2024 年第 10 期 第 0 卷

针刺醒神四穴联合认知-运动双重任务训练对脑梗死合并认知功能障碍的治疗效果研究

Study on the clinical effect of acupuncture Xingshen four points combined with cognitive-motor dual task training in the treatment of cerebral infarction complicated with cognitive dysfunction

作者：陈军陈瑞妹李东鹤李学茬

英文作者：Chen Jun Chen Ruimei Li Donghe Li Xuecha

单位：海南医学院第二附属医院康复医学科，海口570311

英文单位：Department of Rehabilitation Medicine Second Affiliated Hospital of Hainan Medical College Haikou 570311 China

关键词：脑梗死；认知功能障碍；针刺；认知-运动双重任务训练

英文关键词：Stroke；Cognitiveimpairment；Acupuncture；Cognitive-motordualtasktraining

• 摘要：

• 目的 探讨针刺醒神四穴联合认知-运动双重任务训练（CMDT）对脑梗死合并认知功能障碍的治疗效果。方法 选择2020年8月至2023年8月海南医学院第二附属医院收治的96例脑梗死合并认知功能障碍患者，采用随机数字表法分为对照组和观察组，各48例。在基础治疗的基础上，对照组采用CMDT治疗4周，观察组采用针刺醒神四穴联合CMDT治疗4周。比较2组蒙特利尔认知评估量表(MoCA)评分、简易精神状态检查(MMSE)评分、P300振幅和潜伏期、美国国立卫生研究院卒中量表（NIHSS）评分、神经递质水平和生活质量。结果治疗后，2组MoCA、MMSE评分均高于治疗前，且观察组均高于对照组（均P＜0.001）；2组P300潜伏期均短于治疗前，且观察组短于对照组，2组P300振幅均高于治疗前，且观察组高于对照组（均P＜0.05）。治疗后，2组NIHSS评分均低于治疗前，且观察组低于对照组［（7.1±2.0）分比（10.3±2.6）分］（t=6.666，P＜0.001）；2组血清乙酰胆碱、多巴胺水平均高于治疗前，且观察组均高于对照组（均P＜0.05）。治疗后，2组日常生活活动能力量表评分均高于治疗前，且观察组高于对照组［（60±15）分比（53±13）分］（t=2.569，P=0.012）。结论 针刺醒神四穴联合CMDT可有效纠正脑梗死合并认知功能障碍患者神经递质紊乱，改善认知功能和神经功能，提高生活质量。

• Objective To explore the clinical effect of acupuncture Xingshen four points combined with cognitive-motor dual task training (CMDT) in the treatment of cerebral infarction complicated with cognitive dysfunction. Methods A total of 96 patients with cerebral infarction combined with cognitive dysfunction admitted to the Second Affiliated Hospital of Hainan Medical College from August 2020 to August 2023 were selected and divided into control group and observation group by random number table method, with 48 cases in each group. On the basis of basic treatment, the control group was treated with CMDT for 4 weeks, and the observation group was treated with acupuncture Xingshen four points combined with CMDT for 4 weeks. The Montreal cognitive assessment (MoCA) score, Mini-mental state examination (MMSE) score, P300 amplitude and latency, national institutes of health stroke scale (NIHSS) score, neurotransmitter level and quality of life were compared between the two groups. Results After treatment, the MoCA and MMSE scores of the two groups were higher than those before treatment, and those of the observation group were higher than those of the control group (all P<0.001). The P300 latencies of the two groups were shorter than those before treatment, and the observation group was shorter than that of the control group; the P300 amplitudes of the two groups were higher than those before treatment, and the observation group was higher than that of the control group (all P<0.05). After treatment, the NIHSS scores of the two groups were lower than those before treatment, and the NIHSS score of the observation group was lower than that of the control group ［（7.1±2.0） vs （10.3±2.6）］（t=6.666, P＜0.001）. The levels of serum acetylcholine and dopamine in the two groups were higher than those before treatment, and those in the observation group were higher than those in the control group (all P<0.05). After treatment, the activities of daily living scale scores of the two groups were higher than those before treatment, and the observation group was higher than the control group ［（60±15） vs （53±13）］（t=2.569， P=0.012）. Conclusion Acupuncture Xingshen four points combined with CMDT can effectively correct neurotransmitter disorder, improve cognitive function and neurological function, and improve the quality of life in patients with cerebral infarction and cognitive impairment.