高压氧联合针刺督脉经穴治疗对首发缺血性脑卒中患者神经功能及认知功能的影响  

Effects of hyperbaric oxygen therapy combined with acupuncture at acupoints of the Governor Vessel on neurological and cognitive functions in patients with initial onset of ischemic stroke

作　　者：蒋阳 张丹 熊健 徐庶[2] 汤文达 李梅 Jiang Yang;Zhang Dan;Xiong Jian;Xu Shu;Tang Wenda;Li Mei(Department of Rehabilitation Medicine,Zhangjiagang Hospital Affiliated to Soochow University,Suzhou 215600,China;Department of Neurology,Zhangjiagang Hospital Affiliated to Soochow University,Suzhou 215600,China)

机构地区：[1]苏州大学附属张家港医院康复医学科,苏州215600 [2]苏州大学附属张家港医院神经内科,苏州215600

出　　处：《中华航海医学与高气压医学杂志》2024年第3期313-317,共5页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

基　　金：张家港市青年科技项目(ZJGQNKJ201805)。

摘　　要：目的:观察高压氧联合针刺督脉经穴治疗对首发缺血性脑卒中患者神经功能及认知功能的影响。方法:选取2019年6月至2021年12月苏州大学附属张家港医院康复医学科收治的首发缺血性脑卒中患者82例,根据随机数字表法分为对照组和试验组,每组41例。所有患者均予以常规西医治疗,对照组予以单纯针刺督脉经穴治疗,试验组予以高压氧联合针刺督脉经穴治疗,分别于治疗前和治疗4周后,比较2组患者的美国国立卫生研究院卒中量表(NIHSS)、蒙特利尔认知评估法(MoCA)、Fugl-Meyer评估量表(FMA)、改良Barthel指数(MBI)评分及血清神经元特异性烯醇化酶(NSE)、脑源性神经营养因子(BDNF)水平的差异。结果:治疗后,2组患者的NIHSS评分均较治疗前降低,且试验组低于对照组(t=-3.098,P=0.003);MoCA评分均较治疗前升高,且试验组高于对照组(t=3.364,P=0.001);血清NSE水平均较治疗前降低,且试验组低于对照组(t=-4.66,P=0.000);血清BDNF水平均较治疗前升高,且试验组高于对照组(t=2.954,P=0.004);FMA及MBI评分均较治疗前升高,且试验组均高于对照组(t=2.722、3.06,P=0.008、0.003)。2组患者的不良反应发生率比较差异无统计学意义(χ^(2)=0.554,P=0.457)。结论:高压氧联合针刺督脉经穴治疗首发缺血性脑卒中能有效改善患者的神经功能及认知功能,调节血清NSE和BDNF水平,提高运动功能和生活质量,且安全可靠。ObjectiveTo investigate the effects of hyperbaric oxygen(HBO)therapy combined with acupuncture at the acupoints of the Governor Vessel on the neurological and cognitive functions in patients with initial onset of ischemic stroke.MethodsA total of 82 patients with initial onset of ischemic stroke admitted to the Department of Rehabilitation Medicine at Zhangjiagang Hospital Affiliated to Soochow University from June 2019 to December 2021 were selected and divided into control group and experimental group according to the random number table method,with 41 patients in each group.All the patients were treated with conventional western medicine.In addition,the control group was treated with only acupuncture at the acupoints of the Governor Vessel,while the experimental group was treated with HBO therapy combined with acupuncture at the acupoints of the Governor Vessel.The patients were assessed using the National Institutes of Health stroke scale(NIHSS),Montreal cognitive assessment(MoCA),Fugl Meyer assessment scale(FMA),and modified Barthel index(MBI)scores.The above scores and the levels of neuron specific enolase(NSE)and brain-derived neurotrophic factor(BDNF)before and after four weeks of treatment were compared between the two groups.ResultsAfter treatment,the NIHSS scores of both groups decreased compared with those before treatment,with the experimental group lower than the control group(t=-3.098,P=0.003);the MOCA scores increased in both groups compared with those before treatment,with the experimental group higher than the control group(t=3.364,P=0.001);the levels of NSE decreased in both groups compared with those before treatment,with the experimental group lower than the control group(t=-4.66,P=0.000);the levels of BDNF increased in both groups compared with those before treatment,with the experimental group higher than the control group(t=2.954,P=0.004);the FMA and MBI scores all increased in both groups compared with those before treatment,with the experimental group higher than the control group(t=2.72

关 键 词：缺血性脑卒中 高压氧 针刺督脉经穴 神经功能 认知功能 

分 类 号：R459.6[医药卫生—治疗学] R743.3[医药卫生—临床医学]