头皮针联合康复训练对脑卒中后轻度认知障碍患者脑血流动力学及血管内皮功能的影响

目的:观察头皮针联合康复训练对脑卒中后轻度认知障碍患者血管内皮功能及脑血流动力学的影响。方法:选取2011年3月至2017年3月辽宁中医药大学附属第二医院收治并确诊为脑卒中(缺血性脑梗死与脑出血)后合并轻度认知障碍的患者100例,按照入选的先后顺序分为观察组与对照组,每组50例,对照组给予常规药物治疗与康复训练治疗,观察组在对照组基础上给予头皮针治疗,连续治疗3个月。治疗前与治疗过程中(2周、1个月、3个月)比较2组脑循环参数经颅多普勒超声(TCD)测量双侧椎动脉(VA)、大脑中动脉(MCA)、大脑前动脉(ACA)阻力指数(RI)]、血管内皮功能血清一氧化氮(NO)、内皮素-1(ET-1)]的变化。结果:治疗后2组的双侧VA、MCA、ACA的RI均低于治疗前,差异有统计学意义(P 0. 05),且治疗后各时间点观察组低于对照组,差异有统计学意义(P 0. 05);治疗过程中(2周、1个月、3个月) 2组的血清NO均高于治疗前,差异有统计学意义(P 0. 05),且治疗后各时间点观察组高于对照组,差异有统计学意义(P 0. 05),治疗后2组的血清ET-1均低于治疗前,差异有统计学意义(P 0. 05),且治疗后各时间点观察组低于对照组,差异有统计学意义(P 0. 05)。结论:头皮针结合康复训练能通过改善脑卒中后合并轻度认知障碍患者的血管内皮功能而调节血流动力学。

Effects of Scalp Acupuncture Combined with Rehabilitation Training on the Changes of Cerebral Hemodynamics and Vascular Endothelial Function in Patients with Post-stroke Mild Cognitive Impairment

To investigate the effects of scalp acupuncture combined with rehabilitation training on the changes of cerebral hemodynamics (bilateral resistance index (RI) in vertebral artery (VA), arteria cerebri media (MAC), and arteria cerebri anterior (ACA)) and vascular endothelial function (nitrogen oxide (NO) and endothelin-1 (ET-1)) in patients with post-stroke mild cognitive impairment. Methods:A total of 90 patients with post-stroke mild cognitive impairment were selected, and were randomly divided into the observation group (n=50) and the control group (n=50). Patients in control group were given conventional drug therapy and rehabilitation training, and the observation group was given scalp acupuncture on this basic. Each group was treated 3 months. Data was compared before and after treatment (2 weeks, 1 month, 3 months) in cerebral hemodynamics (bilateral RI in VA, MAC, and ACA), which was detected by Transcranial Doppler (TCD); Data was compared before and after treatment (2 weeks, 1 month, 3 months) in vascular endothelial function (NO, ET-1). Results:During the 3-month treatment, the cerebral hemodynamics (bilateral RI in VA, MAC, and ACA) detected by the transcranial doppler (TCD) were lower than pretherapy, and had statistical significance (P<0.05), and the RI in the observation group were lower than control group, and had statistical significance (P<0.05); the concentration of NO were higher than pretherapy, and had statistical significance (P<0.05), and the NO in the observation group were higher than control group, and had statistical significance (P<0.05); the concentration of ET-1 was lower than pretherapy, and had statistical significance (P<0.05), and the ET-1 in the observation group were lower than control group, and had statistical significance (P<0.05). Conclusion:A 3-momth treatment of scalp acupuncture combined with rehabilitation training can improve the cerebral hemodynamics through improving the vascular endothelial function.