“通督调神”针刺联合经颅直流电刺激对脑卒中后认知障碍患者神经损伤标志物和事件相关电位P300的影响  

Effects of"Tongdu Tiaoshen"Acupuncture Combined with Transcranial Direct Current Stimulation on Nerve Injury Markers and Event-Related Potential P300 in Patients with Post-Stroke Cognitive Impairment

作　　者：刘翠[1] 李蕊 甄巧霞[1] 齐琳[1] 刘爱贤[1] LIU Cui;LI Rui;ZHEN Qiao-xia;QI Lin;LIU Ai-xian(Neurorehabilitation Center,Beijing Rehabilitation Hospital Affiliated to Capital Medical University,Beijing,100014,China;Traditional Chinese Medicine Rehabilitation Center,Beijing Rehabilitation Hospital Affiliated to Capital Medical University,Beijing,100014,China)

机构地区：[1]首都医科大学附属北京康复医院神经康复中心,北京100014 [2]首都医科大学附属北京康复医院中医康复中心,北京100014

出　　处：《现代生物医学进展》2024年第7期1244-1247,1215,共5页Progress in Modern Biomedicine

基　　金：北京市医管局科研培育计划项目(PX2018037);北京市肢体残疾人社区和居家康复服务项目(GFTC18AA0252/01)。

摘　　要：目的:探讨"通督调神"针刺联合经颅直流电刺激(tDCS)对脑卒中后认知功能障碍(PSCI)患者神经损伤标志物和事件相关电位P300的影响。方法:选取首都医科大学附属北京康复医院在2020年9月-2022年12月期间收治的100例PSCI患者。按随机数字表法分为对照组(n=50,常规治疗联合tDCS),观察组(n=50,对照组基础上联合"通督调神"针刺)。对比两组疗效、简易精神状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)、日常生活活动能力(ADL)、事件相关电位P300和血清神经损伤标志物。结果:与对照组相比,观察组的临床总有效率更高(P<0.05)。与对照组治疗4周后相比,观察组MoCA、MMSE、ADL评分更高,潜伏期更低;波幅更高,神经元特异性烯醇化酶(NSE)、S100β蛋白水平更低(P<0.05)。结论:"通督调神"针刺联合tDCS治疗PSCI患者,可有效改善患者的认知功能,提高日常生活活动能力,可能与改善神经功能有关。Objective:To investigate the effects of"tongdu tiaoshen"acupuncture combined with transcranial direct current stimulation(tDCS)on nerve injury markers and event-related potential P300 in patients with post-stroke cognitive impairment(PSCI).Methods:100 PSCI patients who were admitted to Beijing Rehabilitation Hospital Affiliated to Capital Medical University from September 2020 to December 2022 were selected.Patients were divided into control group(n=50,conventional treatment combine with tDCS)and observation group(n=50,on the basis of control group,combine with"tongdu tiaoshen"acupuncture)according to the random number table method.The efficacy,mini-mental state examination(MMSE),Montreal cognitive assessment(MoCA),activities of daily living(ADL),event-related potential P300 and serum nerve injury markers were compared in two groups.Results:Compared with control group,the total clinical effective rate in observation group was higher(P<0.05).Compared with control group 4 weeks after treatment,the scores of MoCA,MMSE and ADL in observation group were higher and the latency was lower.The amplitude was higher,and the levels of neuron-specific enolase(NSE)and S100βprotein were lower(P<0.05).Conclusion:The combination of"tongdu tiaoshen"acupuncture and tDCS in the treatment of PSCI patients,which can effectively improve the cognitive function of patients and improve the ability of daily living activities,which may be relate to the improvement of neurological function.

关 键 词："通督调神"针刺 经颅直流电刺激 神经损伤 事件相关电位P300 认知障碍 脑卒中 

分 类 号：R743[医药卫生—神经病学与精神病学] R741.05[医药卫生—临床医学]