[1]樊宇婷,关 莹,李冬岩.针刺结合奥拉西坦治疗脑梗死后轻度认知障碍疗效研究[J].陕西中医,2023,(5):644-647.[doi:DOI:10.3969/j.issn.1000-7369.2023.05.025]
　FAN Yuting,GUAN Ying,LI Dongyan.Effect of acupuncture combined with oxiracetam on mild cognitive impairment after cerebral infarction[J].,2023,(5):644-647.[doi:DOI:10.3969/j.issn.1000-7369.2023.05.025]
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针刺结合奥拉西坦治疗脑梗死后轻度认知障碍疗效研究
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《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2023年5期
页码:
644-647
栏目:
针灸经络
出版日期:
2023-05-05

文章信息/Info

Title:
Effect of acupuncture combined with oxiracetam on mild cognitive impairment after cerebral infarction
作者:
樊宇婷1; 2 ; 关 莹1; 2; 李冬岩3
(1.黑龙江中医药大学,黑龙江 哈尔滨 150006; 2.黑龙江中医药大学附属第二医院,黑龙江 哈尔滨 150001; 3.白城中心医院,吉林 白城 137000)
Author(s):
FAN Yuting; GUAN Ying; LI Dongyan
(Heilongjiang University of Traditional Chinese Medicine,Harbin 150006,China)
关键词:
脑梗死;  针刺;  奥拉西坦;  轻度认知障碍;  脑血流动力学
Keywords:
Cerebral infarction;  Acupuncture;  Oxiracetam;  Mild cognitive impairment;  Cerebral hemodynamics
分类号:
R 743.3
DOI:
DOI:10.3969/j.issn.1000-7369.2023.05.025
文献标志码:
A
摘要:
目的:观察针刺结合奥拉西坦治疗脑梗死后轻度认知障碍的疗效及对患者血清胶质细胞源性神经营养因子(GDNF)、沉默信息调节因子1(SIRT1)表达的影响。方法:将90例脑梗死后轻度认知障碍患者用随机数字表法分为两组。对照组给予奥拉西坦治疗,观察组在奥拉西坦基础上结合针刺治疗。比较两组血清GDNF、S100β、SIRT1、神经元特异性烯醇化酶(NSE)及脑血流动力学的水平,评估两组蒙特利尔认知评估量表(MoCA)评分、Barthel指数的差异,统计两组疗效。结果:两组治疗前血清GDNF、SIRT1等相关因子、脑血流动力学相关评分比较,差异无统计学意义(P>0.05)。与治疗前相比,两组GDNF、SIRT1及收缩期峰值血流速度(Vs)、舒张期血流速度(Vd)、平均血流速度(Vm)治疗后升高,且观察组更高(P<0.05)。两组S100β、NSE及阻力指数(RI)治疗后下降,且观察组更低(P<0.05)。两组简易智能状态检查量表(MMSE)评分、Barthel指数、MoCA评分治疗后升高,且观察组更高(P<0.05)。两组老年性痴呆量表-认知分量表(ADAS-Cog)评分治疗后下降,且观察组更低(P<0.05)。观察组总有效率为92.68%高于对照组的76.74%,差异有统计学意义(P<0.05)。结论:针刺结合奥拉西坦治疗脑梗死后轻度认知障碍可改善脑血流循环,调节GDNF、SIRT1、S100β、NSE的表达,促进认知功能的恢复,提高疗效。
Abstract:
Objective:To observe the therapeutic effect of acupuncture combined with oxiracetam on mild cognitive impairment after cerebral infarction and its effect on the expression of serum glial cell derived neurotrophic factor(GDNF)and silent information regulatory factor 1(SIRT1).Methods:90 patients with mild cognitive impairment after cerebral infarction were selected as subjects,and were divided into two groups by random number table method.The control group was treated with oxiracetam,while the observation group was treated with acupuncture on the basis of oxiracetam.Detected and compared serum GDNF and S100β, SIRT1,neuron-specific enolase(NSE)and cerebral hemodynamics level of the two groups,evaluate the differences of cognitive function scores such as Montreal Cognitive Assessment Scale(MoCA)score and Barthel index between the two groups,and count the curative effects of the two groups.Results:There was no statistical difference between the two groups in serum GDNF,SIRT1 and other related factors and cerebral hemodynamics before treatment(P>0.05).Compared with before treatment,GDNF,SIRT1,peak systolic blood flow velocity(Vs),diastolic blood flow velocity(Vd)and mean blood flow velocity(Vm)of the two groups increased after treatment,and the observation group was higher(P<0.05).Two groups of S100β、 NSE and resistance index(RI)decreased after treatment,and were lower in the observation group(P<0.05).Compared with before treatment,the scores of MMSE,Barthel index and MoCA in the two groups increased after treatment,and the observation group was higher(P<0.05).After treatment,the scores of the Alzheimer's Dementia Scale-cognitive subscale(ADAS-log)in the two groups decreased,and the scores in the observation group were lower(P<0.05).The total effective rate of the observation group was 92.68%,which was higher than 76.74% of the control group,with a statistical difference(P<0.05).Conclusion:Acupuncture combined with oxiracetam can improve cerebral blood circulation and regulate GDNF,SIRT1 and S100 β in the treatment of mild cognitive impairment after cerebral infarction β、 The expression of NSE can promote the recovery of cognitive function and improve the curative effect.

参考文献/References:

[1] Fang G,Xiang J,Yang S,et al.Correlation of serum uric acid,cystatin C and high-sensitivity C-reactive protein with cognitive impairment in lacunar cerebral infarction[J].American Journal of Translational Research,2021,13(6):6717-6723.
[2] Kashibayashi T,Fujita J.Correlation between cerebral blood flow and olfactory function in mild cognitive impairment and Alzheimer's disease[J].International Journal of Geriatric Psychiatry,2021,36(7):1103-1109.
[3] 赵东升,弥婉军.血清同型半胱氨酸、促甲状腺激素、脑钠肽水平动态监测对重度脑血管疾病所致认知功能障碍的预测价值[J].陕西医学杂志,2022,51(9):1146-1148,1170.
[4] 韩 慧,李 鑫,姜海娜,等.早期针刺治疗对脑梗死后血管性痴呆患者认知功能的影响[J].中国针灸,2021,41(9):979-983.
[5] 王作凤,杨泽华,于 洋.中风醒神合剂联合奥拉西坦治疗脑梗死后轻度认知障碍的疗效[J].中南医学科学杂志,2022,50(6):922-925.
[6] 林晓婉,曹 颖,刘鹏飞,等.胶质细胞源性神经营养因子在围手术期神经认知障碍中的研究进展[J].国际麻醉学与复苏杂志,2021,42(10):1094-1097.
[7] Pradhan R.Blood circulatory level of seven sirtuins in Alzheimer's disease:Potent biomarker based on translational research[J].Mol Neurobiol,2022,59(3):1440-1451.
[8] 中国痴呆与认知障碍诊治指南写作组,中国医师协会神经内科医师分会认知障碍疾病专业委员会.2018中国痴呆与认知障碍诊治指南(五):轻度认知障碍的诊断与治疗[J].中华医学杂志,2018,98(17):8-9.
[9] Dodich A,Crespi C,Santi GC,et al.Emotion recognition deficits in the differential diagnosis of amnestic mild cognitive impairment:A cognitive marker for the limbic-predominant phenotype[J].Journal of the International Neuropsychological Society,2022,28(2):203-209.
[10] 史 悦,高小夏,谈 笑,等.中文版认知障碍简要测试量表与简易精神状态检查量表在脑卒中患者认知评估中的比较分析[J].重庆医科大学学报,2021,46(11):1310-1314.
[11] 秦龙江,徐乐义,王孝义.针灸联合偏瘫肢体康复训练对老年脑梗死后偏瘫患者肢体功能、神经功能和生活质量的影响[J].中国老年学杂志,2022,42(5):1071-1074.
[12] 吴佳宏,王 韬,胡远想,等.轻型急性脑梗死后患者认知域功能的变化及认知功能障碍的危险因素分析[J].中风与神经疾病杂志,2022,39(10):872-876.
[13] He W,Li M,Han X,et al.Acupuncture for mild cognitive impairment and dementia:An overview of systematic reviews[J].Frontiers in Aging Neuroscience,2021,13(22):e647629.
[14] Boku Y,Ota M,Nemoto M,et al.Effects of a multicomponent day-care program on cerebral blood flow in patients with mild cognitive impairment[J].Psychogeriatrics,2022,22(4):478-484.
[15] 郑婵娟,夏文广,段 璨,等.“补肾调督益智”针刺联合计算机辅助认知训练治疗卒中后认知功能障碍:随机对照研究[J].中国针灸,2021,41(3):247-251.
[16] Wan Z,Li Y,Ye H,et al.Plasma S100β and neuron-specific enolase,but not neuroglobin,are associated with early cognitive dysfunction after total arch replacement surgery:A pilot study[J].Medicine,2021,100(15):e25446.
[17] Tian R,Jiang Y,Zhang Y,et al.Cognitive training program improves cognitive ability and daily living ability in elderly patients with mild cognitive impairment[J].Aging Clinical And Experimental Research,2022,34(5):997-1005.
[18] Maiese K.Cognitive impairment and dementia:Gaining insight through circadian clock gene pathways[J].Biomolecules,2021,11(7):1002-1004.
[19] 王 岩,白艳杰,张 铭,等.通督醒神针刺法对卒中后轻度认知障碍患者认知功能及精神行为症状的改善效果研究[J].中国全科医学,2021,24(33):4223-4228.
[20] 高梦菲,王朝霞.益肾健脑汤联合针刺对脑梗死后轻度认知障碍患者血清miR-27-3p、miR-409-3p表达的影响[J].陕西中医,2022,43(3):371-375.

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备注/Memo

备注/Memo:
基金项目:国家自然科学基金青年基金资助项目(82004439)
更新日期/Last Update: 2023-05-09