Clinical study of acupuncture plus cognitive training for mild-to-moderate poststroke cognitive impairment  

针刺联合认知训练治疗脑卒中后轻中度认知障碍的临床研究

作　　者：JIANG Xiaofen XU Qiong JIN Yinghao 姜小芬;徐琼;金英豪

机构地区：[1]Zhejiang Jinhua Dongyang Huayuan Tianshi Hospital,Dongyang 322100,China

出　　处：《Journal of Acupuncture and Tuina Science》2025年第2期144-150,共7页针灸推拿医学(英文版)

摘　　要：Objective:To observe the clinical efficacy of acupuncture combined with cognitive training in treating mild-tomoderate poststroke cognitive impairment and the impact on cognitive function and cerebral blood flow.Methods:Eighty-eight participants with mild-to-moderate cognitive impairment after a stroke were allocated to an observation group and a control group using the random number table method,each consisting of 44 cases.The two groups received the same conventional symptomatic treatment.In addition,the control group was intervened by cognitive training,and the observation group by cognitive training and Tong Du Xing Shen(unblocking the Governor Vessel and awakening the mind)acupuncture.The intervention lasted 4 weeks in both groups.By the end of the intervention,the two groups were observed for clinical efficacy and the improvements in the symptom score of traditional Chinese medicine(TCM),cognitive function[mini-mental state examination(MMSE)and Montreal cognitive assessment(MoCA)],cerebral blood flow velocities[cerebral vascular resistance index(RI),arterial blood flow mean velocity(Vm),and arterial systolic velocity(Vs)],and serum biomarkers of neurological deficit[neuron-specific enolase(NSE)and S100βprotein(S100β)].Results:During the observation,each group had 2 eliminated cases.After the intervention,the observation group achieved a total effective rate of 90.5%,higher than that in the control group,which was 73.8%(P<0.05);increases were found in the MMSE and MoCA scores in both groups(P<0.05),and the observation group was higher than the control group(P<0.05);in contrast,decreases were found in the levels of RI and serum NSE and S100β(P<0.05),and the observation group was lower than the control group(P<0.05);the Vs and Vm levels increased in both groups(P<0.05)and were higher in the observation group than in the control group(P<0.05).Conclusion:Tong Du Xing Shen acupuncture plus cognitive training is effective in treating mild-to-moderate poststroke cognitive impairment and can enhance the patient�目的:观察针刺联合认知训练治疗脑卒中后轻中度认知障碍的临床疗效及对认知功能和脑血流的影响。方法:采用随机数字表法将88例脑卒中后轻中度认知障碍患者分为观察组和对照组,每组44例。两组均接受相同的常规对症治疗。对照组接受认知训练,观察组在对照组基础上加用通督醒神针刺治疗。两组均治疗4周。疗程结束后评估两组临床疗效、中医症状评分、认知功能[简易智力状态评价量表(MMSE)和蒙特利尔认知评估量表(MoCA)]、脑血流速度[大脑血管阻力指数(RI)、脑动脉血流平均流速(Vm)、动脉血流量最大峰值(Vs)]及血清神经损伤标志物[神经元特异性烯醇化酶(NSE)、S100β蛋白(S100β)]的改善情况。结果:研究过程中对照组剔除2例,观察组剔除2例。治疗后,观察组总有效率90.5%,高于对照组的73.8%(P<0.05);两组MMSE和MoCA评分均较治疗前升高(P<0.05),观察组均高于对照组(P<0.05),RI及血清NSE、S100β水平均较治疗前降低(P<0.05),观察组均低于对照组(P<0.05);两组Vs、Vm水平均较治疗前提高(P<0.05),观察组均高于对照组(P<0.05)。结论:通督醒神针刺法联合认知训练治疗脑卒中后轻中度认知障碍疗效确切,可提高患者的认知功能;其作用机制可能与改善脑部血液循环,减轻脑神经损伤有关。

关 键 词：Acupuncture Therapy Cognitive Training Poststroke Syndrome Cognitive Dysfunction Cerebrovascular Circulation Blood Flow Velocity Randomized Controlled Trial 

分 类 号：R246.6[医药卫生—针灸推拿学]