头皮针结合认知训练治疗脑外伤后认知障碍的效果
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摘要
目的探讨头皮针结合认知训练对颅脑外伤后认知障碍的临床疗效。方法 2016年6月至2017年10月,脑外伤后认知障碍患者60例随机分为头皮针组(n=20)、认知训练组(n=20)和头皮针结合认知训练组(n=20),分别给予头皮针、认知训练和皮针结合认知训练治疗,共40次。治疗前后采用简易精神状态检查(MMSE)、蒙特利尔认知功能评估量表(MoCA)和改良Barthel指数(MBI)进行评定。结果治疗后,三组MMSE、MoCA和MBI评分均显著改善(F> 21.923, P <0.001),头皮针结合认知训练组评分优于另外两组(F> 3.423, P <0.05)。结论头皮针结合认知训练治疗脑外伤后认知障碍疗效优于单纯头皮针和认知训练。
Objective To investigate the clinical effects of scalp acupuncture combined with cognitive therapy on cognitive impairment after traumatic brain injury.Methods From June, 2016 to October, 2017, 60 patients with cognitive impairment after traumatic brain injury were randomly divided into scalp acupuncture group(n = 20), cognitive training group(n = 20) and combined group(n =20), who accepted their own therapies for 40 times. They were assessed with Mini-Mental State Examination(MMSE), Montreal Cognitive Assessment(MoCA) and modified Barthel Index(MBI) before and after treatment.Results All the groups improved in the scores of MMSE, MoCA and MBI after treatment(F > 21.923, P < 0.001), which were the best in the combined group(F > 3.423, P < 0.05).Conclusion Combination of scalp acupuncture and cognitive training is more effective on cognitive impairment after traumatic brain injury.
Objective To investigate the clinical effects of scalp acupuncture combined with cognitive therapy on cognitive impairment after traumatic brain injury.Methods From June, 2016 to October, 2017, 60 patients with cognitive impairment after traumatic brain injury were randomly divided into scalp acupuncture group(n = 20), cognitive training group(n = 20) and combined group(n =20), who accepted their own therapies for 40 times. They were assessed with Mini-Mental State Examination(MMSE), Montreal Cognitive Assessment(MoCA) and modified Barthel Index(MBI) before and after treatment.Results All the groups improved in the scores of MMSE, MoCA and MBI after treatment(F > 21.923, P < 0.001), which were the best in the combined group(F > 3.423, P < 0.05).Conclusion Combination of scalp acupuncture and cognitive training is more effective on cognitive impairment after traumatic brain injury.
引文
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[8]李彩珠,黄涛,皮党育,等. Rho激酶抑制剂治疗脑外伤认知障碍的临床护理[J].临床护理, 2012, 2(10):283-284.
[9]张皓,张小年,山磊,等.脑外伤患者认知障碍的特点及康复疗效分析[J].中国康复, 2010, 25(2):90-92.
[10] Bayley M T, Tate R, Douglas J M, et al. INCOG Guidelines for cognitive rehabilitation following traumatic brain injury:methods and overview[J]. J Head Trauma Rehabil, 2014, 29(4):290-306.
[11]徐春江,韩扬.高压氧治疗脑外伤认知障碍的临床应用[J].中国医药导报, 2013, 10(17):28-30.
[12]张军,林春,周岩,等.认知训练联合高压氧治疗脑外伤后认知障碍的临床观察[J].中国疗养医学, 2017, 26(1):40-43.
[13] Zhu C F, Yang J, Fei A H, et al. Influence of acupuncturemoxibustion treatment on cognition disorder[J]. J Acup Tuina Sci, 2012, 10(4):218-222.
[14]王海明,蔡琛,张智芳.神经肌肉电刺激联合针灸及康复锻炼治疗颅脑损伤吞咽障碍患者的临床观察[J].南京中医药大学学报, 2015, 31(2):122-125.
[15]黄芳,王晓红,邵彬,等.头针治疗颅脑损伤后认知障碍的临床效果[J].中国康复理论与实践, 2015, 21(1):79-81.
[16]社战锋.轻中度颅脑损伤合并认知障碍患者早期认知训练的疗效[J].神经损伤与功能重建, 2015, 10(6):567-568.
[17]刘浩,贾延兵,王旭豪,等.周围神经电刺激对脑卒中患者运动皮质兴奋性的影响[J].中国康复医学杂志, 2016, 31(8):878-883.
[18]陈华德,李勇.百会穴长留针疗法对智力偏低大鼠学习记忆能力影响的实验研究[J].浙江中医药大学学报, 2012, 36(1):76-78.
[19]林志诚,陈立典,陶静,等.电针百会穴对脑梗死后认知障得患者听觉P300的影响[J].上海针灸杂志, 2014, 33(1):14-17.
[20]李丹,周兆祥,刘志坚.针刺智三针和四神聪穴对脑外伤患者认知障碍的临床观察[J].湖南中医药大学学报, 2013, 33(5):99-102.
[21]冯爱春,李立红,殷建权.头穴久留针对改善管性痴呆患者症状的临床观察[J].浙江中医药大学学报, 2010, 34(5):757-759.
[22]鲍春玲,东红升,东贵荣,等.头穴透刺对急性高血压性脑出血患者血桨ET、CGRP的影响[J].中国针灸, 2005, 25(10):717-719.
[23]徐艳,谢文龙,徐晓红,等.头皮针结合无错行学习对脑外伤患者记忆及认知功能障碍的影响[J].中华中医药学刊, 2011,29(12):2799-2801.
[2] Arciniegas D B, Held K, Wagner P. Cognitive impairment fol‐lowing traumatic brain injury[J]. Curr Treat Options Neurol,2002, 4(1):43-57.
[3] Foster M, Spiegel D R. Use of donepezil in the treatment of cognitive impairments of moderate traumatic brain injury[J]. J Neuropsychiatry Clin Neurosci, 2008, 20(2):106-108.
[4] Finnanger T G, Skandsen T, Andersson S, et al. Differentiated patterns of cognitive impairment 12 months after severe and moderate traumatic brain injury[J]. Brain Inj, 2013, 27(13-14):1606-1616.
[5] Vincent A S, Roebuck-Spencer T M, Cernich A. Cognitive changes and dementia risk after traumatic brain injury:implica‐tions for aging military personnels[J]. Alzheimers Dement,2014, 10:S174-S187.
[6] Barman A, Chatterjee A, Bhide R. Cognitive impairment and rehabilitation strategies after traumatic brain injury[J]. Indian J Psychol Med, 2016, 38(3):172-181.
[7]陆少欢.多奈哌齐治疗重型颅脑外伤后认知障碍100例临床疗效观察[J].中外健康文摘, 2011, 8(7):76-78.
[8]李彩珠,黄涛,皮党育,等. Rho激酶抑制剂治疗脑外伤认知障碍的临床护理[J].临床护理, 2012, 2(10):283-284.
[9]张皓,张小年,山磊,等.脑外伤患者认知障碍的特点及康复疗效分析[J].中国康复, 2010, 25(2):90-92.
[10] Bayley M T, Tate R, Douglas J M, et al. INCOG Guidelines for cognitive rehabilitation following traumatic brain injury:methods and overview[J]. J Head Trauma Rehabil, 2014, 29(4):290-306.
[11]徐春江,韩扬.高压氧治疗脑外伤认知障碍的临床应用[J].中国医药导报, 2013, 10(17):28-30.
[12]张军,林春,周岩,等.认知训练联合高压氧治疗脑外伤后认知障碍的临床观察[J].中国疗养医学, 2017, 26(1):40-43.
[13] Zhu C F, Yang J, Fei A H, et al. Influence of acupuncturemoxibustion treatment on cognition disorder[J]. J Acup Tuina Sci, 2012, 10(4):218-222.
[14]王海明,蔡琛,张智芳.神经肌肉电刺激联合针灸及康复锻炼治疗颅脑损伤吞咽障碍患者的临床观察[J].南京中医药大学学报, 2015, 31(2):122-125.
[15]黄芳,王晓红,邵彬,等.头针治疗颅脑损伤后认知障碍的临床效果[J].中国康复理论与实践, 2015, 21(1):79-81.
[16]社战锋.轻中度颅脑损伤合并认知障碍患者早期认知训练的疗效[J].神经损伤与功能重建, 2015, 10(6):567-568.
[17]刘浩,贾延兵,王旭豪,等.周围神经电刺激对脑卒中患者运动皮质兴奋性的影响[J].中国康复医学杂志, 2016, 31(8):878-883.
[18]陈华德,李勇.百会穴长留针疗法对智力偏低大鼠学习记忆能力影响的实验研究[J].浙江中医药大学学报, 2012, 36(1):76-78.
[19]林志诚,陈立典,陶静,等.电针百会穴对脑梗死后认知障得患者听觉P300的影响[J].上海针灸杂志, 2014, 33(1):14-17.
[20]李丹,周兆祥,刘志坚.针刺智三针和四神聪穴对脑外伤患者认知障碍的临床观察[J].湖南中医药大学学报, 2013, 33(5):99-102.
[21]冯爱春,李立红,殷建权.头穴久留针对改善管性痴呆患者症状的临床观察[J].浙江中医药大学学报, 2010, 34(5):757-759.
[22]鲍春玲,东红升,东贵荣,等.头穴透刺对急性高血压性脑出血患者血桨ET、CGRP的影响[J].中国针灸, 2005, 25(10):717-719.
[23]徐艳,谢文龙,徐晓红,等.头皮针结合无错行学习对脑外伤患者记忆及认知功能障碍的影响[J].中华中医药学刊, 2011,29(12):2799-2801.