温针督脉联合感觉统合训练在脑梗死认知障碍患者中的临床研究

Clinical study of warm acupuncture combined with sensory integration training in cerebral infarction patients with cognitive impairment

关键词:  温针督脉  感觉统合训练  脑梗死  认知障碍

Key words:  warm needle governor pulse  sensory integration training  cerebral infarction  cognitive impairment

摘要:

[目的] 探讨温针督脉联合感觉统合训练在脑梗死认知障碍患者中的临床疗效。[方法] 选取2022年1月—2023年1月南京中医药大学连云港附属医院脑梗死认知障碍患者98例，根据计算机随机数字法随机分为观察组和对照组，每组各49例。对照组给予感觉统合训练，观察组给予温针督脉联合感觉统合训练。治疗3个月后评价疗效。治疗前、治疗3个月评估中医证候积分，采用蒙特利尔认知评估量表（MoCA）、Rivermead行为记忆测验第2版（RBMT-Ⅱ）评估认知功能，采用美国国立研究所卒中量表（NIHSS）评估神经功能缺损程度，检查脑血流量灌注参数脑血容量（CBV）、脑血流量（CBF）、达峰时间（TTP）、平均通过时间（MTT）和神经传导功能，统计两组治疗期间不良反应。[结果] 观察组中医证候疗效总有效率为95.92%，高于对照组73.47%（P＜0.05）。治疗3个月两组中医证候积分、NIHSS评分均降低，MoCA、RBMT-Ⅱ评分升高；组间比较，观察组中医证候积分、NIHSS评分低于对照组，MoCA、RBMT-Ⅱ评分高于对照组（P＜0.05）。治疗3个月两组CBV、CBF较治疗前增加，TTP、MTT较治疗前缩短（P＜0.05）；组间比较，观察组CBF大于对照组，TTP短于对照组（P＜0.05）。治疗3个月两组P300潜伏期、（δ+θ）/（α+β）比值小于治疗前，P300波幅大于治疗前；组间比较，观察组P300潜伏期、（δ+θ）/（α+β）比值小于对照组，P300波幅大于对照组（P＜0.05）。[结论] 温针督脉联合感觉统合训练治疗脑梗死认知障碍效果显著，可有效减轻患者症状及认知功能障碍，降低神经功能缺损程度，改善脑血流量灌注，并有助于促进神经传导功能恢复。

Abstract:

[Objective] To explore the clinical effect of warm acupuncture combined with sensory integration training on cerebral infarction patients with cognitive impairment. [Methods] Ninety-eight patients with cerebral infarction and cognitive impairment in Nanjing University of Chinese Medicine Lianyungang Affiliated Hospital from January 2022 to January 2023 were selected and divided into observation group and control group according to computer random number method,49 cases in each group. The control group was given sensory integration training,and the observation group was given warm acupuncture combined sensory integration training. The curative effect was evaluated after 3 months of treatment. TCM syndrome scores were assessed before treatment and 3 months after treatment. Montreal Cognitive Assessment Scale(MoCA) and Rivermead Behavioral Memory Test Second version(RBMT-Ⅱ) were used to assess cognitive function. National Institute of Stroke Scale(NIHSS) was used to assess the degree of neurological impairment. Cerebral blood flow perfusion parameters Cerebral blood volume(CBV),cerebral blood flow(CBF),peak time(TTP),mean transit time(MTT) and nerve conduction function were examined. [Results] The total effective rate of traditional Chinese medicine syndrome in the observation group was 95.92%,which was higher than 73.47% in the control group (P<0.05). After 3 months of treatment,TCM syndrome scores and NIHSS scores of both groups decreased,while MoCA and RBMT-Ⅱ scores increased. Compared between groups,TCM syndrome scores and NIHSS scores of the observation group were lower than those of the control group,while MoCA and RBMT-Ⅱ scores were higher than those of the control group (P<0.05). After 3 months of treatment,CBV and CBF in both groups were increased and TTP and MTT were shortened compared with those before treatment (P<0.05). Compared between groups,CBF in observation group was greater than that in control group,and TTP was shorter than that in control group(P<0.05). After 3 months of treatment,the P300 latency and(δ+θ)/(α+β) ratio of the two groups were smaller than before treatment,and the P300 amplitude was larger than before treatment. Compared between groups,the P300 latency and (δ+θ)/(α+β) ratio of the observation group were smaller than the control group,and the P300 amplitude was larger than the control group(P<0.05). [Conclusion] Warm acupuncture combined with sensory integration training has a significant effect on cognitive impairment in cerebral infarction,and it can effectively reduce symptoms and cognitive dysfunction,reduce the degree of neurological impairment,improve cerebral blood flow perfusion,and help promote the recovery of nerve conduction function.