岭南头皮针对气虚血瘀型卒中后认知功能障碍患者BDNF、IL-6及认知功能的影响  

Effects of Lingnan Scalp on Serum Brain-Derived Neurotrophic Factor,Interleukin-6 and Cognitive Function in Patients with Post-Stroke Cognitive Impairment of Qi Deficiency and Blood Stasis Type

作　　者：苏利梅[1,2] 李德瑜 陈小芳 蔡伟彬 秦敏 刘洋[1,2] 蔡科达 陈琼君 SU Limei;LI Deyu;CHEN Xiaofang;CAI Weibin;QIN Min;LU Yang;CAI Keda;CHEN Qiongjun(Guangdong Provincial Second Hospital of Traditional Chinese Medicine,Guangzhou 510095,Guangdong,China;Guangdong Provincial Key Laboratory of Research and Development in Traditional Chinese Medicine,Guangzhou 510700,Guangdong,China;Guangzhou Haizhu District Hospital of Traditional Chinese Medicine,Guangzhou 510000,Guangdong,China;Shenzhen Luohu Hospital of Traditional Chinese Medicine,Shenzhen 518000,Guangdong,China;The Fifth Clinical College of GuangzhouUniversity of Chinese Medicine,Guangzhou 510006,Guangdong,China)

机构地区：[1]广东省第二中医院,广东广州510095 [2]广东省中医药研究开发重点实验室,广东广州510700 [3]广州市海珠区中医医院,广东广州510000 [4]深圳市罗湖区中医院,广东深圳518000 [5]广州中医药大学第五临床医学院,广东广州510095

出　　处：《中华中医药学刊》2024年第12期219-223,共5页Chinese Archives of Traditional Chinese Medicine

基　　金：广东省中医药局项目(20221031)。

摘　　要：目的观察岭南头皮针治疗气虚血瘀型卒中后认知功能障碍患者的临床疗效及对其对血清脑源性神经营养因子(Brain Derived Neurotrophic Factor,BDNF)、白细胞介素-6(Interleukin-6,IL-6)的影响。方法将纳入研究的120例患者随机分为治疗组及对照组,两组均予卒中二级预防及口服盐酸多奈哌齐片,治疗组另予岭南头皮针治疗,对照组予常规头皮针治疗。分别在治疗前、治疗4周、治疗8周后通过简易精神状态量表(Minimum Mental State Examination,MMSE)、蒙特利尔认知评估量表(Montreal Cognitive Assessment,MoCA)测评认知功能、日常生活能力评定量表(Modified Barthel Index,MBI)测评日常生活活动能力、简式Fugl-Meyer运动功能评定量表测评运动功能、气虚血瘀证量表评估证候改善情况,检测血清BDNF及IL-6浓度变化,并通过MMSE积分评估临床方面的疗效。结果总有效率方面,对照组(81.67%)较治疗组(95.00%)更低,疗效方面治疗组较对照组更优(P<0.05);治疗后,两组患者MMSE、MoCA、MBI评分及血清BDNF均有提高(P<0.05),中医症候评分、IL-6水平均有下降(P<0.05)。组间比较,治疗组差异更明显(P<0.05)。治疗后两组患者Fugl-Meyer评分均有提高(P<0.05),组间比较P=0.065,P>0.05,差异无统计学意义。结论岭南头皮针可有效改善气虚血瘀型卒中后认知功能障碍患者的认知功能,调节患者血清BDNF、IL-6水平,适宜在临床中应用推广。Objective To observe the clinical efficacy of Lingnan scalp acupuncture in treating cognitive impairment in patients with Qi deficiency and blood stasis type stroke,and its effect on serum levels of brain derived neurotrophic factor(BDNF)and interleukin-6(IL-6).Methods A total of 120 patients included in the study were randomly divided into a treatment group and a control group.Both groups received secondary stroke prevention and oral administration of donepezil hydrochloride tablets.The treatment group also received Lingnan scalp acupuncture treatment,while the control group received conventional scalp acupunc-ture treatment.The cognitive function was assessed using the Minimum Mental State Examination(MMSE)and Montreal Cogni-tive Assessment(MoCA)before treatment,4 and 8 weeks after treatment.The Modified Barthel Index(MBI)was used to assess activities of daily living,the Fugl-Meyer motor function scale was used to assess motor function and the Qi deficiency and blood stasis syndrome scale was used to assess symptom improvement.The changes in serum BDNF and IL-6 concentrations were de-tected and the clinical efficacy was evaluated using MMSE scores.Results The total effective rate of the control group(81.67%)was lower than that of the treatment group(95.00%),and the treatment group was better than the control group in terms of effica-cy(P<0.05).After treatment,the scores of MMSE,MOCA and MBI and serum BDNF level in two groups increased(P<0.05)and the scores of traditional Chinese medicine symptoms and the levels of IL-6 decreased(P<0.05).The difference between two groups was more obvious(P<0.05).After treatment,the Fugl-Meyer scores were improved in two groups(P<0.05),and there was no obvious difference between two groups(P=0.065,P>0.05).Conclusion Lingnan scalp acupuncture can effective-ly improve the cognitive function of daily living in patients with post-stroke cognitive impairment due to Qi deficiency and blood stasis,and regulate the serum levels of BDNF and IL-6.It is suitable for clinical application.

关 键 词：岭南头皮针 气虚血瘀型 卒中后认知功能障碍 BDNF IL-6 

分 类 号：R245.31[医药卫生—针灸推拿学]