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头皮针联合认知训练对脑卒中患者认知和运动功能的影响。

The effect of combined scalp acupuncture and cognitive training in patients with stroke on cognitive and motor functions.

机构信息

Department of Physical Medicine and Rehabilitation, Zhongnan Hospital of Wuhan University, Wuhan, China.

Department of Physical Medicine and Rehabilitation, Wuhan Hospital of Traditional Chinese and Western Medicine, Wuhan, China.

出版信息

NeuroRehabilitation. 2020;46(1):75-82. doi: 10.3233/NRE-192942.

Abstract

OBJECTIVE

To investigate the effect of combined scalp acupuncture and cognitive training on cognitive and motor functioning in patients with stroke during the recovery stage.

METHODS

Seventy patients with post-stroke cognitive impairment were randomly divided into an experimental group and a control group. Patients in the experimental group additionally received scalp acupuncture and cognitive training, while the control group received sham scalp acupuncture and cognitive training. The cognitive and motor functioning of all patients were assessed using MMSE, LOTCA, and FMA, before and 12 weeks after treatment. In addition, the plasma BDNF and NGF levels were measured from peripheral blood samples using ELISA kits.

RESULTS

After 12 weeks, the MMSE, LOTCA and FMA scores were significantly higher in the experimental group than in the control group. In the experimental group, there was an improvement in the total MMSE score, orientation, spatial executive function, the total LOTCA score, and the score of command of language orientation post-treatment. Significant improvements of BDNF and NGF were found in the experimental group after treatment, while only significant improvements of NGF was found in the control group after treatment. Both BDNF and NGF in the experiment group were higher than those in the control group at the last day of treatment.

CONCLUSIONS

Combined scalp acupuncture and cognitive training can efficiently enhance cognitive and motor functions in patients with stroke during the recovery stage, which may be a more effective rehabilitation treatment after stroke than routine therapy and rehabilitation training alone.

摘要

目的

研究头部针刺联合认知训练对恢复期脑卒中患者认知和运动功能的影响。

方法

将 70 例脑卒中后认知障碍患者随机分为实验组和对照组。实验组患者在接受认知训练的同时还接受头部针刺治疗,对照组患者则接受假头部针刺和认知训练。治疗前和治疗 12 周后,采用简易精神状态检查量表(MMSE)、洛文斯顿认知测验(LOTCA)和 Fugl-Meyer 运动功能评估量表(FMA)评估所有患者的认知和运动功能。此外,采用酶联免疫吸附试验(ELISA)试剂盒检测外周血样本中的血浆 BDNF 和 NGF 水平。

结果

治疗 12 周后,实验组的 MMSE、LOTCA 和 FMA 评分均明显高于对照组。实验组患者的 MMSE 总分、定向力、空间执行功能、LOTCA 总分和语言定向指令得分在治疗后均有所改善。实验组治疗后 BDNF 和 NGF 均显著升高,而对照组治疗后仅 NGF 显著升高。实验组治疗结束时的 BDNF 和 NGF 均高于对照组。

结论

头部针刺联合认知训练可有效提高恢复期脑卒中患者的认知和运动功能,是脑卒中后比常规治疗和康复训练更有效的康复治疗方法。

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