互动式头针对脑卒中后认知功能及抑郁、焦虑状态的临床研究

张绍华; 王玉龙; 章春霞; 章春平; 肖鹏; 李浅峰; 梁伟容; 潘小华; 周明超

doi:10.3969/j.issn.1006-2157.2021.07.012

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互动式头针对脑卒中后认知功能及抑郁、焦虑状态的临床研究

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互动式头针对脑卒中后认知功能及抑郁、焦虑状态的临床研究
A clinical study of interactive scalp acupuncture on cognition, depression, and anxiety among post cerebral stroke patients
1.深圳市大鹏新区南澳人民医院　广东　518121
2.深圳市第二人民医院
3.广州中医药大学深圳医院
DOI：10.3969/j.issn.1006-2157.2021.07.012

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张绍华, 王玉龙, 章春霞, 等. 互动式头针对脑卒中后认知功能及抑郁、焦虑状态的临床研究[DB/OL].（2023-09-15）[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails#10.3969/j.issn.1006-2157.2021.07.012

Zhang Shaohua, Wang Yulong, Zhang Chunxia, et al. A clinical study of interactive scalp acupuncture on cognition, depression, and anxiety among post cerebral stroke patients[DB/OL].（2023-09-15）[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails#10.3969/j.issn.1006-2157.2021.07.012
张绍华, 王玉龙, 章春霞, 等. 互动式头针对脑卒中后认知功能及抑郁、焦虑状态的临床研究[DB/OL].（2023-09-15）[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails#10.3969/j.issn.1006-2157.2021.07.012 DOI：

Zhang Shaohua, Wang Yulong, Zhang Chunxia, et al. A clinical study of interactive scalp acupuncture on cognition, depression, and anxiety among post cerebral stroke patients[DB/OL].（2023-09-15）[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails#10.3969/j.issn.1006-2157.2021.07.012 DOI：

摘要

目的,2,观察互动式头针对脑卒中患者认知功能，抑郁、焦虑状态及睡眠质量的影响。,方法,2,选择2019年5月—2020年5月就诊于深圳市大鹏新区南澳人民医院康复科、深圳市第二人民医院康复科、深圳市福田区中医院康复科的脑卒中患者，共445例，随机分为试验组（,n,=223）、对照组（,n,=222），试验组脱落23例，对照组脱落22例。2组患者均予常规药物及常规康复运动治疗，试验组在此基础上给予互动式头针治疗，对照组给予常规头针、认知训练治疗，共治疗8周。比较2组患者首次治疗前、疗程结束时及2月后随访时蒙特利尔认知评估量表（MoCA）、简易智力状态检查量表（MMSE）、汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）、匹兹堡睡眠质量指数（PSQI）、改良Barthel指数（MBI），及首次治疗前、疗程结束时血清脑源性神经营养因子（BDNF）和血清神经生长因子（NGF）含量。,结果,2,与治疗前比较，试验组患者在疗程结束时和随访时，MoCA、MMSE、MBI评分均升高（,P,<,0.01），HAMD、HAMA、PSQI评分均降低（,P,<,0.01）。对照组患者在疗程结束时和随访时，MoCA评分升高（,P,<,0.01），HAMD评分降低（,P,<,0.01），MMSE、MBI评分仅在疗程结束时升高（,P,<,0.01）；与对照组比较，试验组在疗程结束时、随访时MoCA、MMSE、MBI评分均升高（,P,<,0.01），HAMD、HAMA、PSQI评分均降低（,P,<,0.01）。血清学指标方面，与治疗前比较，2组患者疗程结束时血清BDNF、NGF含量均升高（,P,<,0.01），且试验组高于对照组（,P,<,0.01）。,结论,2,互动式头针能明显改善脑卒中患者认知功能及抑郁、焦虑状态，改善患者睡眠质量及生活自理能力，促进脑神经功能恢复，较常规康复治疗有一定的优势，且停止治疗后仍然可以保持疗效优势。

Abstract

Objective,2,To observe the effects of interactive scalp acupuncture on cognitive function, depression, anxiety and sleep quality in patients with post-stroke patients.,Methods,2,A total of 445 patients with stroke who had been admitted to the Rehabilitation Department of Nan'ao People's Hospital, Shenzhen Second People's Hospital and Shenzhen Futian District Hospital of Traditional Chinese Medicine from May 2019 to May 2020 were selected and randomly divided into the experimental group (,n,=223) and the control group (,n,=222), with 23 cases shed in the experimental group and 22 cases shed in the control group. Two groups of patients were treated with standard care and conventional rehabilitation exercise therapy. The experimental group was given interactive head acupuncture therapy, while the control group was given conventional scalp acupuncture and cognitive training therapy for a course of 8 weeks. Before the initial treatment, at the end of the treatment course, and at the follow-up 2 months later, Montreal Cognitive Assessment Scale (MoCA), Mini-mental State Examination (MMSE), Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), Pittsburgh Sleep Quality Index (PSQI), and Modified Barthel Index (MBI) were evaluated. The levels of serum Brain-derived Neurotrophic Factor (BDNF) and Nerve Growth factor (NGF) were measured before and after the first treatment.,Results,2,At the end of the treatment course and at the follow-up, the scores of MoCA, MMSE and MBI in the experimental group were increased compared with those before treatment (,P,<,0.01), and the scores of HAMD, HAMA and PSQI were decreased compared with those before treatment (,P,<,0.01). MoCA scores increased (,P,<,0.01) and HAMD scores of the control group decreased (,P,<,0.01) both at the end of the treatment course and at the follow-up, whereas MMSE and MBI scores of the control group increased only at the end of treatment (,P,<,0.01). The scores of MoCA, MMSE and MBI in the experimental group were higher than those in the control group at the end of the course and at the follow-up (,P,<,0.01), and the scores of HAMD, HAMA and PSQI in the experimental group were lower than those in the control group (,P,<,0.01). In terms of serological indexes, the levels of BDNF and NGF in both groups at the end of the course of treatment were higher than those before treatment (,P,<,0.01), and those in the experimental group were higher than those in the control group (,P,<,0.01).,Conclusion,2,Interactive scalp acupuncture can significantly improve not only the cognitive function, depression, anxiety but also the sleep quality and self-care ability of patients with stroke, and promote the recovery of cerebral nerve function. Compared with conventional rehabilitation treatment, it has the efficacy advantage which can be maintained after stopping the treatment.

关键词

互动式头针脑卒中认知功能抑郁焦虑

Keywords

interactive scalp acupuncturestrokecognitive functiondepressionanxiety

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