电针结合认知训练治疗脑卒中后认知障碍患者拔针后留置针的多中心随机对照试验。

Needle retaining after electroacupuncture combined with cognitive training for post-stroke cognitive impairment: a multi-center randomized controlled trial.

机构信息

Rehabilitation Center, First Affiliated Hospital of Henan University of CM, Zhengzhou 450000, China.

Department of Rehabilitation, Henan Province Hospital of TCM.

出版信息

Zhongguo Zhen Jiu. 2023 Oct 11;43(11):1221-1225. doi: 10.13703/j.0255-2930.20221115-k0008.

DOI:10.13703/j.0255-2930.20221115-k0008

PMID:37984918

Abstract

OBJECTIVES

To compare the efficacy of needle retaining after electroacupuncture combined with cognitive training and electroacupuncture combined with cognitive training in the treatment of post-stroke cognitive impairment (PSCI).

METHODS

A total of 206 patients with PSCI were randomized into a needle retaining group (103 cases, 9 cases dropped out) and an electroacupuncture group (103 cases, 6 cases dropped out). In addition to the conventional basic medical treatment and the rehabilitation treatment, in the needle retaining group, electroacupuncture at Shenting (GV 24) and Baihui (GV 20) was applied, with continuous wave of 50 Hz in the first 15 min and with disperse-dense wave of 2 Hz/50 Hz in the last 15 min, the needles were continuously retained for 1 h after electroacupuncture, during which cognitive training was adopted; in the electroacupuncture group, cognitive training was performed after the same electric stimulation exerted for 30 min, without additional needles retaining. The treatment was given once a day, 5 times a week for totally 8 weeks in the two groups. Before and after 8-week treatment, the TCM syndrome score was observed; before and after 4,8-week treatment, the scores of mini-mental state examination (MMSE), Montreal cognitive assessment (MoCA) and ability of daily living were observed in the two groups. The clinical efficacy of the two groups was evaluated after 8-week treatment.

RESULTS

After 8-week treatment, the TCM syndrome scores were increased compared with those before treatment in both groups (<0.05); the TCM syndrome score in the needle retaining group was higher than that in the electroacupuncture group (<0.05).After 4,8-week treatment, the scores of MMSE, MoCA and ability of daily living were increased compared with those before treatment in both groups (<0.05); MMSE, MoCA scores after 4,8-week treatment and ability of daily living score after 8-week treatment in the needle retaining group were higher than those in the electroacupuncture group (<0.05). The total effective rate was 90.4% (85/94) in the needle retaining group, which was superior to 82.5% (80/97) in the electroacupuncture group (<0.05).

CONCLUSIONS

Both needle retaining after electroacupuncture combined with cognitive training and electroacupuncture combined with cognitive training can effectively treat PSCI, improve the clinical symptom, cognitive function and ability of daily living in PSCI patients. Needle retaining after electroacupuncture combined with cognitive training has a better therapeutic effect.

摘要

目的

比较电针留针结合认知训练与电针结合认知训练治疗脑卒中后认知障碍（PSCI）的疗效。

方法

将 206 例 PSCI 患者按随机数字表法分为留针组（103 例，脱落 9 例）和电针组（103 例，脱落 6 例）。两组均给予常规基础治疗和康复治疗，留针组在常规治疗基础上加用电针（百会穴 GV 20、神庭穴 GV 24）治疗，电针采用疏密波（2 Hz/50 Hz），先连续波 15 min，再疏密波 15 min，电针结束后留针 1 h 并结合认知训练，电针组在常规治疗基础上加用电针（百会穴 GV 20、神庭穴 GV 24）治疗，电针采用连续波（50 Hz），治疗 30 min 后结合认知训练，两组均每天治疗 1 次，每周治疗 5 次，共治疗 8 周。于治疗前、治疗 8 周后观察两组中医证候积分，于治疗前、治疗 4、8 周后观察两组简易精神状态检查量表（MMSE）、蒙特利尔认知评估量表（MoCA）及日常生活能力量表评分，于治疗 8 周后评价两组临床疗效。

结果

治疗 8 周后，两组中医证候积分均较治疗前升高（P<0.05），且留针组高于电针组（P<0.05）；治疗 4、8 周后，两组 MMSE、MoCA 及日常生活能力量表评分均较治疗前升高（P<0.05），留针组治疗 4、8 周后 MMSE、MoCA 评分及治疗 8 周后日常生活能力量表评分均高于电针组（P<0.05）；留针组总有效率为 90.4%（85/94），高于电针组的 82.5%（80/97）（P<0.05）。