脑电仿生电刺激神门穴、乳突穴对皮质下动脉硬化性脑病患者的影响
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摘要
目的探讨脑电仿生电刺激神门穴、乳突穴对皮质下动脉硬化性脑病(SAE)患者的影响。方法选取2015年2月—2017年6月苏州市吴江区中医医院内科收治的SAE患者124例,采用随机数字表法分为对照组和研究组,每组62例。对照组患者给予盐酸多奈哌齐治疗,研究组患者在对照组治疗基础上给予脑电仿生电刺激神门穴、乳突穴治疗;两组患者均连续治疗6周。比较两组患者临床疗效,治疗前后中文版蒙特利尔认知评估量表(MoCA)、长谷川痴呆量表(HDS)评分、脑部血流速度、同型半胱氨酸(Hcy)、D-二聚体及血液流变学指标(包括全血高切黏度、全血低切黏度、血浆黏度、红细胞聚集指数),并观察两组患者治疗期间不良反应发生情况。结果 (1)研究组患者临床疗效优于对照组(P<0.05)。(2)治疗前两组患者中文版MoCA评分、HDS评分比较,差异无统计学意义(P>0.05);治疗后研究组患者中文版MoCA评分、HDS评分高于对照组(P<0.05)。(3)治疗前两组患者左椎动脉、右椎动脉、基底动脉血流速度比较,差异无统计学意义(P>0.05);治疗后研究组患者左椎动脉、右椎动脉、基底动脉血流速度快于对照组(P<0.05)。(4)两组患者治疗前血浆Hcy、D-二聚体水平比较,差异无统计学意义(P>0.05);治疗后研究组患者血浆Hcy、D-二聚体水平低于对照组(P<0.05)。(5)两组患者治疗前全血高切黏度、全血低切黏度、血浆黏度、红细胞聚集指数比较,差异均无统计学意义(P>0.05);治疗后研究组患者全血高切黏度、全血低切黏度、血浆黏度、红细胞聚集指数均低于对照组(P<0.05)。(6)两组患者治疗期间均未发生严重不良反应。结论脑电仿生电刺激神门穴、乳突穴可有效减轻SAE患者痴呆程度,改善患者神经功能、认知功能,加快脑部血流速度,降低血液黏稠度,且安全性较高。
Objective To investigate the impact of electroencephalographic bionic electrical stimulation of otopoint ear-shenmen and rutu point on patients with subcortical arteriosclerotic encephalopathy(SAE). Methods From February 2015 to June 2017,a total of 124 patients with SAE were selected in the Department of Internal Medicine,the Traditional Chinese Medicine Hospital of Wujiang District,Suzhou,and they were divided into control group and study group according to random number table method,with 62 cases in each group. Patients in control group received donepezil,while patients in study group received electroencephalographic bionic electrical stimulation of otopoint ear-shenmen and rutu point based on that of control group;both group continuously treated for 6 weeks. Clinical effect,Chinese version Montreal Cognitive Assessment Scale(MoCA)score,Hasegawa Dementia Scale(HDS)score,cerebral blood flow velocity,Hcy,D-dimer and hemorheological index(including whole blood high shear viscosity,whole blood low shear viscosity,plasma viscosity and erythrocyte aggregation index)before and after treatment were compared between the two groups,and incidence of adverse reactions was observed during treatment. Results(1)Clinical effect in study group was statistically significantly better than that in control group(P<0.05).(2)No statistically significant difference of Chinese version MoCA score or HDS score was found between the two groups before treatment(P>0.05),while Chinese version MoCA score and HDS score in observation group were statistically significantly higher than those in control group after treatment(P<0.05).(3)No statistically significant difference of blood flow velocity of left vertebral artery,right vertebral artery or basilar artery was found between the two groups before treatment(P>0.05);while blood flow velocity of left vertebral artery,right vertebral artery and basilar artery in study group was statistically significantly faster than those in control group after treatment,respectively(P<0.05).(4)No statistically significant difference of plasma levels of Hcy or D-dimer was found between the two groups before treatment(P>0.05),while plasma levels of Hcy and D-dimer in study group were statistically significantly lower than those in control group after treatment(P<0.05).(5)No statistically significant difference of whole blood high shear viscosity,whole blood low shear viscosity,plasma viscosity or erythrocyte aggregation index was found between the two groups before treatment(P>0.05),while whole blood high shear viscosity,whole blood low shear viscosity,plasma viscosity and erythrocyte aggregation index in study group were statistically significantly lower than those in control group after treatment(P<0.05).(6)No one in the two groups occurred any serious adverse reactions during treatment. Conclusion In patients with SAE,electroencephalographic bionic electrical stimulation of otopoint ear-shenmen and rutu point can effectively relieve the severity of dementia,improve the neurological function and cognitive function,quicken the cerebral blood flow velocity,reduce the blood viscosity,with relatively high safety.
Objective To investigate the impact of electroencephalographic bionic electrical stimulation of otopoint ear-shenmen and rutu point on patients with subcortical arteriosclerotic encephalopathy(SAE). Methods From February 2015 to June 2017,a total of 124 patients with SAE were selected in the Department of Internal Medicine,the Traditional Chinese Medicine Hospital of Wujiang District,Suzhou,and they were divided into control group and study group according to random number table method,with 62 cases in each group. Patients in control group received donepezil,while patients in study group received electroencephalographic bionic electrical stimulation of otopoint ear-shenmen and rutu point based on that of control group;both group continuously treated for 6 weeks. Clinical effect,Chinese version Montreal Cognitive Assessment Scale(MoCA)score,Hasegawa Dementia Scale(HDS)score,cerebral blood flow velocity,Hcy,D-dimer and hemorheological index(including whole blood high shear viscosity,whole blood low shear viscosity,plasma viscosity and erythrocyte aggregation index)before and after treatment were compared between the two groups,and incidence of adverse reactions was observed during treatment. Results(1)Clinical effect in study group was statistically significantly better than that in control group(P<0.05).(2)No statistically significant difference of Chinese version MoCA score or HDS score was found between the two groups before treatment(P>0.05),while Chinese version MoCA score and HDS score in observation group were statistically significantly higher than those in control group after treatment(P<0.05).(3)No statistically significant difference of blood flow velocity of left vertebral artery,right vertebral artery or basilar artery was found between the two groups before treatment(P>0.05);while blood flow velocity of left vertebral artery,right vertebral artery and basilar artery in study group was statistically significantly faster than those in control group after treatment,respectively(P<0.05).(4)No statistically significant difference of plasma levels of Hcy or D-dimer was found between the two groups before treatment(P>0.05),while plasma levels of Hcy and D-dimer in study group were statistically significantly lower than those in control group after treatment(P<0.05).(5)No statistically significant difference of whole blood high shear viscosity,whole blood low shear viscosity,plasma viscosity or erythrocyte aggregation index was found between the two groups before treatment(P>0.05),while whole blood high shear viscosity,whole blood low shear viscosity,plasma viscosity and erythrocyte aggregation index in study group were statistically significantly lower than those in control group after treatment(P<0.05).(6)No one in the two groups occurred any serious adverse reactions during treatment. Conclusion In patients with SAE,electroencephalographic bionic electrical stimulation of otopoint ear-shenmen and rutu point can effectively relieve the severity of dementia,improve the neurological function and cognitive function,quicken the cerebral blood flow velocity,reduce the blood viscosity,with relatively high safety.
引文
[1]潘海英.动脉硬化性脑白质病的CT与临床分析[J].实用医技杂志,2005,12(24):3595-3596.DOI:10.3969/j.issn.1671-5098.2005.24.018.
[2]唐涌,赵科鹏,丁雪明.皮层下动脉硬化性脑病C-反应蛋白和纤维蛋白原的测定及其临床意义[J].实用临床医药杂志,2015,19(24):141-142.DOI:10.7619/jcmp.201524056.
[3]王春霞,孙远征.原络通经针法治疗皮质下动脉硬化性脑病的研究[J].针灸临床杂志,2006,22(3):7-8.DOI:10.3969/j.issn.1005-0779.2006.03.004.
[4]郭洪志,屈传强.Binswanger病的诊断[J].临床神经病学杂志,2002,15(6):377-378.DOI:10.3969/j.issn.1004-1648.2002.06.031.
[5]田金州,韩明向,涂晋文,等.血管性痴呆诊断、辨证及疗效评定标准(研究用)[J].中国老年学杂志,2002,22(5):329-331.DOI:10.3969/j.issn.1005-9202.2002.05.001.
[6]孙远征,杨加顺,寇吉友,等.针刺药物治疗皮质下动脉硬化性白质脑病的研究[J].中国针灸,2002,22(10):651-652.
[7]孙远征,孙颖哲.头穴丛刺对皮质下动脉硬化性脑病认知功能干预效应的临床研究[J].上海针灸杂志,2013,32(5):342-344.DOI:10.3969/j.issn.1005-0957.2013.05.342.
[8]刘锋,李响.针灸治疗持续性植物状态的研究进展[J].环球中医药,2013,6(8):632-635.
[9]王亮,冯珍.神经电刺激的临床应用及机制研究进展[J].中国康复医学杂志,2013,28(8):775-778.
[10]LIU J T,TAN W C,LIAO W J.Effects of electrical cervical spinal cord stimulation on cerebral blood perfusion,cerebrospinal fluid catecholamine levels,and oxidative stress in comatose patients[J].Acta Neurochir Suppl,2008,101:71-76.
[11]贺顺龙,谢培增,刘剑,等.颈部脊髓硬膜外电刺激综合治疗颅脑损伤后持续性植物状态疗效观察[J].海军医学杂志,2012,33(4):236-238.
[12]倪莹莹,邓丽霞,邱承尧,等.脑电仿生电刺激对持续植物状态患者脑血流速度和脑代谢的影响[J].中国康复理论与实践,2015,21(3):303-306.DOI:10.3969/j.issn.1006-9771.2015.03.014.
[13]齐力.电刺激小脑顶核改善缺血性脑损害的研究进展[J].国外医学(脑血管疾病分册),1996,4(1):33-35.
[14]朱烨,吴雅利,李宝香.阿尔茨海默病患者同型半胱氨酸的表达水平及认知功能减退的危险因素[J].中国老年学杂志,2018,38(10):2406-2408.
[15]隆昱洲,雷进,罗丽华,等.小脑顶核电刺激对脑梗死患者脑执行功能的影响[J].山东医药,2012,52(46):5-7.
[16]赵晓冬,顾成华,徐明,等.联合应用电磁疗在中枢性协调障碍治疗中的研究[J].河北医药,2013,35(21):3269-3270.
[17]韩桂茹.自拟通脉降脂丸联合针灸护理对非酒精性脂肪肝患者血清TC TG LDL-C的影响[J].河北医学,2016,22(5):829-831.
[18]赵敏,张春雨,王凤春.针灸结合西医常规疗法对脑卒中后运动性失语患者语言功能及血液流变学的影响[J].国际中医中药杂志,2016,38(11):974-977.DOI:10.3760/cma.j.issn.1673-4246.2016.11.004.
[19]丁乔,胡颖.脑电仿生刺激联合通窍化瘀汤对缺血性脑卒中患者血浆组织因子、D-二聚体及内皮素水平的影响[J].西部中医药,2015,28(6):123-124.
[2]唐涌,赵科鹏,丁雪明.皮层下动脉硬化性脑病C-反应蛋白和纤维蛋白原的测定及其临床意义[J].实用临床医药杂志,2015,19(24):141-142.DOI:10.7619/jcmp.201524056.
[3]王春霞,孙远征.原络通经针法治疗皮质下动脉硬化性脑病的研究[J].针灸临床杂志,2006,22(3):7-8.DOI:10.3969/j.issn.1005-0779.2006.03.004.
[4]郭洪志,屈传强.Binswanger病的诊断[J].临床神经病学杂志,2002,15(6):377-378.DOI:10.3969/j.issn.1004-1648.2002.06.031.
[5]田金州,韩明向,涂晋文,等.血管性痴呆诊断、辨证及疗效评定标准(研究用)[J].中国老年学杂志,2002,22(5):329-331.DOI:10.3969/j.issn.1005-9202.2002.05.001.
[6]孙远征,杨加顺,寇吉友,等.针刺药物治疗皮质下动脉硬化性白质脑病的研究[J].中国针灸,2002,22(10):651-652.
[7]孙远征,孙颖哲.头穴丛刺对皮质下动脉硬化性脑病认知功能干预效应的临床研究[J].上海针灸杂志,2013,32(5):342-344.DOI:10.3969/j.issn.1005-0957.2013.05.342.
[8]刘锋,李响.针灸治疗持续性植物状态的研究进展[J].环球中医药,2013,6(8):632-635.
[9]王亮,冯珍.神经电刺激的临床应用及机制研究进展[J].中国康复医学杂志,2013,28(8):775-778.
[10]LIU J T,TAN W C,LIAO W J.Effects of electrical cervical spinal cord stimulation on cerebral blood perfusion,cerebrospinal fluid catecholamine levels,and oxidative stress in comatose patients[J].Acta Neurochir Suppl,2008,101:71-76.
[11]贺顺龙,谢培增,刘剑,等.颈部脊髓硬膜外电刺激综合治疗颅脑损伤后持续性植物状态疗效观察[J].海军医学杂志,2012,33(4):236-238.
[12]倪莹莹,邓丽霞,邱承尧,等.脑电仿生电刺激对持续植物状态患者脑血流速度和脑代谢的影响[J].中国康复理论与实践,2015,21(3):303-306.DOI:10.3969/j.issn.1006-9771.2015.03.014.
[13]齐力.电刺激小脑顶核改善缺血性脑损害的研究进展[J].国外医学(脑血管疾病分册),1996,4(1):33-35.
[14]朱烨,吴雅利,李宝香.阿尔茨海默病患者同型半胱氨酸的表达水平及认知功能减退的危险因素[J].中国老年学杂志,2018,38(10):2406-2408.
[15]隆昱洲,雷进,罗丽华,等.小脑顶核电刺激对脑梗死患者脑执行功能的影响[J].山东医药,2012,52(46):5-7.
[16]赵晓冬,顾成华,徐明,等.联合应用电磁疗在中枢性协调障碍治疗中的研究[J].河北医药,2013,35(21):3269-3270.
[17]韩桂茹.自拟通脉降脂丸联合针灸护理对非酒精性脂肪肝患者血清TC TG LDL-C的影响[J].河北医学,2016,22(5):829-831.
[18]赵敏,张春雨,王凤春.针灸结合西医常规疗法对脑卒中后运动性失语患者语言功能及血液流变学的影响[J].国际中医中药杂志,2016,38(11):974-977.DOI:10.3760/cma.j.issn.1673-4246.2016.11.004.
[19]丁乔,胡颖.脑电仿生刺激联合通窍化瘀汤对缺血性脑卒中患者血浆组织因子、D-二聚体及内皮素水平的影响[J].西部中医药,2015,28(6):123-124.