针刺颈夹脊穴和督脉穴联合阿托伐他汀对脑卒中后轻度认知障碍患者血流动学的影响

目的:研究针刺颈夹脊穴和督脉穴联合阿托伐他汀对脑卒中后轻度认知障碍患者脑血流动力学的影响机制.方法:选取我院2012年9月~2015年9月脑卒中后轻度认知障碍患者84例,抽签随机分为观察组与对照组两组,每组42例,给予对照组患者阿托伐他汀治疗,给予观察组针刺联合阿托伐他汀治疗,比较两组患者治疗后临床认知疗效及简易智力状态检查量表(MMSE)评分,比较两组患者脑血流流变学指标并利用经颅多普勒(TCD)检测两组患者平均血流速度(Vmean)、平均血流量(Qmean)、外周阻力(R)等脑循环动力学指标水平.结果:观察组患者临床认知治疗总有效率为80.95%较对照组显著较高;观察组治疗后MMSE评分较对照组显著较高;观察组患者治疗后血浆黏度、全血黏度高切、全血黏度低切较对照组均显著较低;治疗后观察组Vmean、Qmean较对照组显著较高;观察组R水平较对照组显著较低.结论:针灸颈夹脊穴和督脉穴联合阿托伐他汀治疗可显著改善脑卒中患者轻度认知障碍,患者的脑循环动力学状况得到改善,生活质量得到提高.

Effect of acupuncture at cervical Jiaji point and Du Channel point combined with atorvastatin on hemodynamics in patients with mild cognitive impairment after stroke

Objective To study the effect of acupuncture at cervical Jiaji point and Du Channel point combined with ator-vastatin on cerebral hemodynamics in patients with mild cognitive impairment after stroke. Methods Eighty-four patients with mild cognitive impairment after stroke who were admitted in our hospital between September 2012 and September 2015 were randomized into observation group and control group with 42 cases in each group. Patients in the control group were treated with atorvastatin, while patients in the observation group were treated with acupuncture combined with atorvastatin. The clini-cal curative effect, score of mini-mental state examination scale (MMSE) and cerebral blood rheological indexes were compared between the two groups after treatment. The mean blood flow velocity (Vmean), mean blood flow (Qmean), peripheral resistance (R) and other cerebral circulation hemodynamic indexes were determined by transcranial color Doppler (TCD). Results In the observation group, the total effective rate of treatment for cognitive impairment (80.95%) was significantly higher than that in the control group; After treatment, the MMSE score in the observation group was significantly higher than that in the control group while the plasma viscosity, whole blood viscosity at high and low shear in the observation group were significantly lower than those in the control group; After treatment, the Vmean and Qmean in the observation group were significantly higher than those in the control group while R level was significantly lower. Conclusion Acupuncture at cervical Jiaji point and Du Channel point combined with atorvastatin can significantly relieve mild cognitive impairment in stroke patients, improve thecerebral hemody-namic status in patients and improve quality of life.