,济南250014 [3]山东中医药大学第一临床学院

出　　处：《中国针灸》2023年第12期1379-1383,共5页Chinese Acupuncture & Moxibustion

基　　金：国家中医药管理局中医药事业传承与发展中央补助资金项目:YWC2022ZYYSY001;山东省卫生健康委员会齐鲁医派中医学术流派传承项目:lp2022-01。

摘　　要：目的:在生活方式健康宣教、元记忆训练基础上,观察针刺颈夹脊穴联合推拿对主观认知下降(SCD)患者认知功能、睡眠质量、血流动力学指标的影响。方法:将60例SCD患者随机分为观察组(30例,脱落1例)和对照组(30例,脱落3例)。对照组予生活方式健康宣教和元记忆训练,每天训练2次,每次15 min,每周5 d,连续4周;在对照组基础上,观察组采用针刺颈夹脊穴联合推拿治疗,先使用一指禅偏锋推法结合拨法分别沿足太阳膀胱经和督脉按摩颈部10~15 min,然后针刺双侧C1-C7颈夹脊穴,留针30 min,每日1次,每周5次,连续4周。于治疗前后,观察两组简易智能精神状态量表(MMSE)评分、韦克斯勒记忆量表第四版(WMS-Ⅳ)评估的总记忆商(FSMQ)评分、匹兹堡睡眠质量指数(PSQI)评分,采用经颅多普勒超声检测两组患者血流动力学指标[左侧椎动脉(LVA)、右侧椎动脉(RVA)、基底动脉(BA)的平均血流速度(Vm)和血管搏动指数(PI)]。结果:治疗后,两组患者MMSE、FSMQ评分较治疗前升高(P<0.05,P<0.001),观察组PSQI评分较治疗前降低(P<0.05),观察组BA的Vm值较治疗前升高(P<0.001);观察组MMSE、FSMQ评分以及BA的Vm值均高于对照组(P<0.05,P<0.001),PSQI评分低于对照组(P<0.05)。结论:针刺颈夹脊穴联合推拿在改善SCD患者认知功能、缓解慢性情绪应激和改善睡眠状态方面更具优势,其作用机制可能是改善BA的供血。Objective To observe the effects on cognitive function,sleep quality and hemodynamics in the patients with subjective cognitive decline(SCD)after treated with acupuncture at neck-Jiaji(EX-B 2)and tuina on the base of healthy lifestyle education and meta-memory training.Methods Sixty SCD patients were randomly divided into an observation group(30 cases,1 case dropped out)and a control group(30 cases,3 cases dropped out).In the control group,the healthy lifestyle education and meta-memory training was performed,twice daily,15 min each time;the 5-day intervention was delivered a week,lasting consecutively 4 weeks.On the base of the intervention as the control group,in the observation group,acupuncture at neck-Jiaji(EX-B 2)and tuina was conducted.First,one-finger pushing and plucking method of tuina was exerted on the neck region along the running courses of the bladder meridian of foot-taiyang and the governor vessel,for 10 min to 15 min;afterwards,acupuncture was delivered at bilateral neck-Jiaji(EX-B 2),from C1 to C7;and the needles were retained for 30 min.This intervention was given once daily,5 times a week,for consecutive 4 weeks.Before and after treatment,the score of the mini-mental state examination(MMSE),the score of full scale memory quotient(FSMQ)were assessed by Wechsler memory scale-fourth edition(WMS-Ⅳ)and the score of the Pittsburgh sleep quality index(PSQI)was compared between the two groups.Using transcranial Doppler ultrasound,the hemodynamic indexes(the mean velocity[Vm]and pulsatility index[PI]of the left vertebral artery[LVA],the right vertebral artery[RVA]and the basilar artery[BA])were determined in the two groups.Results After treatment,the scores of MMSE and FSMQ increased compared with those before treatment in the two groups(P<0.05,P<0.001),PSQI score was lower(P<0.05)and Vm of BA was higher(P<0.001)in the observation group when compared with those before treatment.The scores of MMSE and FSMQ,as well as Vm of BA were higher(P<0.05,P<0.001),and PSQI score was decreased(P<0.05)in the obse

关 键 词：主观认知下降 针刺 推拿 认知功能 颈夹脊穴 随机对照试验 

分 类 号：R246.6[医药卫生—针灸推拿学]