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针刺联合热敏灸治疗卒中后认知障碍的临床观察

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目的 观察"三通醒脑针法"联合热敏灸治疗卒中后认知功能障碍(post-stroke cognitive impairment,PSCI)的临床疗效.方法 将 90 例PSCI患者随机分为针刺组、热敏灸组和联合组,每组 30 例.3 组均予常规内科和康复治疗,在此基础上,针刺组予"三通醒脑"针刺治疗,热敏灸组给予单纯热敏灸治疗,联合组予"三通醒脑"针刺治疗联合热敏灸治疗.观察 3 组治疗前后简易精神状态检查(mini-mental state examiniation,MMSE)、蒙特利尔认知评估(Montreal cognitive assessment,MoCA)评分、改良Barthel指数(modified Barthel index,MBI)评分、听觉事件相关电位 P300 的波幅和潜伏期、血清同型半胱氨酸(homocysteine,Hcy)和白细胞介素-6(interleukin-6,IL-6)水平变化.结果 3 组治疗后MoCA、MMSE和MBI评分高于治疗前,联合组高于针刺组和热敏灸组,差异有统计学意义(P<0.05).3 组治疗后P300 潜伏期缩短,波幅延长;联合组P300 潜伏期短于针刺组和热敏灸组,波幅长于针刺组和热敏灸组,差异有统计学意义(P<0.05).3组治疗后血清Hcy和IL-6水平均降低,联合组低于针刺组和热敏灸组,差异有统计学意义(P<0.05).结论 在常规内科和康复治疗基础上,"三通醒脑针法"联合热敏灸有助于提高PSCI患者认知功能及日常生活能力.
Clinical observation of acupuncture combined with heat-sensitive moxibustion in the treatment of post-stroke cognitive impairment
Objective To observe the clinical efficacy of"San Tong Xing Nao acupuncture"combined with heat-sensitive moxibustion in the treatment of post-stroke cognitive impairment(PSCI).Method Ninety patients with PSCI were randomly divided into the acupuncture group,the thermal moxibustion group and the combined group,with 30 cases in each group.Patients in each of the three groups were treated with conventional internal medicine and rehabilitation,based on which,the acupuncture group was treated with"San Tong Xing Nao"acupuncture,the heat-sensitive moxibustion group was treated with heat-sensitive moxibustion,and the combined group was treated with"San Tong Xing Nao"acupuncture combined with heat-sensitive moxibustion.The mini-mental state examination(MMSE),Montreal cognitive assessment(MoCA),modified Barthel index(MBI)score,amplitude and latency of auditory event-related potential P300,and changes in serum homocysteine(Hcy)and interleukin-6(IL-6)levels were observed in the three groups before and after treatment.Result The MoCA,MMSE and MBI scores of the three groups were higher than those before treatment,and those in the combined group were higher than those in the acupuncture and heat-sensitive moxibustion groups,with statistically significant differences(P<0.05).The P300 latency of the combined group was shorter than that of the acupuncture group and heat-sensitive moxibustion group,and the amplitude of P300 in the combined group was longer than that in the acupuncture and heat-sensitive moxibustion groups;the differences were statistically significant(P<0.05).Serum Hcy and IL-6 levels were reduced in the three groups after treatment,and those in the combined group was lower than those in the acupuncture and heat-sensitive moxibustion groups;the difference was statistically significant(P<0.05).Conclusion The combination of heat-sensitive moxibustion with"San Tong Xing Nao acupuncture"on the basis of conventional internal medicine and rehabilitation treatment can help to improve the cognitive function and daily life ability of PSCI patients.

Acupuncture-moxibustion therapyHeat-sensitive moxibustionAcupuncture-medication combinedPost-stroke sequelaeCognitive impairment

施凤飞、鲍杰伟、张衍辉、邹坤、刘清、康明非

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江西中医药大学附属医院,南昌 330000

针灸疗法 热敏灸 针药并用 中风后遗症 认知障碍

2025

上海针灸杂志
福建省水利学会

上海针灸杂志

影响因子:1.273
ISSN:1005-0957
年,卷(期):2025.44(1)