化瘀通络灸结合针刺治疗脑卒中后轻度认知障碍的临床疗效观察

目的 观察化瘀通络灸法结合常规针刺治疗脑卒中后轻度认知障碍(mild cognitive impair-ment,MCI)患者的临床疗效及其对血液相关因子的影响.方法 将60例脑卒中后MCI患者随机分为对照组与观察组,每组30例.两组均采用常规治疗,观察组在此基础上加用化瘀通络灸法治疗.治疗2周后,观察两组患者认知功能状态和血清同型半胱氨酸(homocysteine,Hcy)、超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)和超氧化物歧化酶(superoxide dismutase,SOD)水平的变化.结果 观察组临床疗效明显优于对照组(P<0.05).与治疗前比较,两组治疗后蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)、简易智力状态检查量表(mini-mental state examina-tion,MMSE)评分均明显升高(P<0.05),且观察组治疗后MoCA、MMSE评分升高程度显著大于对照组(P<0.05).与治疗前比较,两组治疗后血清SOD水平均显著升高(P<0.05),hs-CRP和血浆Hcy水平均明显下降(P<0.05);且治疗后观察组血清SOD升高程度明显大于对照组(P<0.05),血清hs-CRP和血浆Hcy降低程度明显大于对照组(P<0.05).结论 化瘀通络灸结合常规针刺治疗脑卒中后MCI,可降低炎症水平,清除氧自由基,显著改善患者的认知功能.

Clinical Effect of Blood Stasis-removing and Collateral-dredging Moxibustion Combined with Acupuncture in Treatment of Mild Cognitive Impairment after Stroke

Objective To investigate the clinical effect of blood stasis-removing and collateral-dredging moxibustion combined with conventional acupuncture in the treatment of patients with mild cognitive impairment (MCI) after stroke and its influence on related blood factors. Methods A total of 60 patients with MCI after stroke were randomly divided into control group and observation group, with 30 patients in each group. The patients in the control group were treated with conventional acupuncture, and those in the observation group were treated with blood stasis-removing and collateral-dredging moxibustion in addition to the treatment in the control group. After 2 weeks of treatment, the two groups were observed in terms of the changes in the status of cognitive function and the levels of homocysteine (Hcy), high-sensitivity C-reactive protein (hs-CRP), and superoxide dismutase (SOD). Results The observation group had a significantly better clinical outcome than the control group (P<0.05). After treatment, both groups had significant increases in Montreal Cognitive Assessment and Mini-Mental State Examination scores (P<0.05), and the observation group had significantly greater increases than the control group (P<0.05). After treatment, both groups had a significant increase in the serum level of SOD (P<0.05) and significant reductions in the serum level of hs-CRP and the plasma level of Hcy (P<0.05), and compared with the control group, the observation group had a significantly greater increase in the serum level of SOD (P<0.05) and significantly greater reductions in the serum level of hs-CRP and the plasma level of Hcy (P<0.05). Conclusion In the treatment of post-stroke cognitive impairment, blood stasis-removing and collateral-dredging moxibustion combined with conventional acupuncture can reduce the level of inflammation, scavenge oxygen free radicals, and significantly improve cognitive function.