针刺夹脊穴对脑卒中伴认知障碍及偏瘫患者认知与肢体运动功能的影响

目的:探析脑卒中伴认知障碍及偏瘫患者接受针刺夹脊穴治疗的效果。方法:纳入230例脑卒中伴认知障碍及偏瘫患者为研究对象,采用随机数字表法分为对照组(115例)、观察组(115例)两组,对照组接受常规治疗联合康复训练,观察组在此基础上接受针刺夹脊穴治疗。比较两组治疗前后肢体困重、偏身麻木、手脚胀痛证候积分。采用躯干控制测试(TCT)、Fugl-Meyer量表(FMA)、改良Ashworth评定量表(MAS)及蒙特利尔认知评估(MoCA)量表分别评估治疗前后躯干控制能力、肢体运动功能、肢体痉挛程度及认知功能。比较两组治疗前后全血高切黏度、全血低切黏度、血浆黏度、D-二聚体(D-D)、纤维蛋白原(FIB)指标。结果:治疗前,两组证候积分、TCT评分、FMA评分、MoCA评分、MAS评分及血液流变学指标比较,差异无统计学意义(均P>0.05)。治疗后,观察组肢体困重、偏身麻木、手脚胀痛证候积分、MAS评分低于对照组,差异有统计学意义(均P<0.05)。观察组TCT评分、FMA评分高于对照组,差异有统计学意义(均P<0.05)。治疗后,观察组全血高切黏度、全血低切黏度、血浆黏度、D-D、FIB水平低于对照组,差异有统计学意义(均P<0.05)。结论:针刺夹脊穴治疗脑卒中伴认知功能障碍及偏瘫患者效果较好,可缓解临床症状,改善认知、肢体运动功能及血液循环。

Effect of acupuncture at Jiaj i point on cognition and limb motor function of stroke patients with cognitive impairment and hemiplegia

Objective:To explore effect of acupuncture at Jiaji point on stroke patients with cognitive impairment and hemiplegia.Methods:230 stroke patients with cognitive impairment and hemiplegia were randomly divided into control group(115 cases)and observation group(115 cases).The control group received routine treatment combined with rehabilitation training.On the basis,the observation group received acupuncture at Jiaji point.The symptom scores of limb sleepiness partial numbness and swelling pain of hands and feet were compared between the two groups before and after treatment.TCT,FMA,MAS and MoCA were used to evaluate the trunk control ability,limb motor function,limb spasm degree and cognitive function before and after treatment.Whole blood high shear viscosity,whole blood low shear viscosity,plasma viscosity,D-D,FIB were compared between the two groups before and after treatment.Results:Before treatment,there were no significant differences in symptom score,TCT score,FMA score,MoCA score,MAS score and hemorheology indexes between the two groups(all P>0.05).After treatment,the body weight,partial numbness,the score of pain syndrome and MAS in the observation group were lower than those in the control group,difference statistically significant(all P<0.05).The TCT score and FMA score in the observation group were higher than those in the control group,difference statistically significant(all P<0.05).After treatment,whole blood high shear viscosity,whole blood low shear viscosity,plasma viscosity,D-D and FIB levels in the observation group were lower than those in the control group,difference statistically significant(all P<0.05).Conclusion:Acupuncture at Jiaji point is effective in the treatment of stroke patients with cognitive impairment and hemiplegia,which can relieve clinical symptoms and significantly improve cognition,limb motor function and blood circulation.