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低频重复经颅磁刺激联合醒脑开窍针刺改善脑卒中后认知障碍,具有较好的临床疗效。

Low frequency-repetitive transcranial magnetic stimulation combined with Xingnao Kaiqiao acupuncture improves post-stroke cognitive impairment and has better clinical efficacy.

作者信息

Xun Xiao, Liu Yanhong, Pan Weimin, Tang Lang, Hu Changling, Ouyang Hua, Liu Qiu, Zeng Hongliang, Li Dan

机构信息

Department of Acupuncture and Moxibustion Massage Rehabilitation, Integrated Traditional Chinese and Western Medicine Second Hospital Affiliated with Hunan University of Chinese Medicine, Liuyang, China.

Liling Traditional Chinese Medicine Hospital, Liling, China.

出版信息

Psychogeriatrics. 2025 Jan;25(1):e13199. doi: 10.1111/psyg.13199. Epub 2024 Oct 27.

Abstract

BACKGROUND

Enhancing post-stroke cognitive impairment (PSCI) is a key aspect of prognosis for stroke patients. Low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) is currently a widely utilised method for treating PSCI. With the increasing promotion of traditional Chinese medicine, Xingnao Kaiqiao (XNKQ) acupuncture has been progressively incorporated into clinical treatment. This paper observes the effect of LF-rTMS with XNKQ acupuncture on patients with PSCI.

METHODS

Totally, 192 patients with PSCI were consecutively recruited and treated either with LF-rTMS and XNKQ acupuncture (observation group) or LF-rTMS only (control group) for 4 weeks. The pre- and post-treatment Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores, P300 latency and amplitude, inflammatory factor levels were compared and clinical efficacy was assessed.

RESULTS

Both groups exhibited increased MMSE/MoCA scores, and P300 amplitude, and shortened P300 latency, and the observation group had higher scores and P300 amplitude, and shorter P300 latency than the control group. Both groups displayed decreased inflammatory factor levels (Tumour necrosis factor-α, interleukin (IL)-6, IL-10, IL-1β) after treatment, which were lower in the observation group than the control group. Inflammatory factor levels in PSCI patients were negatively interrelated with MMSE, MoCA score and P300 amplitude, and positively with P300 latency. The observation group showed an increased number of patients showing cured and significantly effective results, a decreased number of patients showing effective and invalid results, and an observably elevated total effective rate.

CONCLUSION

LF-rTMS with XNKQ acupuncture can improve cognitive function and reduce inflammatory immune response, and has better clinical efficacy in PSCI patients.

摘要

背景

改善卒中后认知障碍(PSCI)是卒中患者预后的关键环节。低频重复经颅磁刺激(LF-rTMS)是目前治疗PSCI广泛应用的方法。随着中医药的日益推广,醒脑开窍(XNKQ)针刺已逐渐纳入临床治疗。本文观察LF-rTMS联合XNKQ针刺对PSCI患者的疗效。

方法

连续纳入192例PSCI患者,分别采用LF-rTMS联合XNKQ针刺(观察组)或仅采用LF-rTMS(对照组)治疗4周。比较治疗前后简易精神状态检查表(MMSE)和蒙特利尔认知评估量表(MoCA)评分、P300潜伏期和波幅、炎症因子水平,并评估临床疗效。

结果

两组患者MMSE/MoCA评分、P300波幅均升高,P300潜伏期缩短,且观察组评分及P300波幅更高,P300潜伏期更短。两组患者治疗后炎症因子水平(肿瘤坏死因子-α、白细胞介素(IL)-6、IL-10、IL-1β)均降低,且观察组低于对照组。PSCI患者炎症因子水平与MMSE、MoCA评分及P300波幅呈负相关,与P300潜伏期呈正相关。观察组治愈和显效患者数量增加,有效和无效患者数量减少,总有效率显著提高。

结论

LF-rTMS联合XNKQ针刺可改善认知功能,减轻炎症免疫反应,对PSCI患者具有更好的临床疗效。

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