Clinical Efficacy of Tongqiao Huoxuetang Plus Acupuncture on Post-stroke Cognitive Impairment and Its Effect on Neurotransmitters and Neurological Function of Patients

Cheng HE; Ting ZHOU; Wen-jun WAN

doi:10.13422/j.cnki.syfjx.20200522

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Clinical Efficacy of Tongqiao Huoxuetang Plus Acupuncture on Post-stroke Cognitive Impairment and Its Effect on Neurotransmitters and Neurological Function of Patients

Clinic | 更新时间：2021-02-09

- Clinical Efficacy of Tongqiao Huoxuetang Plus Acupuncture on Post-stroke Cognitive Impairment and Its Effect on Neurotransmitters and Neurological Function of Patients
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 26, Issue 8, Pages: 112-117(2020)
- 作者机构：
  
  华中科技大学　同济医学院　附属武汉中心医院，武汉　 430022
- 作者简介：
- 基金信息：
- DOI：10.13422/j.cnki.syfjx.20200522
  CLC： R22; R242; R2-031;R287
- Received：08 August 2019，
  
  Published Online：18 November 2019，
  
  Published：20 April 2020
- 稿件说明：
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Cheng HE, Ting ZHOU, Wen-jun WAN. Clinical Efficacy of Tongqiao Huoxuetang Plus Acupuncture on Post-stroke Cognitive Impairment and Its Effect on Neurotransmitters and Neurological Function of Patients[J]. Chinese journal of experimental traditional medical formulae, 2020, 26(8): 112-117.
DOI：

Cheng HE, Ting ZHOU, Wen-jun WAN. Clinical Efficacy of Tongqiao Huoxuetang Plus Acupuncture on Post-stroke Cognitive Impairment and Its Effect on Neurotransmitters and Neurological Function of Patients[J]. Chinese journal of experimental traditional medical formulae, 2020, 26(8): 112-117. DOI： 10.13422/j.cnki.syfjx.20200522.

摘要

目的：

探讨通窍活血汤联合针刺治疗卒中后认知障碍(post-stroke cognitive impairment，PSCI)的临床疗效及其对患者神经递质和神经功能的影响。

方法：

选取2017年1月至2019年3月本院收治的122例PSCI患者，运用简单随机数字表法将其随机分成观察组与对照组，每组61例。两组患者均给予口服盐酸多奈哌齐片，对照组辅以针灸治疗，观察组予以通窍活血汤联合针刺治疗，所有受试者均连续治疗4周。比较两组临床疗效；治疗前后，运用简易精神状态检查(mini-mental state examination，MMSE)测试两组患者总体认知功能状况，分别使用美国国立卫生研究院卒中量表(national institutes of health stroke scale，NIHSS)，Barthel指数(barthel index，BI)评估神经功能缺损程度和日常生活能力变化，采用酶联免疫吸附法测定血清神经递质[乙酰胆碱(acetylcholine，ACh)，多巴胺(dopamine，DA)，去甲肾上腺素(norepinephrine，NE)，5-羟色胺(5-hydroxytryptamine，5-HT)]和神经损伤标志物[神经元特异性烯醇化酶(neuron-specific enolase，NSE)，视锥蛋白样蛋白-1(visinin like protein-1，VILIP-1)，髓鞘碱性蛋白(myelin basic protein，MBP)]水平；并汇总受试者副反应发生情况。

结果：

观察组总有效率为91.8%(56/61)，高于对照组[78.7%(48/61)，

0.05]。与本组治疗前比较，两组治疗后MMSE，BI评分均明显升高(

0.05)，NIHHS评分均明显降低(

0.05)；且治疗后，观察组以上量表评分的改善效果均明显优于对照组同期(

0.05)。两组治疗后血清ACh，DA，NE及5-HT含量均明显高于本组治疗前(

0.05)；且治疗后，观察组上述神经递质(ACh，DA，NE，5-HT)水平较对照组同期均明显更高(

0.05)。与本组治疗前比较，两组治疗后血清NSE，VILIP-1，MBP水平均明显下降(

0.05)；治疗后观察组血清NSE，VILIP-1，MBP含量均明显低于对照组同期(

0.05)。两组都未见严重不良事件。

结论：

通窍活血汤联合针刺能有效改善PSCI患者的认知功能，其机制可能与通过上调体内认知相关神经递质表达水平有关，此外本中医综合疗法可明显促进患者神经功能恢复，增强患者日常生活能力，整体疗效确切，且患者耐受性好。

Abstract

Objective:

To explore the clinical efficacy of Tongqiao Huoxuetang plus acupuncture on post-stroke cognitive impairment (PSCI) and its effect on neurotransmitters and neurological function of patients.

Method:

Totally 122 PSCI patients admitted in our hospital from January 2017 to March 2019 were randomly divided into observation group and control group by simple random number table method

with 61 patients in each group. Both groups were given oral donepezil hydrochloride tablets. The control group was given acupuncture treatment

while the observation group was given Tongqiao Huoxuetang plus acupuncture in addition to therapy of control group. All patients were treated continuously for 4 weeks. The clinical efficacy was compared between two groups. Before and after treatment

the general cognitive function of two groups was tested by mini-mental state examination (MMSE)

changes of their neurologic impairment and daily living ability were evaluated by National institutes of health stroke scale (NIHSS) and Barthel index (BI) respectively

and euzymelinked immunosorbent assay was adopted to test the levels of neurotransmitters [acetyl choline (ACh)

dopamine (DA)

noradrenaline (NE)

5-hydroxytryptamine (5-HT)] and neurologic impairment markers [neuronspecific enolase (NSE)

visinin-like protein-1 (VILIP-1)

myelin basic protein (MBP)]. And the occurrence of adverse reactions was recorded.

Result:

The overall effective rate of the observation group was 91.8% (56/61)

which was much higher than 78.7% (48/61) of control group (

0.05). After treatment

both groups saw much higher MMSE and BI scores but lower NIHHS scores than before treatment (

0.05)

and above indicators in observation group were improved more significantly than those in control group over the same period after treatment (

0.05). The levels of serum ACh

NE and 5-HT after treatment were obviously higher than those before treatment (

0.05)

and observation group had significantly higher ACh

NE and 5-HT levels than control group over the same period (

0.05). After treatment

both groups witnessed a great decrease in NSE

VILIP-1

MBP (

0.05)

while the observation group saw dramatically lower NSE

VILIP-1

MBP levels than control group over the same period after treatment (

0.05). Neither of two groups saw serious adverse reactions.

Conclusion:

In treating PSCI

Tongqiao Huoxuetang plus acupuncture can significantly improve neurological function of the patients

which may be due to increase of neurotransmitters. Besides

Tongqiao Huoxuetang plus acupuncture is proved to be generally effective in promoting the recovery of patients' neurological function and enhancing their abilities in daily life

with a good tolerance among patients.

关键词

Keywords

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