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基于肠道菌群理论探讨温针灸对卒中后认知障碍的影响

Effects of warm acupuncture on post-stroke cognitive impairment based on the theory of intestinal flora

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目的 以肠道菌群理论为基础,观察温针灸对卒中后认知障碍(PSCI)的疗效.方法 随机对照试验研究.选择2020年10月—2022年6月新疆医科大学第一附属医院针灸推拿科及神经内科60例PSCI患者作为观察对象,采用随机数字表法分为2组,每组30例.在认知康复训练基础上,治疗组给予温针灸,对照组给予常规针刺治疗.2组均1周为1个疗程,共治疗4个疗程.分别于治疗前后采用蒙特利尔认知评估量表(MoCA)评估患者认知功能,简易智力状态检查量表(MMSE)评估患者智力水平;计算粪便样本中双歧杆菌、乳酸菌数量;采用ELISA法检测血浆γ-氨基丁酸(GABA)水平,评价临床疗效.结果 研究过程中,2组各脱落1例,最终各有29例患者进入疗效统计.治疗组总有效率为79.3%(23/29)、对照组为65.5%(19/29),2组比较差异有统计学意义(x2=43.39,P<0.05).治疗后,治疗组 MoCA评分[(24.23±1.36)分比(21.26±1.30)分,t=3.12]、MMSE评分[(25.35±1.24)分比(21.52±1.22)分,t=3.25]高于对照组(P<0.05);双歧杆菌[(9.20±1.25)LgCFU/g 比(7.23±1.21)LgCFU/g,t=2.98]、乳酸菌[(8.24±1.12)LgCFU/g 比(6.25±1.22)LgCFU/g,t=2.92]数量及GABA[(283.80±83.54)mmol/L 比(264.76±61.38)mmol/L,t=10.54]水平高于对照组(P<0.05或P<0.01).结论 温针灸可有效调节PSCI患者的肠道有益菌数量,升高GABA水平,促进脑组织修复,提高认知功能.
Objective To observe the effects of warm acupuncture on post-stroke cognitive impairment(PSCI)based on the theory of intestinal flora.Methods A randomized controlled trial was conducted.60 patients with PSCI in the Department of Acupuncture and Neurology of the First Affiliated Hospital of Xinjiang Medical University from October 2020 to June 2022 were selected as the observation objects,and were divided into 2 groups by random number table,with 30 cases in each group.On the basis of cognitive rehabilitation training,the treatment group was given warm acupuncture treatment,and the control group was given routine acupuncture treatment.2 groups were treated for 4 weeks as 1 course,and a total of 4 courses were treated.Montreal cognitive assessment(MoCA)was used to assess patients'cognitive function before and after treatment,and mini-mental state examination(MMSE)was used to assess patients'intelligence level.The numbers of bifidobacteria and lactic acid bacteria in fecal samples were calculated,and plasma gamma-aminobutyric acid(GABA)levels were detected by ELISA to evaluate the clinical efficacy.Results During the study,1 case was lost in each of the two groups,and finally 29 cases were included in the curative effect statistics.The total effective rate was 79.3%(23/29)in the treatment group and 65.5%(19/29)in the control group,with statistical significance(x2=43.39,P<0.05).After treatment,MoCA score[(24.23±1.36)vs.(21.26±1.30),t=3.12]and MMSE score[(25.35±1.24)vs.(21.52±1.22),t=3.25]in the treatment group were higher than those in the control group(P<0.05);Bifidobacterium[(9.20±1.25)LgCFU/g vs.(7.23±1.21)LgCFU/g,t=2.98],Lactic acid bacteria[(8.24±1.12)LgCFU/g vs.(6.25±1.22)LgCFU/g,t=2.92],and the level of GABA[(283.80± 83.54)mmol/L vs.(264.76±61.38)mmol/L,t=10.54]were higher than those in the control group(P<0.05 or P<0.01).Conclusion Warm acupuncture and moxibustion can effectively regulate the number of intestinal beneficial bacteria in PSCI patients,increase the level of GABA,promote brain tissue repair and improve cognitive function.

StrokeCognition disordersNeedle warming therapyGamma-aminobutyric acidGastrointestinal tractProbiotics

肖亚平、李秀娟、吴扬、苗紫烟、牛相来、周钰

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新疆医科大学第一附属医院针灸推拿科,乌鲁木齐 830011

卒中 认知障碍 温针疗法 γ-氨基丁酸 胃肠道 益生菌

国家自然科学基金新疆维吾尔自治区自然科学基金

819608982022D01C777

2024

国际中医中药杂志
中华医学会,中国中医科学院中医药信息研究所

国际中医中药杂志

CSTPCD
影响因子:0.411
ISSN:1673-4246
年,卷(期):2024.46(1)
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