针刺结合奥拉西坦治疗脑梗死后轻度认知障碍疗效研究

目的:观察针刺结合奥拉西坦治疗脑梗死后轻度认知障碍的疗效及对患者血清胶质细胞源性神经营养因子(GDNF)、沉默信息调节因子1(SIRT1)表达的影响。方法:将90例脑梗死后轻度认知障碍患者用随机数字表法分为两组。对照组给予奥拉西坦治疗，观察组在奥拉西坦基础上结合针刺治疗。比较两组血清GDNF、S100β、SIRT1、神经元特异性烯醇化酶(NSE)及脑血流动力学的水平，评估两组蒙特利尔认知评估量表(MoCA)评分、Barthel指数的差异，统计两组疗效。结果:两组治疗前血清GDNF、SIRT1等相关因子、脑血流动力学相关评分比较，差异无统计学意义(P>0.05)。与治疗前相比，两组GDNF、SIRT1及收缩期峰值血流速度(Vs)、舒张期血流速度(Vd)、平均血流速度(Vm)治疗后升高，且观察组更高(P<0.05)。两组S100β、NSE及阻力指数(RI)治疗后下降，且观察组更低(P<0.05)。两组简易智能状态检查量表(MMSE)评分、Barthel指数、MoCA评分治疗后升高，且观察组更高(P<0.05)。两组老年性痴呆量表-认知分量表(ADAS-Cog)评分治...

Effect of acupuncture combined with oxiracetam on mild cognitive impairment after cerebral infarction

Objective:To observe the therapeutic effect of acupuncture combined with oxiracetam on mild cognitive impairment after cerebral infarction and its effect on the expression of serum glial cell derived neurotrophic factor(GDNF)and silent information regulatory factor 1(SIRT1).Methods:90 patients with mild cognitive impairment after cerebral infarction were selected as subjects,and were divided into two groups by random number table method.The control group was treated with oxiracetam,while the observation group was treated with acupuncture on the basis of oxiracetam.Detected and compared serum GDNF and S100β, SIRT1,neuron-specific enolase(NSE)and cerebral hemodynamics level of the two groups,evaluate the differences of cognitive function scores such as Montreal Cognitive Assessment Scale(MoCA)score and Barthel index between the two groups,and count the curative effects of the two groups.Results:There was no statistical difference between the two groups in serum GDNF,SIRT1 and other related factors and cerebral hemodynamics before treatment(P>0.05).Compared with before treatment,GDNF,SIRT1,peak systolic blood flow velocity(Vs),diastolic blood flow velocity(Vd)and mean blood flow velocity(Vm)of the two groups increased after treatment,and the observation group was higher(P<0.05).Two groups of S100β、 NSE and resistance index(RI)decreased after treatment,and were lower in the observation group(P<0.05).Compared with before treatment,the scores of MMSE,Barthel index and MoCA in the two groups increased after treatment,and the observation group was higher(P<0.05).After treatment,the scores of the Alzheimer's Dementia Scale-cognitive subscale(ADAS-log)in the two groups decreased,and the scores in the observation group were lower(P<0.05).The total effective rate of the observation group was 92.68%,which was higher than 76.74% of the control group,with a statistical difference(P<0.05).Conclusion:Acupuncture combined with oxiracetam can improve cerebral blood circulation and regulate GDNF,SIRT1 and S100 β in the treatment of mild cognitive impairment after cerebral infarction β、 The expression of NSE can promote the recovery of cognitive function and improve the curative effect.