[1]萨仁,李长君,蔡海鑫.头穴丛刺对脑卒中后血管性痴呆患者认知功能及血清HIF1α的影响*[J].陕西中医,2019,(11):1622-1626.
　SA Ren,LI Changjun,CAI Haixin..Effect of scalp acupuncture on cognitive function and serum HIF1α in patients with vascular dementia after stroke[J].,2019,(11):1622-1626.
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头穴丛刺对脑卒中后血管性痴呆患者认知功能及血清HIF1α的影响*
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《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2019年11期
页码:
1622-1626
栏目:
针灸经络
出版日期:
2019-11-05

文章信息/Info

Title:
Effect of scalp acupuncture on cognitive function and serum HIF1α in patients with vascular dementia after stroke
文章编号:
DOI:10.3969/j.issn.10007369.2019.11.037
作者:
萨仁; 李长君; 蔡海鑫
海南省三亚市中医院(三亚 572000)
Author(s):
SA Ren; LI Changjun;  CAI Haixin.
Sanya Hospital of Traditional Chinese Medicine in Hainan Province（Sanya 572000）
关键词:
脑卒中; 血管性痴呆; 头穴丛刺; 疗效; 脑血管储备功能; 血清HIF1α
Keywords:
Key words Stroke; Vascular dementia; Cluster needling of scalp point; Efficacy; Cerebrovascular reserve; Serum HIF1α
分类号:
R743.9
文献标志码:
A
摘要:
摘要目的:分析头穴丛刺治疗脑卒中后血管性痴呆的有效性与安全性，观察头穴丛刺对患者认知功能、日常生活能力及血清低氧诱导因子1α（HIF1α）的影响。方法:选择脑卒中后血管性痴呆患者110例，按照随机数字表法将其分为研究组与对照组，各55例。全部患者在入院后均接受脑内科常规治疗及基础疾病对症治疗，在此基础上给予对照组常规针刺治疗，给予研究组头穴丛刺治疗，以5d为1个治疗疗程，连续治疗3个疗程。疗程结束时评估并对比两组患者疗效，治疗期间记录不良反应。分别于治疗前、治疗3个疗程后，检测并对比两组患者血清HIF1α水平变化情况，同时使用简易精神状态量表（MMSE）和日常生活能力量表（ADL）两个指标分别评价患者认知功能与日常生活能力。结果:研究组治疗总有效率（92.73%）高于对照组（72.73%），差异有统计学意义（P＜005）；治疗3个疗程后，两组患者MMSE评分均较治疗前升高，ADL评分均较治疗前降低，研究组升高/降低幅度大于对照组，差异有统计学意义（P＜005）。治疗3个疗程后，研究组血清HIF1α水平均较治疗前降低，且研究组降低幅度均高于对照组，差异有统计学意义（P＜005）；所有患者针刺期间无不良反应发生。结论:头穴丛刺治疗脑卒中后血管性痴呆疗效确切，较常规针刺更利于改善患者认知功能，提高其日常生活能力，患者血清HIF1α表达降低，且针刺期间未见不良反应发生。
Abstract:
AbstractObjective：To analyze the effectiveness and safety of cluster needling of scalp point in treatment of vascular dementia after stroke,and to observe its effect on cognitive function,activity of daily living and serum hypoxiainducible factor1α (HIF1α).Methods：110 patients with vascular dementia after stroke were selected as the research subjects.All selected cases were divided into control group and research group according to the random number table,with 55 cases in each group.All patients received routine treatment of brain internal medicine department and symptomatic treatment of underlying diseases after admission.And on this basis,control group was given routine acupuncture,and research group was treated with cluster needling of scalp point.Taking 5 d as a course of treatment,and the overall treatment lasted for 3 courses.The efficacy of two groups was compared at the end of course of treatment,and the adverse reactions during treatment were recorded.Before treatment and after treatment for 3 courses,the changes of serum HIF1α were detected and compared between the two groups.The cognitive function and activity of daily living of patients were evaluated by Minimum mental state examination (MMSE)
[11] and Activities of daily living scale (ADL)
[12].Results：The total curative effective rate of research group (92.73%) was higher than that of control group (72.73%),and the difference was statistically significant (P＜005).After treatment for 3 courses,the scores of MMSE in two groups were higher than those before treatment,and the scores of ADL in two groups were lower than those before treatment,and the increased/decrease range of research group was larger than that of control group,and the difference was statistically significant (P＜005).After treatment for 3 courses,the level of serum HIF1α in research group was lower than that before treatment,and the decreased range of research group was higher than that of control group,and the difference was statistically significant (P＜005).There 〖LM〗were no adverse reactions in all patients during acupuncture therapy.Conclusion：Compared with routine acupuncture,cluster needling of scalp point in treatment of vascular dementia after stroke is more effective,it can improve cognitive function,increase activity of daily living,decrease the expression of serum HIF1α,and have no adverse reactions during acupuncture,which is safe and reliable.

参考文献/References:

[1]曹冰清，王涛，康涛，等.银杏叶提取物联合尼莫地平对轻中度血管性痴呆患者血清同型半胱氨酸、S100B及认知功能的影响[J].陕西医学杂志，2018，47(3)：379381,385.
[2]Venkat P,Chopp M,Chen J.Models and mechanisms of vascular dementia[J].Exp Neur,2015,272:97108.
[3]石柳，张永健，尹祥.缺血性脑卒中后血管性痴呆危险因素分析[J].中西医结合心脑血管病杂志，2017，15(11)：13991402.
[4]Kurz AF,Erkinjuntti T,Small GW,et al.Longterm safety and cognitive effects of galantamine in the treatment of probable vascular dementia or Alzheimer's disease with cerebrovascular disease[J].Eur J Neurol,2015,10(6):633640.
[5]Mizuno D,Konohamizuno K,Mori M,et al.Protective activity of carnosine and anserine against zincinduced neurotoxicity:a possible treatment for vascular dementia[J].Metallomics,2015,7(8):12331239.
[6]Xiao AA,Durkin M,Iftikhar I,et al.Acupuncture for treatment on cognitive function in vascular dementia:a metaanalysis[J].Am J Geriatr Psychiat,2015,23(3):S74S75.
[7]中华医学会神经病学分会.血管性痴呆诊断标准草案[J].中华神经科杂志，2002，35(4)：246.
[8]中华医学会神经病学分会.中国急性缺血性脑卒中诊治指南2014[J].中华神经科杂志，2015，48(4)：246257.
[9]田金洲，韩明向，涂晋文，等.血管性痴呆的诊断、辨证及疗效判定标准[J].北京中医药大学学报，2000，23（5）:1624.
[10]国家中医药管理局脑病急症协作组.中风病诊断与疗效评定标准[J].北京中医药大学学报，1996，19（1）：357365.
[11]Cockrell JR,Folstein MF.Minimental state examination (MMSE)[J].Aust J Physiother,2005,51(3):689692.
[12]Lawton,Brody.日常生活能力量表(ADL)[J].中国微侵袭神经外科杂志，2006，11(11)：516516.
[13]贾东佩，李春雷.调神通络针刺法对脑梗死后血管性痴呆患者血清BDNF、VEGF、MMP9的影响[J].陕西中医，2019，40(1)：121123.
[14]靳小莹，王文娜，韩纪荣，等.头针联合磁圆梅针治疗血管性认知障碍疗效研究[J].陕西中医，2018，39(5):9698.
[15]马莉，王诗陶，顾兰馨.头穴丛刺法配合针刺八脉交会穴治疗血管性痴呆疗效观察[J].上海针灸杂志，2018，37(12)：3841.
[16]王康锋，张立娟，陈新勇.电针大椎及百会穴治疗老年性痴呆36例临床观察[J].中华中医药杂志，2015，30(3)：784786.
[17]刘斐雯，俞坤强，彭洪卫，等.电针百会、神庭穴对局灶性脑缺血再灌注大鼠学习记忆能力及海马区GAP43蛋白表达的影响[J].中国中医急症，2016，25(2)：189192.
[18]李国强，杨佃会.从气街四海理论探析风府穴治疗脑病发微[J].辽宁中医杂志，2016，43(6)：11871188.
[19]吕有魁，何宗宝.人中穴“醒脑开窍”作用机理的研究进展[J].中国中医基础医学杂志，2016，22(1)：147148.
[20]张立，李季，陈静，等.头穴丛刺结合康复训练治疗血管性痴呆的临床观察[J].中医药信息，2015，32(1)：9596.
[21]Zagzag D,Zhong H,Scalzitti JM,et al.Expression of hypoxia‐inducible factor 1α in brain tumors[J].Cancer,2015,88(11):26062618.

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备注/Memo

备注/Memo:
*海南省科技厅资助项目(SQ2014GJXM0018)
更新日期/Last Update: 2019-11-15