首页|补阳还五汤加减联合针刺、低频重复经颅磁刺激治疗脑卒中后认知障碍临床研究

补阳还五汤加减联合针刺、低频重复经颅磁刺激治疗脑卒中后认知障碍临床研究

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目的:观察补阳还五汤加减联合针刺、低频重复经颅磁刺激(rTMS)治疗脑卒中后认知障碍的临床疗效。方法:选取2022年7月—2023年7月于杭州市上城区人民医院治疗的脑卒中后认知障碍患者96例,按随机数字表法分为对照组和观察组各48例。对照组采用rTMS治疗,观察组在对照组基础上采用补阳还五汤加减联合针刺治疗,2组均治疗6周。比较2组临床疗效、中医证候评分、认知功能、血液流变学指标及不良反应发生率。结果:观察组总有效率为95。83%(46/48),高于对照组81。25%(39/48)(P<0。05)。治疗后,2组各项中医证候评分较治疗前降低(P<0。05),且观察组各项中医证候评分低于对照组(P<0。05)。治疗后,2组蒙特利尔认知评估量表(MoCA)评分较治疗前升高(P<0。05),且观察组MoCA评分高于对照组(P<0。05)。治疗后,2组纤维蛋白原(Fib)、血浆黏度及红细胞比容(HCT)水平较治疗前降低(P<0。05),且观察组Fib、血浆黏度及HCT水平低于对照组(P<0。05)。2组不良反应发生率比较,差异无统计学意义(P>0。05)。结论:补阳还五汤加减联合针刺、rTMS治疗脑卒中后认知障碍效果较好,可改善患者临床症状,提高认知功能,改善血液循环,安全性较高。
Clinical Study on Combination Use of Modified Buyang Huanwu Decoction and Acupuncture and Low-Frequency Repetitive Transcranial Magnetic Stimulation for Post-Stroke Cognitive Disorder
Objective:To observe the clinical effect of the combination use of modified Buyang Huanwu Decoction and acupuncture and low-frequency repetitive transcranial magnetic stimulation(rTMS)on post-stroke cognitive disorder.Methods:A total of 96 patients with post-stroke cognitive disorder treated in Hangzhou Shangcheng District People's Hospital from July 2022 to July 2023 were selected and divided into the control group and the observation group according to the random number table method,with 48 cases in each group.The control group was treated with rTMS,and the observation group was additionally treated with modified Buyang Huanwu Decoction combined with acupuncture based on the treatment of the control group.Both groups were treated for six weeks.The clinical effect,traditional Chinese medicine syndrome scores,cognitive function,hemorheology indexes and incidence of adverse reactions were compared between the two groups.Results:The total effective rate was 95.83%(46/48)in the observation group,higher than that of 81.25%(39/48)in the control group(P<0.05).After treatment,the traditional Chinese medicine syndrome scores in the two groups were dwindled when compared with those before treatment(P<0.05),and the above scores in the observation group were lower than those in the control group(P<0.05).After treatment,the scores of Montreal Cognitive Assessment(MoCA)in the two groups were elevated when compared with those before treatment(P<0.05),and the MoCA score in the observation group was higher than that in the control group(P<0.05).After treatment,the levels of fibrinogen(Fib),plasma viscosity and hematocrit(HCT)in the two groups were down-regulated when compared with those before treatment(P<0.05),and the above three levels in the observation group were lower than those in the control group(P<0.05).There was no significant difference being found in the comparison of the incidence of adverse reactions between the two groups(P>0.05).Conclusion:The combination use of modified Buyang Huanwu Decoction and acupuncture and rTMS has a great curative effect on post-stroke cognitive disorder,which can improve the clinical symptoms,cognitive function and blood circulation with great safety.

Post-stroke cognitive disorderBuyang Huanwu DecoctionAcupunctureLow-frequency repetitive transcranial magnetic stimulationTraditional Chinese medicine syndrome scoresCognitive functionHemorheology indexes

沈海锋、郭根平、孙赟、殷子杰

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杭州市上城区人民医院/杭州烧伤专科医院综合康复科,浙江 杭州 310020

浙江大学医学院附属第二医院城东院区中医康复科,浙江 杭州 310017

脑卒中后认知障碍 补阳还五汤 针刺 低频重复经颅磁刺激 中医证候评分 认知功能 血液流变学指标

2025

新中医
广州中医药大学 中华中医药学会

新中医

影响因子:0.595
ISSN:0256-7415
年,卷(期):2025.57(1)