针刺督脉穴及颈椎夹脊穴治疗脑卒中后轻度血管性痴呆疗效观察

目的观察针刺督脉穴及颈椎夹脊穴治疗脑卒中后轻度血管性痴呆患者的临床疗效。方法选择2016年5月—2018年10月于北京中医医院顺义医院脑病科住院治疗的脑卒中后轻度血管性痴呆患者120例,按照随机数字表法分成治疗组和对照组各60例。对照组患者给予马来酸桂哌齐特注射液、前列地尔注射液静滴和针刺治疗(主穴取印堂、四神聪、风池、太溪、悬钟、合谷、太冲);治疗组患者西医治疗同对照组,同时配合针刺督脉穴及颈椎夹脊穴(主穴取百会、神庭、人中、风府、哑门、大椎、至阳、腰阳关、颈椎夹脊穴)。针刺治疗每日1次,每周5次,治疗2周。分别于治疗前及治疗2周后采用简易智能量表(MMSE)、日常生活能力量表(ADL)、蒙特利尔认知评估量表(MoCA)评估2组患者的智能、日常生活能力和认知功能,比较2组治疗2周后总体疗效。结果治疗2周后,2组患者MMSE、ADL、MoCA评分均较治疗前明显升高,且治疗组患者治疗后MMSE、ADL、MoCA评分均明显高于对照组,差异均有统计学意义(P均<0.05)。治疗2周后,治疗组总有效率为80.4%(45/56),对照组总有效率为62.1%(36/58),治疗组总有效率明显高于对照组(P<0.05)。结论针刺督脉穴及颈椎夹脊穴治疗脑卒中后轻度血管性痴呆的疗效优于普通针刺,为脑卒中后轻度血管性痴呆的治疗提供了新的手段。

Observation on therapeutic Effect of acupuncture at Dumai point and cervical Jiaji points on mild vascular dementia after stroke

Objective It is to observe the clinical curative effect of acupuncture at Dumai point and cervical Jiaji points in patients with mild vascular dementia after stroke.Methods 120 patients with mild vascular dementia after stroke who were hospitalized in the department of encephalology of Shunyi Hospital from May 2016 to October 2018 were selected,and divided into a treatment group and a control group according to the random number table method,60 cases in each group.The patients in the control group were treated with guiprazide maleate injection and alprostadil injection by intravenous drip and acupuncture(main acupoints were Yintang,Sishencong,Fengchi,Taixi,Hangzhong,Hegu,Taichong);The patients in the treatment group were treated with western medicine in the same way as those in the control group,and were treated with acupuncture at Dumai and cervical spine acupoints(main points were Baihui,Shenting,Renzhong,Fengfu,Yamen,Dazhui,Zhiyang,Yaoyangguan,cervical Jiaji points)at the same time.Acupuncture treatment was performed once a day,5 times a week,and for 2 weeks.The intelligence,daily living ability and cognitive function of the patients in the two groups were evaluated before the treatment and after 2 weeks of treatment by the Simple Intelligent Scale(MMSE),Ability to Daily Life Scale(ADL),Montreal Cognitive Assessment Scale(MoCA),the overall efficacy of 2 groups after 2 weeks of treatment were compared.Results After 2 weeks of treatment,the scores of MMSE,ADL,and MoCA of the two groups were significantly higher than those before treatment,and the scores of MMSE,ADL,and MoCA of the treatment group were significantly higher than those of the control group,the differences were statistically significant(P<0.05).After 2 weeks of treatment,the total effective rate in the treatment group was 80.4%(45/56),and the total effective rate in the control group was 62.1%(36/58),the total effective rate in the treatment group was significantly higher than that in the control group(P<0.05).Conclusion The clinical curative effect of acupuncture at Dumai point and cervical Jiaji points is better than ordinary acupuncture in the treatment of mild vascular dementia after stroke,which provides a new method for the treatment of this disease.