醒脑开窍针刺法联合中药治疗脑梗死后轻度认知障碍的疗效观察  

Therapeutic observation of Xing Nao Kai Qiao acupuncture plus Chinese medication for mild cognitive impairment after cerebral infarction

作　　者：赵鑫[1] 杨环玮 薛秀娟[1] 王珊珊[1] 赵楠楠 ZHAO Xin;YANG Huanwei;XUE Xiujuan;WANG Shanshan;ZHAO Nannan(Qinhuangdao Hospital of Traditional Chinese Medicine of Hebei Province,Qinhuangdao 066000,China)

机构地区：[1]河北省秦皇岛市中医医院,秦皇岛066000

出　　处：《上海针灸杂志》2024年第2期142-147,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：秦皇岛市科学技术研究与发展计划(202004A095)。

摘　　要：目的 观察醒脑开窍针刺法联合补肾益髓汤治疗脑梗死后轻度认知障碍的临床疗效。方法 将80例脑梗死后轻度认知障碍的患者随机分为研究组(40例)和对照组(40例)。两组均予基础治疗,研究组在基础治疗外另予醒脑开窍针刺法联合补肾益髓汤治疗。比较两组临床疗效,观察两组治疗前后简易精神状态检查表(mini-mental state examination,MMSE)、蒙特利尔认知评估(Montreal cognitive assessment,MoCA)和Rivermead行为记忆测验(Rivermead behavioural memory test,RBMT)的评分变化,观察两组治疗前后连线测验-B(trail making test-B,TMT-B)结果、血清淀粉样蛋白A(serum amyloid A,SAA)和β-淀粉样蛋白(amyloid β-protein,Aβ)水平以及脑微循环指标(颈总动脉的平均血流量、最大血流速度、最小血流速度、临界压力、脉搏速度、特性阻抗、外周阻力和动态阻力)的变化。结果 研究组总有效率高于对照组(P<0.05)。治疗后,两组MMSE、MoCA和RBMT评分均高于同组治疗前(P<0.05),且研究组上述评分均高于对照组(P<0.05)。治疗后,两组TMT-B结果以及SAA和Aβ水平均优于同组治疗前(P<0.05),且研究组上述指标优于对照组(P<0.05)。治疗后,两组脑微循环指标均较治疗前改善(P<0.05),且研究组优于对照组(P<0.05)。结论 在基础治疗以上,采用醒脑开窍针刺法联合补肾益髓汤治疗脑梗死后轻度认知障碍可提高临床疗效,能进一步改善患者认知功能,并调节SAA和Aβ水平。Objective To observe the clinical efficacy of Xing Nao Kai Qiao(brain-awakening and orifice-opening) acupuncture plus Bu Shen Yi Sui Tang in treating mild cognitive impairment after cerebral infarction.Method Eighty patients with mild cognitive impairment after cerebral infarction were randomized into a research group(40 cases) and a control group(40 cases).Basic treatments were offered to both groups.In addition,the research group received Xing Nao Kai Qiao acupuncture plus Bu Shen Yi Sui Tang.The clinical efficacy was compared between the two groups.Before and after the treatment,the mini-mental state examination(MMSE),Montreal cognitive assessment(MoCA),and Rivermead behavioural memory test(RBMT) scores were observed,as well as the trail making test-B(TMT-B)results,serum amyloid A(SAA) and amyloidβ-protein(Aβ) levels,and cerebral microcirculation indicators(mean blood flow volume,maximum blood flow velocity,minimum blood flow velocity,critical pressure,pulse velocity,characteristic impedance,peripheral resistance,and dynamic resistance of the common carotid artery).Result The research group achieved a higher total effective rate than the control group(P<0.05).After the treatment,the MMSE,MoCA,and RBMT scores increased in the two groups(P<0.05) and were higher in the research group than in the control group(P<0.05).After the intervention,the TMT-B results and the levels of SAA and Aβ improved in both groups(P<0.05) and were better in the research group than in the control group(P<0.05).The brain microcirculation indicators improved after the intervention in both groups(P<0.05),and the research group outperformed the control group(P<0.05).Conclusion Based on the basic treatment,Xing Nao Kai Qiao acupuncture plus Bu Shen Yi Sui Tang can enhance clinical efficacy,further improve cognitive function,and regulate SAA and Aβ levels in treating mild cognitive impairment after cerebral infarction.

关 键 词：针刺疗法 针药并用 醒脑开窍 脑梗死 中风后遗症 认知障碍 

分 类 号：R246.6[医药卫生—针灸推拿学]