头皮针联合虚拟现实技术治疗脑卒中后轻度认知障碍患者的临床观察  

Efficacy of scalp acupuncture combined with virtual reality technology in treating post-stroke mild cognitive impairment

作　　者：杨昆[1] 王小莉[1] 伍俊[1] 汪娅莉 Yang Kun;Wang Xiaoli;Wu Jun;Wang Yali(Department of Neurorehabilitation,Xi'an Gaoxin Hospital,Xi'an 710065,China;Classic Department of Traditional Chinese Medicine,Xi'an International Medical Center Hospital,Xi'an 710100,China)

机构地区：[1]西安高新医院神经康复科,西安710065 [2]西安国际医学中心医院中医经典科,西安710100

出　　处：《国际医药卫生导报》2025年第3期462-468,共7页International Medicine and Health Guidance News

基　　金：陕西省重点研发计划(2023-YBSF-546)。

摘　　要：目的观察头皮针联合虚拟现实(VR)技术在脑卒中后轻度认知障碍(MCI)患者中的临床疗效。方法采用随机对照试验。选取2021年3月至2024年3月西安高新医院接诊的脑卒中后MCI患者92例,经抽签法分为对照组、试验组,各46例。对照组:男27例,女19例,年龄(67.43±8.32)岁;脑出血16例,脑梗死30例;行常规基础治疗,口服尼莫地平片(20 mg/次,3次/d)、丁苯酞软胶囊(0.2 g/次,4次/d)。试验组:男23例,女23例,年龄(66.50±7.79)岁;脑出血19例,脑梗死27例;在对照组基础上增加头皮针和VR技术,3次/周,每次30 min。两组均治疗3个月。评价并比较两组认知功能、日常生活能力、脑血流动力学、血管内皮功能,治疗3个月的治疗效果,以及治疗期间不良反应。统计学方法采用重复测量方差、LSD-t检验、独立样本t检验、χ^(2)检验、校正χ^(2)检验。结果重复测量方差分析显示,两组蒙特利尔认知评估量表(MoCA)评分、陶氏日常生活能力量表(ADL)评分、大脑中动脉血流阻力指数(RI)、大脑前动脉RI、动脉椎动脉RI、血清内毒素-1(ET-1)、一氧化氮(NO)水平在组间、时间、交互效应上差异均有统计学意义(均P<0.001)。组间:治疗1、3个月试验组MoCA评分、ADL评分、NO水平均高于对照组[(25.26±3.12)分比(23.87±3.10)分、(26.61±2.89)分比(25.33±2.97)分;(70.04±9.32)分比(65.39±8.25)分、(75.22±8.02)分比(71.11±8.87)分;(58.12±9.41)μmol/L比(53.39±8.32)μmol/L、(65.54±8.12)μmol/L比(59.26±9.31)μmol/L],差异均有统计学意义(均P<0.05);大脑中动脉、大脑前动脉、动脉椎动脉RI均小于对照组(均P<0.05),血清ET-1水平均低于对照组(均P<0.05)。组内:两组治疗1、3个月MoCA评分、ADL评分、NO水平均高于治疗前,大脑中动脉、大脑前动脉、动脉椎动脉RI均小于治疗前,血清ET-1水平均低于治疗前(均P<0.05);治疗3个月MoCA评分、ADL评分、NO水平均高于治疗1个月,大脑中动脉、大脑前�Objective To evaluate the clinical efficacy of combining scalp acupuncture with virtual reality(VR)technology in treating post-stroke mild cognitive impairment(MCI).Methods This study was a randomized controlled trial.Ninety-two post-stroke MCI patients admitted to the Xi'an Gaoxin Hospital between March 2021 and March 2024 were selected and were randomly assigned to either a control group or an experimental group,with 46 patients in each group.In the control group,there were 27 males and 19 females,aged(67.43±8.32)years,16 cases of cerebral hemorrhage and 30 cases of cerebral infarction.In the experimental group,there were 23 males and 23 females,aged(66.50±7.79)years,19 cases of cerebral hemorrhage and 27 cases of cerebral infarction.The control group received routine basic treatment,oral nimodipine tablets(20 mg/time,3 times/d),butylphthalide soft capsules(0.2 g/time,4 times/d).In the experimental group,scalp acupuncture and VR technology were added on the basis of the control group,3 times/week,30 min/time.Both groups were treated for 3 months.The cognitive function,daily living abilities,cerebral hemodynamics,and vascular endothelial function before treatment and after 1 month and 3 months of treatment,therapeutic effect after 3 months of treatment,and adverse reactions during treatment were compared between the two groups.Repeated measure ANOVA,LSD-t test,independent sample t test,and Chi-square test were used for statistical analysis.Results Repeated measure ANOVA showed that,the scores of Montreal Cognitive Assessment Scale(MoCA),Dow Scale of Activity of Daily Living(ADL),middle cerebral artery flow resistance index(RI),anterior cerebral artery RI,arterial vertebral artery RI,and serum endotoxin-1(ET-1)and nitric oxide(NO)levels between the two groups were statistically significant in terms of inter-group,time,and interaction effects(all P<0.001).After 1 and 3 months of treatment,the MoCA score,ADL score,and NO level of the experimental group were higher than those of the control group[(25.26±3.12)poin

关 键 词：脑卒中 轻度认知障碍 头皮针 虚拟现实技术 

分 类 号：R74[医药卫生—神经病学与精神病学]