针康法对缺血性脑卒中患者同型半胱氨酸及认知功能的影响
|
摘要
目的探讨针康法对缺血性脑卒中后认知障碍患者同型半胱氨酸(Hcy)和认知功能的影响。方法 2017年7月至2018年6月,88例缺血性脑卒中患者随机分为A组(n=29,头穴丛刺)、B组(n=30,认知训练)和C组(n=29,针康法)。治疗前和治疗30 d后行血清Hcy测定,采用蒙特利尔认知评估量表(MoCA)进行评定。结果治疗后,血清Hcy含量C组最低(F=6.570, P <0.01);MoCA评分C组最高,A组最低(F=31.526, P <0.001)。结论针康法对缺血性脑卒中后认知障碍疗效优于单纯头穴丛刺和认知训练。
Objective To investigate the effects of acupuncture-rehabilitation therapy on homocysteine(Hcy) and cognitive function in patients with cognitive impairment after ischemic stroke.Methods From July, 2017 to June, 2018, 88 patients with cognitive impairment after ischemic stroke were randomly divided into group A(n = 29, cluster needling), group B(n = 30, cognitive training) and group C(n = 29, acupuncture-rehabilitation). Their serum Hcy content was measured and they were assessed with Montreal Cognitive Assessment(MoCA) before and 30 days after treatment.Results The serum Hcy content was the least in group C after treatment(F = 6.570, P < 0.01), with the most score of MoCA(F = 31.526, P < 0.001).Conclusion Acupuncture-rehabilitation therapy is more effective than simple cluster needling or cognitive training for patients with cognitive impairment after ischemic stroke.
Objective To investigate the effects of acupuncture-rehabilitation therapy on homocysteine(Hcy) and cognitive function in patients with cognitive impairment after ischemic stroke.Methods From July, 2017 to June, 2018, 88 patients with cognitive impairment after ischemic stroke were randomly divided into group A(n = 29, cluster needling), group B(n = 30, cognitive training) and group C(n = 29, acupuncture-rehabilitation). Their serum Hcy content was measured and they were assessed with Montreal Cognitive Assessment(MoCA) before and 30 days after treatment.Results The serum Hcy content was the least in group C after treatment(F = 6.570, P < 0.01), with the most score of MoCA(F = 31.526, P < 0.001).Conclusion Acupuncture-rehabilitation therapy is more effective than simple cluster needling or cognitive training for patients with cognitive impairment after ischemic stroke.
引文
[1]邱立云,石雯娟,张尚裕.认知康复训练治疗脑卒中后认知功能障碍效果分析[J].数理医药学杂志, 2018, 31(7):1008-1009.
[2]王芳,梁晖,陈甦,等.针刺调控脑组织代谢治疗卒中后轻度认知障碍的磁共振波谱研究[J].中国中医急症, 2014, 23(10):1928-1930.
[3]王清华,储照虎,许业松,等.头针治疗对脑卒中认知障碍患者MoCA评分和血清Hcy水平的影响[J].中国临床药理学与治疗学, 2017, 22(2):165-169.
[4]中华医学会神经病学分会痴呆与认知障碍学组写作组.血管性认知障碍诊治指南[J].中华神经科杂志, 2011, 44(2):142-147.
[5]中华医学会神经病学分会脑血管病学组急性缺血性脑卒中诊治指南撰写组.中国急性缺血性脑卒中诊治指南2010[J].中国全科医学, 2011, 14(35):4013-4017.
[6]于致顺.头穴基础与临床[M].北京:中国医药科技出版社,1992.
[7]郑婷婷,朱路文,李宏玉,等.唐强教授治疗中风病康复经验总结[J].世界中西医结合杂志, 2018, 13(8):1062-1064, 1098.
[8]郑婷婷,秦萍,朱路文,等.脑卒中康复新策略:针康法研究进展[J].世界中西医结合杂志, 2018, 13(7):1034-1036.
[9]唐强,李宏玉,朱路文,等.针康法对脑卒中后非流畅性时运患者言语功能的影响[J].针灸临床杂志, 2016, 32(7):35-37.
[10]黄晓琳,燕铁斌.康复医学[M].北京:人民卫生出版社,2013.
[11]林延敏.计算机辅助认知训练对非痴呆型血管性认知障碍患者认知功能及P300的影响[D].青岛:青岛大学, 2015.
[12]刘斌,姜敏,张晋霞.急性脑梗死患者认知障碍的临床特征分析[J].山东医药, 2009, 49(33):5-7.
[13]杨小旺,滕兆平,褚小朋,等.脑梗死后血管性认知障碍的危险因素探讨[J].吉林医学, 2018, 39(11):2005-2007.
[14]唐强.头穴丛刺与康复治疗的有机结合[J].中国康复理论与实践, 2011, 17(4):301-303.
[15]唐强,朱路文.脑卒中康复新策略——针康法[J].中国康复医学杂志, 2015, 30(10):1071-1073.
[16]白晶,李宝栋,戈杰英,等.头穴丛刺联合认知训练治疗血管性认知障碍临床观察[J].上海针灸杂志, 2013, 32(10):819-821.
[17]王永新,苗维,张红顺,等.头穴丛刺联合认知康复对脑梗死后认知障碍的影响[J].中医药导报, 2018, 24(17):84-86, 93.
[18]张金朋.针康法对局灶性脑缺血大鼠神经功能缺损及缺血区皮层RhoA、PTEN表达的影响[D].哈尔滨:黑龙江中医药大学, 2015.
[19]张坤. Hcy、叶酸、VitB12与脑梗死认知功能障碍的相关性研究[D].芜湖:皖南医学院, 2013.
[20]朱佳佳,蔡秀英.血浆同型半胱氨酸水平与脑卒中及卒中后认知障碍的相关性[J].中外医学研究, 2018, 16(15):177-180.
[21]何昕,邓建中,黄晓宇.脑小血管病患者认知损害程度与高同型半胱氨酸及hs-CRP的相关性[J].中国实用神经疾病杂志, 2017, 20(1):59-61.
[22]牟梓樟.浅析血浆同型半胱氨酸水平与缺血性脑血管病的关系[J].当代医药论丛, 2017, 15(11):84-85.
[23] Djuric D, Jakovljevic V, Zivkovic V, et al. Homocysteine and homocysteine-related compounds:an overview of the roles in the pathology of the cardiovascular and nervous systems[J].Can J Physiol Pharmacol, 2018, 96(10):991-1003.
[24]董芳,杜怡峰.小剂量叶酸对伴高同型半胱氨酸血症脑梗死患者认知功能的影响[J].中国老年学杂志, 2018, 38(21):5135-5137.
[25] Smach M A, Naffeti S, Charfeddine B, et al. Homocysteine,vitamin B-12, folic acid and the cognitive decline in the elderly[J]. Pathol Biol(Paris), 2013, 61(5):184-192.
[26] Chalhoub N E, Luggen M E. Screening for cognitive dys‐function in systemic lupus erythematosus:the Montreal Cogni‐tive Assessment Questionnaire and the Informant Question‐naire on Cognitive Decline in the Elderly[J]. Lupus, 2019, 28(1):51-58.
[27]涂秋云,靳慧,丁斌蓉,等.长沙版蒙特利尔认知评估量表的信度、效度检测与血管性认知障碍理想划界分值[J].中国神经精神疾病杂志, 2012, 38(6):339-345.
[28]王益.蒙特利尔认知评估量表在非痴呆行血管性认知障碍筛查总的研究[C].中华医学会,中华医学会神经病学分会.中华医学会第十七次全国神经病学学会会议论文汇编(上),2014:1.
[29]陈娟,李瑜霞,周晶,等. MoCA、MMSE与AVLT在非痴呆型缺血性小血管性认知障碍的应用[J].华北理工大学学报(医学版), 2018, 20(1):25-30.
[30] Nasreddine Z S, Phillips N A, Bédirian V, et al. The Montreal Cognitive Assessment, MoCA:a brief screening tool for mild cognitive impairment[J]. J Am Geriatr Soc, 2005, 53(4):695-699.
[31]方云华,陈善佳,周小炫,等. MoCA、MMSE、NCSE等6个脑卒中认知康复评价工具的使用现状调查[J].中国康复,2014, 29(1):40-42.
[32]韩璎,李林英. MoCA在轻度认知障碍诊断中的应用和发展[J].大连医科大学学报, 2012, 34(1):81-84.
[33]黄菲芸. MoCA量表在中国人群中筛查轻度认知功能障碍最佳截断值的系统综述[D].北京:北京协和医学院, 2017.
[2]王芳,梁晖,陈甦,等.针刺调控脑组织代谢治疗卒中后轻度认知障碍的磁共振波谱研究[J].中国中医急症, 2014, 23(10):1928-1930.
[3]王清华,储照虎,许业松,等.头针治疗对脑卒中认知障碍患者MoCA评分和血清Hcy水平的影响[J].中国临床药理学与治疗学, 2017, 22(2):165-169.
[4]中华医学会神经病学分会痴呆与认知障碍学组写作组.血管性认知障碍诊治指南[J].中华神经科杂志, 2011, 44(2):142-147.
[5]中华医学会神经病学分会脑血管病学组急性缺血性脑卒中诊治指南撰写组.中国急性缺血性脑卒中诊治指南2010[J].中国全科医学, 2011, 14(35):4013-4017.
[6]于致顺.头穴基础与临床[M].北京:中国医药科技出版社,1992.
[7]郑婷婷,朱路文,李宏玉,等.唐强教授治疗中风病康复经验总结[J].世界中西医结合杂志, 2018, 13(8):1062-1064, 1098.
[8]郑婷婷,秦萍,朱路文,等.脑卒中康复新策略:针康法研究进展[J].世界中西医结合杂志, 2018, 13(7):1034-1036.
[9]唐强,李宏玉,朱路文,等.针康法对脑卒中后非流畅性时运患者言语功能的影响[J].针灸临床杂志, 2016, 32(7):35-37.
[10]黄晓琳,燕铁斌.康复医学[M].北京:人民卫生出版社,2013.
[11]林延敏.计算机辅助认知训练对非痴呆型血管性认知障碍患者认知功能及P300的影响[D].青岛:青岛大学, 2015.
[12]刘斌,姜敏,张晋霞.急性脑梗死患者认知障碍的临床特征分析[J].山东医药, 2009, 49(33):5-7.
[13]杨小旺,滕兆平,褚小朋,等.脑梗死后血管性认知障碍的危险因素探讨[J].吉林医学, 2018, 39(11):2005-2007.
[14]唐强.头穴丛刺与康复治疗的有机结合[J].中国康复理论与实践, 2011, 17(4):301-303.
[15]唐强,朱路文.脑卒中康复新策略——针康法[J].中国康复医学杂志, 2015, 30(10):1071-1073.
[16]白晶,李宝栋,戈杰英,等.头穴丛刺联合认知训练治疗血管性认知障碍临床观察[J].上海针灸杂志, 2013, 32(10):819-821.
[17]王永新,苗维,张红顺,等.头穴丛刺联合认知康复对脑梗死后认知障碍的影响[J].中医药导报, 2018, 24(17):84-86, 93.
[18]张金朋.针康法对局灶性脑缺血大鼠神经功能缺损及缺血区皮层RhoA、PTEN表达的影响[D].哈尔滨:黑龙江中医药大学, 2015.
[19]张坤. Hcy、叶酸、VitB12与脑梗死认知功能障碍的相关性研究[D].芜湖:皖南医学院, 2013.
[20]朱佳佳,蔡秀英.血浆同型半胱氨酸水平与脑卒中及卒中后认知障碍的相关性[J].中外医学研究, 2018, 16(15):177-180.
[21]何昕,邓建中,黄晓宇.脑小血管病患者认知损害程度与高同型半胱氨酸及hs-CRP的相关性[J].中国实用神经疾病杂志, 2017, 20(1):59-61.
[22]牟梓樟.浅析血浆同型半胱氨酸水平与缺血性脑血管病的关系[J].当代医药论丛, 2017, 15(11):84-85.
[23] Djuric D, Jakovljevic V, Zivkovic V, et al. Homocysteine and homocysteine-related compounds:an overview of the roles in the pathology of the cardiovascular and nervous systems[J].Can J Physiol Pharmacol, 2018, 96(10):991-1003.
[24]董芳,杜怡峰.小剂量叶酸对伴高同型半胱氨酸血症脑梗死患者认知功能的影响[J].中国老年学杂志, 2018, 38(21):5135-5137.
[25] Smach M A, Naffeti S, Charfeddine B, et al. Homocysteine,vitamin B-12, folic acid and the cognitive decline in the elderly[J]. Pathol Biol(Paris), 2013, 61(5):184-192.
[26] Chalhoub N E, Luggen M E. Screening for cognitive dys‐function in systemic lupus erythematosus:the Montreal Cogni‐tive Assessment Questionnaire and the Informant Question‐naire on Cognitive Decline in the Elderly[J]. Lupus, 2019, 28(1):51-58.
[27]涂秋云,靳慧,丁斌蓉,等.长沙版蒙特利尔认知评估量表的信度、效度检测与血管性认知障碍理想划界分值[J].中国神经精神疾病杂志, 2012, 38(6):339-345.
[28]王益.蒙特利尔认知评估量表在非痴呆行血管性认知障碍筛查总的研究[C].中华医学会,中华医学会神经病学分会.中华医学会第十七次全国神经病学学会会议论文汇编(上),2014:1.
[29]陈娟,李瑜霞,周晶,等. MoCA、MMSE与AVLT在非痴呆型缺血性小血管性认知障碍的应用[J].华北理工大学学报(医学版), 2018, 20(1):25-30.
[30] Nasreddine Z S, Phillips N A, Bédirian V, et al. The Montreal Cognitive Assessment, MoCA:a brief screening tool for mild cognitive impairment[J]. J Am Geriatr Soc, 2005, 53(4):695-699.
[31]方云华,陈善佳,周小炫,等. MoCA、MMSE、NCSE等6个脑卒中认知康复评价工具的使用现状调查[J].中国康复,2014, 29(1):40-42.
[32]韩璎,李林英. MoCA在轻度认知障碍诊断中的应用和发展[J].大连医科大学学报, 2012, 34(1):81-84.
[33]黄菲芸. MoCA量表在中国人群中筛查轻度认知功能障碍最佳截断值的系统综述[D].北京:北京协和医学院, 2017.