通督醒神针刺法对卒中后轻度认知障碍患者认知功能及精神行为症状的改善效果研究

背景　卒中后轻度认知障碍（PSMCI）常会导致卒中患者生活质量下降，引发许多不良后果，已成为目前国际卒中研究的热点。目的　观察通督醒神针刺法对PSMCI患者认知功能及精神行为症状的改善效果。方法　选取2019年1月至2020年1月河南中医药大学第一附属医院康复中心收治的符合纳入标准的PSMCI患者60例为研究对象，采用随机数字表法将其分为研究组和对照组，各30例。对照组患者给予常规治疗及常规认知功能康复训练，研究组患者在对照组基础上给予通督醒神针刺法治疗，1次/d，5次/周，持续4周。比较两组治疗前后患者蒙特利尔认知评估量表（MoCA）及各子项、神经精神问卷（NPI）、日常生活能力量表（ADL）评分。结果　研究组患者治疗后MoCA评分高于对照组（P<0.05）。两组患者治疗后命名评分比较，差异无统计学意义（P>0.05）；研究组患者治疗后视空间与执行功能、注意力和计算力、延迟回忆、语言和抽象能力、定向力评分均高于对照组（P<0.05）。研究组患者治疗后NPI-1、NPI-2评分低于对照组，ADL评分高于对照组（P<0.05）。结论　通督醒神针刺法可有效改善PSMCI患者认知功能和精神行为症状，提高PSMCI患者的日常生活能力。

Tongduxingshen Acupuncture Improves the Cognitive Function and Psycho-behavioral Symptoms in Patients with Post-stroke Mild Cognitive Impairment

Background　Post-stroke mild cognitive impairment （PSMCI） often leads to declined quality of life and other adverse outcomes，which has become a hot topic in international stroke research. Objective　To observe the effect of Tongduxingshen acupuncture on improving cognitive function and psycho-behavioral symptoms in PSMCI patients. Methods　Eligible patients with PSMCI（n=60） who were treated in Rehabilitation Center，the First Affiliated Hospital of Henan University of Chinese Medicine from January 2019 to January 2020 were selected，and equally randomized into control group （routine treatment plus routine cognitive rehabilitation training） and study group〔routine treatment plus routine cognitive rehabilitation training and Tongduxingshen acupuncture（once daily，five times per week）〕，received four consecutive weeks of treatment. Montreal Cognitive Assessment （MoCA） and its subscales，Neuropsychiatric Inventory （NPI），and Activity of Daily Living Scale （ADL） scores were compared between the two groups before and after treatment. Results　The mean total MoCA score showed a more significant increase in the study group after treatment （P<0.05）. There was no statistically significant difference between the mean post-treatment naming scores of the two groups（P>0.05）. The mean scores of post-treatment executive function/visuospatial ability，attention and calculation，delayed recall，language abilities and abstraction，and orientation scores in the study group were higher than those in the control group（P<0.05）. The study group had lower mean NPI-1 and NPI-2 scores and higher mean ADL scores than the control group after treatment （P<0.05）. Conclusion　Tongduxingshen acupuncture could effectively improve the cognitive function and psycho-behavioral symptoms as well as activities of daily living in PSMCI patients.