针灸联合活血通络汤治疗脑卒中后认知功能障碍的临床研究

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摘要目的探讨针灸联合活血通络汤治疗脑卒中后认知功能障碍的临床效果。方法选择2015年1月～2016年12月武汉市第十一医院收治的79例脑卒中后认知功能障碍患者，随机分为对照组（39例）和治疗组（40例）。对照组患者给予活血通络汤治疗，治疗组患者给予针灸联合活血通络汤治疗，两组患者均连续治疗30 d。评价并比较两组患者临床疗效。应用简易精神状态检查量表（MMSE）评价认知功能，检测治疗前后血清皮质醇（Cor）、热休克蛋白70（HSP70）水平，观察患者在治疗过程中的不良反应。结果治疗组总有效率明显高于对照组（P ＜ 0.05）。治疗后，两组患者MMSE评分明显高于治疗前，且治疗组MMSE评分明显高于对照组，差异有统计学意义（P ＜ 0.05）。两组患者血清Cor水平明显低于治疗前，血清HSP70水平明显高于治疗前，且治疗组治疗后血清Cor、HSP70水平变化均明显优于对照组，差异均有统计学意义（P ＜ 0.05）。两组在治疗过程中均未见明显的不良反应。结论针灸联合活血通络汤治疗脑卒中后认知功能障碍临床效果显著，能够明显改善患者认知功能和神经功能预后，且安全性较好，值得在临床上推广应用。

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	贾云哲1 吕晓宇2

关键词 ：针灸, 活血通络汤, 脑卒中后认知功能障碍, 疗效

Abstract：Objective To investigate the effects of acupuncture combined with Huoxue Tongluo Decoction in the treatment of post-stroke cognitive impairment. Methods A total of 79 patients with post-stroke cognitive impairment in Wuhan Eleventh Hospital from January 2015 to December 2016 were enrolled in this study. The subjects were randomly divided into the control group (39 cases) and the treatment group (40 cases). The control group was treated with Huoxue Tongluo Decoction, the treatment group was treated with acupuncture combined with Huoxue Tongluo Decoction. The two groups were treated for 30 days. The clinical effects of the two groups after treatment were compared. The cognitive function by mini-mental state examination (MMSE) was evaluated, the levels of serum cortisol (Cor) and heat shock protein 70 (heat shock protein 70, HSP70) were detected before and after treatment, the adverse reactions of the two groups during treatment were observed. Results The total effective rate of the treatment group was significantly higher than that of control group (P ＜ 0.05). After treatment, the MMSE score of the two groups was significantly higher than that before treatment, the MMSE score of the treatment group was significantly higher than that of control group (P ＜ 0.05). After treatment, the levels of serum Cor in the two groups were significantly lower than those before treatment, the levels of serum HSP70 in the two groups were significantly higher than those before treatment, and the changes of serum Cor and HSP70 levels after treatment in the treatment group were significantly better than those in the control group, the differences were statistically significant (P ＜ 0.05). There were no significant adverse reactions in the two groups during the treatment. Conclusion Acupuncture combined with Huoxue Tongluo Decoction for patients with post-stroke cognitive impairment has a good efficacy, which can improve the cognitive function and neurologic prognosis, with good safety, and it is worthy of clinical promotion and application.

Key words： Acupuncture Huoxue Tongluo Decoction Post-stroke cognitive impairment Efficacy

通讯作者: 吕晓宇（1962-），男，硕士，主任医师；研究方向：中医康复临床及理论研究。

引用本文:

贾云哲1 吕晓宇2. 针灸联合活血通络汤治疗脑卒中后认知功能障碍的临床研究[J]. 中国医药导报, 2018, 15(4): 113-116.
JIA Yunzhe1 LYU Xiaoyu2. Clinical study of acupuncture combined with Huoxue Tongluo Decoction in the treatment of post-stroke cognitive impairment. 中国医药导报, 2018, 15(4): 113-116.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2018/V15/I4/113

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