滋肾益髓针法联合复方麝香注射液治疗脑卒中后认知障碍效果观察
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摘要
目的研究滋肾益髓针法联合复方麝香注射液治疗脑卒中后认知障碍的临床效果。方法选取2015年6月—2016年6月在乐亭县医院就诊的脑卒中后认知障碍患者110例,根据治疗方式不同分为对照组和联合组,对照组患者给予20 mL复方麝香注射液溶于5%的葡萄糖,进行静脉滴注治疗,1次/d,联合组在对照组治疗的基础上进行滋肾益髓针法治疗,2组连续治疗3周。统计中医证候积分、巴氏指数评分(Barthel评分)、蒙特利尔认知评估量表(montreal cognitive assessment,MoCA)积分、格拉斯哥昏迷评分(glasgow coma scale,GCS)及脑血肿量,统计2组不良反应。结果治疗后,联合组面色(t=21.080,P<0.001)、乏力(t=20.340,P<0.001)、精神疲惫(t=20.880,P<0.001)、头晕(t=22.510,P<0.001)中医证候积分均低于对照组,差异有统计学意义(均P<0.05)。治疗后联合组Barthel评分(t=6.490,P<0.001)、MoCA积分(t=10.130,P<0.001)高于对照组;治疗后联合组脑血肿量低于对照组(t=6.490,P<0.001),GCS评分高于对照组(t=10.130,P<0.001)。联合组不良反应发生率为3.64%,低于对照组的14.55%。结论滋肾益髓针法联合复方麝香注射液治疗脑卒中后认知障碍效果显著,可以改善患者中医证候和认知功能水平,促进患者恢复。
Objective To study the effect of kidney-nourishing needle combined with compound musk injection on cognitive impairment after stroke. Methods A total of 110 patients with post-stroke cognitive impairment who visited our hospital from June 2015 to June 2016 were selected. They were divided into control group and combined group according to different treatments. The patients in the control group were treated with 20 ml compound musk injection dissolved in 5% glucose and intravenous drip once a day. The patients in the combined group were treated with nourishing kidney and benefiting marrow acupuncture on the basis of the treatment in the control group. The two groups were treated continuously for 3 weeks. Statistical data included TCM syndrome score, Barthel score, Montreal Cognitive Assessment(MoCA) score, Glasgow Coma Scale(GCS), cerebral hematoma volume and adverse reactions. Results After treatment, the scores of TCM syndromes in the combined group(t=21.080, P<0.001), fatigue(t=20.340, P<0.001), mental fatigue(t=20.880, P<0.001), dizziness(t=22.510, P<0.001) were lower than those in the control group(all P<0.05). After treatment, the Barthel score(t =6.490, P<0.001), MoCA score(t=10.130, P<0.001) in the combined group were higher than those in the control group. The amount of cerebral hematoma in the combined group was lower than that in the control group(t=6.490, P<0.001), and the GCS score was higher than that in the control group(t=10.130, P<0.001). The incidence of adverse reactions in the combined group was 3.64%, lower than 14.55% in the control group. Conclusion The combination of kidney-nourishing needle therapy with compound musk injection has a significant effect on cognitive impairment after stroke, which can improve the level of TCM syndromes and cognitive functions and promote the recovery of patients.
Objective To study the effect of kidney-nourishing needle combined with compound musk injection on cognitive impairment after stroke. Methods A total of 110 patients with post-stroke cognitive impairment who visited our hospital from June 2015 to June 2016 were selected. They were divided into control group and combined group according to different treatments. The patients in the control group were treated with 20 ml compound musk injection dissolved in 5% glucose and intravenous drip once a day. The patients in the combined group were treated with nourishing kidney and benefiting marrow acupuncture on the basis of the treatment in the control group. The two groups were treated continuously for 3 weeks. Statistical data included TCM syndrome score, Barthel score, Montreal Cognitive Assessment(MoCA) score, Glasgow Coma Scale(GCS), cerebral hematoma volume and adverse reactions. Results After treatment, the scores of TCM syndromes in the combined group(t=21.080, P<0.001), fatigue(t=20.340, P<0.001), mental fatigue(t=20.880, P<0.001), dizziness(t=22.510, P<0.001) were lower than those in the control group(all P<0.05). After treatment, the Barthel score(t =6.490, P<0.001), MoCA score(t=10.130, P<0.001) in the combined group were higher than those in the control group. The amount of cerebral hematoma in the combined group was lower than that in the control group(t=6.490, P<0.001), and the GCS score was higher than that in the control group(t=10.130, P<0.001). The incidence of adverse reactions in the combined group was 3.64%, lower than 14.55% in the control group. Conclusion The combination of kidney-nourishing needle therapy with compound musk injection has a significant effect on cognitive impairment after stroke, which can improve the level of TCM syndromes and cognitive functions and promote the recovery of patients.
引文
[1] 张超丽,钟雪华,柯秋琴,等.认知功能训练配合康复护理对脑卒中后认知障碍患者康复的疗效观察[J].广州医科大学学报,2018,46(3):112-114,121.
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[9] 王嘉麟,邢佳,贺立娟,等.针灸治疗脑卒中后认知障碍研究进展[J].环球中医药,2015,8(9):1140-1144.
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[11] 刘斐雯,郑国华,陶静,等.针刺综合疗法治疗脑卒中后认知障碍的研究进展[J].中国康复,2016,31(5):384-386.
[12] 张静,张磊,陈希源,等.滋肾益髓针法配合康复训练治疗脑卒中后认知障碍65例临床疗效观察[J].世界中西医结合杂志,2018,13(3):370-373.
[13] 叶太财,周良军,曹强,等.复方麝香注射液对老年患者全麻术后早期轻度认知障碍的影响[J].广东医学,2016,37(18):2714-2717.
[14] 董艳红,郭明东.复方麝香注射液治疗老年急性脑卒中致意识障碍患者的临床应用观察及生活质量评估[J].中国急救医学,2015,35(z2):159-160.
[15] 于超,郭昌云,伍育旗,等.复方麝香注射液对冠状动脉旁路移植术后谵妄发生率的影响[J].中国社区医师,2018,34(16):89-90.
[16] 李海滨,刘江华.通腑泻热、逐瘀化痰法治疗急性脑卒中意识障碍的临床观察[J].内蒙古中医药,2016,35(2):31.
[17] 郝孝盈,郭新荣,张亚军,等.针刺睛明穴治疗急性脑卒中伴意识障碍的临床疗效[J].西部中医药,2015,28(7):115-117.
[18] 罗银星,郑时珍,郝浩,等.认知训练结合针灸治疗脑卒中认知障碍的临床疗效时效性观察[J].中国中医药现代远程教育,2018,16(16):118-120.
[19] 吴树靖,孝金萍,孙艳,等.高压氧联合复方麝香注射液对弥漫性轴索损伤的临床应用[J].中华航海医学与高气压医学杂志,2016,23(2):104-106.
[20] 高涛,郭电渠,韩冰,等.复方麝香注射液联合醒脑静注射液治疗脑出血后意识障碍的疗效观察[J].中国实用神经疾病杂志,2017,20(10):119-121.
[21] 张铭铭,杨杰.穴位注射联合针刺治疗脑梗死后吞咽障碍疗效观察[J].中国中医急症,2017,26(12):2232-2234.
[22] 史玉虎,许辉,刘慧芳,等.复方麝香注射液联合羚羊角汤治疗痰热内闭清窍型脑出血26例[J].安徽中医药大学学报,2016,35(3):30-33.
[23] 于朝旭,武焕颖,孙实安,等.复方麝香注射液联合依达拉奉对颅脑外伤患者凝血和神经功能的影响[J].中国药房,2017,28(20):2827-2830.
[2] 张勇,杨百瑜,张振馨,等.卒中后认知障碍的概念、病理生理和受损认知域[J].中国老年学杂志,2016,36(2):509-511.
[3] 陈希源,陆霞,周华,等.滋肾益髓针法配合康复训练治疗脑卒中后认知障碍的随机对照研究[J].现代中西医结合杂志,2018,27(1):43-45.
[4] 中华神经科学会,中华神经外科学会.各类脑血管疾病诊断要点[J].中华神经科杂志,1996,29(6):379-380.
[5] HACHINSKI V,IADECOLA C,PETERSEN R C,et al.National institute of neurological disorders and stroke-canadian stroke network vascular cognitive impairment harmonization standards[J].Stroke,2006,37(9):2220-2241.
[6] 刘娜,孟品,耿闪,等.脑卒中后认知障碍患者蒙特利尔认知评估量表变化特征及其与TOAST亚型的关系[J].中华老年心脑血管病杂志,2016,18(4):345-348.
[7] 周贝,刘亚琳,唐健元,等.我国中药新药临床研究技术指导原则体系发布概况[J].中国临床药理学杂志,2017,33(18):1850-1852.
[8] 黄菲芸,王艳红,李娟娟,等.蒙特利尔认知评估量表在中国中老年人群筛查轻度认知功能障碍中的截断值的系统评价[J].中国循证医学杂志, 2017,17(4):84-91.
[9] 王嘉麟,邢佳,贺立娟,等.针灸治疗脑卒中后认知障碍研究进展[J].环球中医药,2015,8(9):1140-1144.
[10] 张阳,唐巍,宋小鸽,等.针灸联合认知康复训练治疗脑卒中后认知障碍效果的系统评价和Meta分析[J].上海针灸杂志,2015,34(10):1013-1020.
[11] 刘斐雯,郑国华,陶静,等.针刺综合疗法治疗脑卒中后认知障碍的研究进展[J].中国康复,2016,31(5):384-386.
[12] 张静,张磊,陈希源,等.滋肾益髓针法配合康复训练治疗脑卒中后认知障碍65例临床疗效观察[J].世界中西医结合杂志,2018,13(3):370-373.
[13] 叶太财,周良军,曹强,等.复方麝香注射液对老年患者全麻术后早期轻度认知障碍的影响[J].广东医学,2016,37(18):2714-2717.
[14] 董艳红,郭明东.复方麝香注射液治疗老年急性脑卒中致意识障碍患者的临床应用观察及生活质量评估[J].中国急救医学,2015,35(z2):159-160.
[15] 于超,郭昌云,伍育旗,等.复方麝香注射液对冠状动脉旁路移植术后谵妄发生率的影响[J].中国社区医师,2018,34(16):89-90.
[16] 李海滨,刘江华.通腑泻热、逐瘀化痰法治疗急性脑卒中意识障碍的临床观察[J].内蒙古中医药,2016,35(2):31.
[17] 郝孝盈,郭新荣,张亚军,等.针刺睛明穴治疗急性脑卒中伴意识障碍的临床疗效[J].西部中医药,2015,28(7):115-117.
[18] 罗银星,郑时珍,郝浩,等.认知训练结合针灸治疗脑卒中认知障碍的临床疗效时效性观察[J].中国中医药现代远程教育,2018,16(16):118-120.
[19] 吴树靖,孝金萍,孙艳,等.高压氧联合复方麝香注射液对弥漫性轴索损伤的临床应用[J].中华航海医学与高气压医学杂志,2016,23(2):104-106.
[20] 高涛,郭电渠,韩冰,等.复方麝香注射液联合醒脑静注射液治疗脑出血后意识障碍的疗效观察[J].中国实用神经疾病杂志,2017,20(10):119-121.
[21] 张铭铭,杨杰.穴位注射联合针刺治疗脑梗死后吞咽障碍疗效观察[J].中国中医急症,2017,26(12):2232-2234.
[22] 史玉虎,许辉,刘慧芳,等.复方麝香注射液联合羚羊角汤治疗痰热内闭清窍型脑出血26例[J].安徽中医药大学学报,2016,35(3):30-33.
[23] 于朝旭,武焕颖,孙实安,等.复方麝香注射液联合依达拉奉对颅脑外伤患者凝血和神经功能的影响[J].中国药房,2017,28(20):2827-2830.