首页|头皮针治疗缺血性脑卒中后认知功能障碍之探讨

头皮针治疗缺血性脑卒中后认知功能障碍之探讨

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脑卒中具有高发病率、高病死率、高致残率、高复发率,缺血性卒中占比更高,而其后遗症较为复杂,往往包括运动障碍、语言障碍、认知障碍、精神障碍等,其中认知功能恢复与改善往往容易被忽略,随着病情进展,演变为血管性痴呆,严重影响患者的生活质量.因此,超早期干预缺血性脑卒中,对于改善疾病预后及患者的认知功能具有重要意义.目前国内外治疗卒中后认知减退以药物疗法为主,所用药物包括中药、胆碱酯酶抑制剂、抗抑郁药物、脑保护剂等,以及非药物疗法,包括针灸推拿、运动疗法、作业疗法、高压氧、重复经颅电刺激等.其中,针灸疗法是具有中医特色的防治手段,能够疏通经络、调和阴阳,历年研究提示针灸治疗中风及认知障碍均具有确切疗效,而对于脑源性疾病,头皮针疗效独特.目前科室研究头皮针联合中西药对于急性脑缺血性卒中患者磁共振波谱及认知功能的影响,头皮针选穴以四神聪穴、百会穴、头维穴、神庭穴、本神穴、风池穴、风府穴为主.文章从选穴中医理论以及卒中后认知功能减退机制出发,将传统中医与现代医学结合,经络理论与血流神经分布、大脑皮层功能相联系,探讨课题所选用头皮针改善缺血性脑卒中后认知功能的相关理论,以期打好基础,为中医治疗卒中后认知功能的恢复提供一定的思路.
The effect of scalp acupuncture on post ischemic stroke cognitive impairment
Stroke has high incidence,high mortality,high disability,and high recurrence rates,and ischemic stroke holds a higher proportion.The sequelae are more complex,often including dyskinesia,lalopathy,cognitive disorders,mental disorders,etc.,among which the recovery and improvement of cognitive function are often overlooked,and with the progression of the disease,it will evolve into vascular dementia,which seriously affects the quality of life of patients.Therefore,ultra-early intervention in stroke is of great significance for ameliorating disease prognosis and cognitive function of patients.At present,the treatment method of post-stroke cognitive impairment is mainly drug therapy,including traditional Chinese medicinal materials,cholinesterase inhibitors,antidepressants,brain protective agents,etc.,as well as non-drug therapy,including acupuncture and massage,exercise therapy,occupational therapy,hyperbaric oxygen,repetitive transcranial electrical stimulation,etc..Among them,acupuncture and moxibustion therapy is a prevention and treatment method with TCM characteristics,which can dredge meridians and collaterals,regulate Yinyang(阴 阳).Studies over the years have suggested that acupuncture and moxibustion have a definite effect on stroke and cognitive impairment,and scalp acupuncture has a unique effect on brain-derived diseases.At present,our department researches the effect of scalp acupuncture plus medicine on magnetic resonance spectroscopy and cognitive function in acute cerebral ischemic stroke patients,and the points selected for scalp acupuncture are mainly Sishencong(EX-HN1),Baihui(DU20),Touwei(ST8),Shenting(DU24),Benshen(GB13),Fengchi(GB20)and Fengfu(DU16).And the mechanism of post-stroke cognitive impairment,this paper combines TCM with modern medicine,connects meridian theory with blood flow nerve distribution and cerebral cortex function,and discusses the relevant theory of acupuncture selected for improving cognitive function of ischemic stroke patients,in order to lay a good foundation and provide some ideas for treating cognitive impairment after stroke in TCM.

Scalp acupunctureIschemic strokeCognitive function

吴炜、王传兰、于建锋、陶燕华、彭飞、张丽、季艳、朱敏、庄向东

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江苏省南通市通州区中医院,江苏 南通,226300

头皮针 缺血性脑卒中 认知功能

南通市社会民生科技计划课题基金资助项目

MS1202104

2024

中医临床研究
中华中医药学会

中医临床研究

影响因子:0.839
ISSN:1674-7860
年,卷(期):2024.16(2)
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