互动式头针治疗脑卒中后认知功能障碍:随机对照研究

目的:比较互动式头针与单纯头针、头针+认知训练治疗脑卒中后认知功能障碍的疗效。方法:将660例脑卒中后认知功能障碍患者随机分为互动式头针组(218例,脱落18例)、单纯头针组(220例,脱落20例)和头针+认知训练组(222例,脱落22例)。3组患者均予常规药物及运动康复训练,互动式头针组在认知训练的同时于顶中线,患肢对侧顶颞前斜线、顶颞后斜线行头针治疗;单纯头针组仅予头针治疗;头针+认知训练组于上午、下午分别进行头针和认知训练。均每日1次,每周6次,共治疗8周。于治疗前、治疗4周、治疗8周时采用蒙特利尔认知评估(Mo CA)量表评分评价各组患者认知功能。结果:治疗4、8周时,3组患者MoCA量表总评分均高于治疗前(P<0.01),且互动式头针组高于单纯头针组和头针+认知训练组(P<0.05,P<0.01)。3组患者治疗8周时MoCA量表各维度评分均高于治疗前(P<0.01);且互动式头针组高于单纯头针组和头针+认知训练组(P<0.01),除注意力评分外,头针+认知训练组Mo CA量表其余各维度评分均高于单纯头针组(P<0.01)。结论:互动式头针能明显改善脑卒中后认知功能障碍患者认知功能,疗效优于单纯头针和头针+认知训练。

Interactive scalp acupuncture for cognitive dysfunction after stroke:a randomized controlled trial

Objective To compare the efficacy of interactive scalp acupuncture,scalp acupuncture alone and scalp acupuncture plus cognitive training for cognitive dysfunction after stroke.Methods A total of 660 patients with cognitive dysfunction after stroke were randomly divided into an interactive scalp acupuncture group(218 cases,18 cases dropped off),a scalp acupuncture group(220 cases,20 cases dropped off)and a scalp acupuncture plus cognitive training group(222 cases,22 cases dropped off).All the patients were treated with routine medication and exercise rehabilitation training.The interactive scalp acupuncture group was treated with scalp acupuncture on the parietal midline,and contralateral anterior parietal temporal oblique line and posterior parietal temporal oblique line at the same time of cognitive training;the scalp acupuncture group was treated with scalp acupuncture alone,and the scalp acupuncture plus cognitive training group was treated with scalp acupuncture and cognitive training in the morning and afternoon respectively.All the treatments were given once a day,6 times a week for 8 weeks.Montreal cognitive assessment(MoCA)scale score was used to evaluate the cognitive function before treatment,4 weeks and 8 weeks into treatment.Results Compared before treatment,the total score of Mo CA was increased after 4-week treatment and 8-week treatment in the three groups(P<0.01),and the score in the interactive scalp acupuncture group was higher than that in the scalp acupuncture group and the scalp acupuncture plus cognitive training group(P<0.05,P<0.01).Compared before treatment,each item score of MoCA was increased after 8-week treatment in the three groups(P<0.01),and the score in the interactive scalp acupuncture group was higher than that in the scalp acupuncture group and the scalp acupuncture plus cognitive training group(P<0.01).Except for the attention,the remaining items scores of MoCA in the scalp acupuncture plus cognitive training group were higher than those in the scalp acupuncture group(P<0.01).Conclusion The interactive scalp acupuncture could significantly improve the cognitive function in patients with cognitive dysfunction after stroke,and the efficacy is superior to scalp acupuncture alone and scalp acupuncture plus cognitive training.