针灸配合认知训练治疗颅脑外伤致认知障碍临床研究

摘要

Objective To observe the clinical efficacy of acupuncture and moxibustion combined with cognitive training in treating cognitive impairment after traumatic brain injury (TBI). MethodsSixty patients were recruited into the study and randomly divided into the control group and the treatment group according to the MINIMIZE software. Patients in the control group were treated with cognitive training and regular treatment. Besides the traditional treatment, patients in the treatment group were additionally treated with acupuncture and moxibution. The treatment lasted four weeks. Mini-Mental State Examination (MMSE) and Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) were applied to evaluate the patients’ cognitive function before and after the treatment.Results In the end, there were 27 patients in the control group and 28 patients in the treatment group, because 5 patients withdrew from the study. After treatment, scores of MMSE, LOTCA and their sub-items in the control group and the treatment group increased significantly (P<0.05), and the scores in the treatment group were higher than the control group (P<0.05).Conclusion Combination of acupuncture, moxibution, and cognitive training could help patients after TBI to increase the scores of MMSE and LOTCA, and improve the cognitive impairment caused by TBI. Its therapeutic effect is superior than the pure cognitive training.%目的：观察针灸配合认知训练对颅脑外伤(TBI)致认知障碍的临床疗效。方法采用MINIMIZE分层软件将60例TBI患者随机分为对照组和治疗组。对照组予认知训练＋常规治疗，治疗组予针灸＋认知训练＋常规治疗，疗程4周。采用简明精神状态量表(MMSE)、洛文斯顿认知功能评定测验(LOTCA)评定2组患者治疗前后的认知功能。结果有5例患者中途退出，最终对照组27例、治疗组28例完成治疗。治疗后，对照组和治疗组MMSE、LOTCA 的总分及各子项目得分均较治疗前增加(P＜0.05)，治疗组各项得分均高于对照组(P＜0.05)。结论针灸配合认知训练能提高MMSE和LOTCA得分，改善TBI所致的认知障碍，疗效优于单纯认知训练。