[针刺颅底周围改良穴位组合治疗中风后轻度认知障碍：一项随机对照试验]

[Acupuncture of revised acupoint combination around the skull base for post-stroke mild cognitive impairment: a randomized controlled trial].

作者信息

Li Zi-Ting, Ban Lin-Qiang, Chen Feng

机构信息

Graduate School, Beijing University of CM, Beijing 100029,China; Department of Acupuncture and Moxibustion, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing 100102.

Graduate School, Beijing University of CM, Beijing 100029,China.

出版信息

Zhongguo Zhen Jiu. 2023 Oct 12;43(10):1104-8. doi: 10.13703/j.0255-2930.20221231-0002.

DOI:10.13703/j.0255-2930.20221231-0002

PMID:37802513

Abstract

OBJECTIVE

To observe the clinical efficacy of acupuncture of revised acupoint combination around the skull base in treating post-stroke mild cognitive impairment (PSMCI), and preliminary explore its action mechanism.

METHODS

A total of 76 PSMCI patients were randomly divided into an observation group (38 cases, 4 cases dropped off) and a control group (38 cases, 3 cases dropped off, 1 case was removed). In the observation group, acupuncture of revised acupoint combination around the skull base (bilateral Fengchi [GB 20], Wangu [GB 12], Tianzhu [BL 10] and Yamen [GV 15], Baihui [GV 20]) was used for treatment. In the control group, 8 non-meridian and non-acupoint points at the distal end were selected for shallow puncture treatment. Retaining the needles of 30 min, once every other day,3 times a week for 4 weeks in both groups. The scores of Montreal cognitive assessment (MoCA), mini-mental state examination (MMSE), Barthel index (BI) and serum levels of cystatin C (Cys-C) and homocysteine (Hcy) were compared in the two groups before and after treatment, and the clinical efficacy was evaluated.

RESULTS

After treatment, the scores of MoCA were increased compared with those before treatment in the two groups (<0.05), and the score in the observation group was higher than that in the control group (<0.05). The scores of MMSE and BI were increased compared with those before treatment in the observation group (<0.05), and the score of MMSE in the observation group was higher than that in the control group (<0.05). After treatment, the serum levels of Cys-C and Hcy were decreased compared with those before treatment in the observation group (<0.05), and lower than those in the control group (<0.05). After treatment, the serum level of Cys-C was increased compared with that before treatment in the control group (<0.05). The total effective rate of the observation group was 88.2% (30/34), which was higher than 32.4% (11/34) of the control group (<0.05).

CONCLUSION

Acupuncture of revised acupoint combination around the skull base can improve cognitive function and daily living ability of PSMCI patients, which may be related to the down regulation of serum levels of Cys-C and Hcy.

摘要

目的

观察改良颅底周围穴位组合针刺治疗脑卒中后轻度认知障碍（PSMCI）的临床疗效，并初步探讨其作用机制。

方法

将76例PSMCI患者随机分为观察组（38例，脱落4例）和对照组（38例，脱落3例，剔除1例）。观察组采用改良颅底周围穴位组合针刺治疗（双侧风池[GB 20]、完骨[GB 12]、天柱[BL 10]、哑门[GV 15]、百会[GV 20]）。对照组选取远端8个非经非穴点行浅刺治疗。两组均留针30分钟，隔日1次，每周3次，共治疗4周。比较两组治疗前后蒙特利尔认知评估（MoCA）、简易精神状态检查表（MMSE）、Barthel指数（BI）评分及血清胱抑素C（Cys-C）、同型半胱氨酸（Hcy）水平，并评价临床疗效。

结果

治疗后，两组MoCA评分均较治疗前升高（<0.05），且观察组高于对照组（<0.05）。观察组MMSE、BI评分较治疗前升高（<0.05），且观察组MMSE评分高于对照组（<0.05）。治疗后，观察组血清Cys-C、Hcy水平较治疗前降低（<0.05），且低于对照组（<0.05）。治疗后，对照组血清Cys-C水平较治疗前升高（<0.05）。观察组总有效率为88.2%（30/34），高于对照组的32.4%（11/34）（<0.05）。