双歧杆菌三联活菌胶囊联合tDCS对脑卒中后认知障碍的效果探究  

Efficacy of bifidobacterium triple viable capsules combined with transcranial direct current stimulation in patients with post-stroke cognitive impairment

作　　者：罗挺 徐挺立 吴慧娟[1,2] 祁敏芳 LUO Ting;XU Tingli;WU Huijuan;QI Minfang(Department of Intensive Care Medicine/Intensive Rehabilitation,Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University,Taizhou 318050,Zhejiang Province,China;Department of Intensive Care Medicine/Intensive Rehabilitation,Taizhou Rehabilitation Hospital,Taizhou Enze Medical Center,Taizhou 318050,Zhejiang Province,China)

机构地区：[1]浙江省台州医院重症医学科/重症康复科,浙江台州318050 [2]台州市康复医院重症医学科/重症康复科,浙江台州318050

出　　处：《药学前沿》2025年第3期444-450,共7页China Pharmacist

基　　金：台州市科技计划项目(1902ky70)。

摘　　要：目的探究双歧杆菌三联活菌胶囊(BVC)联合经颅直流电刺激(tDCS)对脑卒中后认知障碍(PSCI)患者的疗效。方法本研究回顾性纳入了2022年1月至2024年1月台州市康复医院诊疗的PSCI患者。根据治疗方案分为联合组(BVC联合tDCS)和tDCS组(tDCS)。疗效指标在4周后进行评估,包括临床有效率、认知功能[简易智力状态检查量表(MMSE)]评分和[蒙特利尔认知评估量表(MoCA)]评分、睡眠质量[匹兹堡睡眠质量指数(PSQI评分)]、生活质量[卒中专用生活质量量表(SS-QOL)评分]和神经生化指标[同型半胱氨酸(Hcy)、脑源性神经营养因子(BDNF)和神经元特异性烯醇化酶(NES)]变化情况。结果研究共纳入95例患者,联合组53例,tDCS组42例。联合组临床有效率高于tDCS组(P<0.05)。治疗后,tDCS组和联合组MoCA评分、MMSE评分、SS-QOL评分较治疗前均显著上升(P<0.05),而PSQI评分较治疗前显著下降(P<0.05);此外,联合组MoCA评分、MMSE评分和SS-QOL评分显著高于tDCS组(P<0.05),而PSQI显著低于tDCS组(P<0.05)。联合组治疗后Hcy和NSE水平显著低于tDCS组,而BDNF水平显著高于tDCS组(P<0.05)。结论BVC联合tDCS治疗能显著改善PSCI的认知功能,提高睡眠质量和生活质量,其机制可能与下调神经递质水平有关。Objective To explore the efficacy of bifidobacterium triple viable capsules(BVC)combined with transcranial direct current stimulation(tDCS)in patients with post-stroke cognitive impairment(PSCI).Methods Patients diagnosed and treated with PSCI in Taizhou Rehabilitation Hospital between January 2022 and January 2024 were retrospectively included.They were divided into a combination group(BVC combined with tDCS)and a tDCS group(tDCS)according to the treatment regimens.Efficacy endpoints included clinical effective rate,as well as alterations in cognitive function(MMSE and MoCA scores),sleep quality(PSQI score),quality of life(SS-QOL score),the change of neurochemical indicators(Hcy,BDNF,and NES)were evaluated after 4 weeks.Results A total of 95 patients were included in the study,with 53 in the combination group and 42 in the tDCS group.The clinical effective rate in the combination group was significantly higher than that in the tDCS group(P<0.05).After treatment,the MoCA socre,MMSE score,and SS-QOL score in both groups increased significantly compared with the baseline values,whereas the PSQI score decreased significantly(P<0.05).In addition,the MoCA socre,MMSE score,and SS-QOL score in the combination group were significantly higher than those in the tDCS group(P<0.05),while the PSQI score was significantly lower than that in the tDCS group(P<0.05).Otherwise,the levels of Hcy and NSE in the combination group after treatment were significantly lower than those in the tDCS group(P<0.05),while the level of BDNF was significantly higher than that in the tDCS group(P<0.05).Conclusion BVC combined with tDCS can improve cognitive function,sleep quality,and quality of life in patients with PSCI effectively,which may be related to the downregulation of neurochemical levels.

关 键 词：益生菌 经颅直流电刺激 脑卒中后认知障碍 短期疗效 

分 类 号：R971[医药卫生—药品]