金文杰,孟殿怀,罗开涛,等.重复经颅磁刺激联合针灸治疗对血管性认知障碍患者认知功能及神经炎症因子的影响[J].中华物理医学与康复杂志,2025,47(4):319-324
扫码阅读全文
|
| 重复经颅磁刺激联合针灸治疗对血管性认知障碍患者认知功能及神经炎症因子的影响 |
|
| |
| DOI：10.3760/cma.j.cn421666-20240523-00385 |
| 中文关键词: 血管性认知障碍 重复经颅磁刺激 针灸 神经炎症因子 |
| 英文关键词: Vascular cognitive impairment Transcranial magnetic stimulation Acupuncture Neuroinflammatory factors |
| 基金项目:江苏省科技厅重点研发计划（BE2021012-4）；浙江省基础公益计划项目（LGF20H270003）；浙江省医药卫生科技计划项目（2021KY1126）；嘉兴市脑血管病中西医结合康复重点实验室（A类） |
|
| 摘要点击次数: 29 |
| 全文下载次数: 37 |
| 中文摘要: |
| 目的 观察重复经颅磁刺激（rTMS）联合针灸治疗对血管性认知障碍（VCI）患者认知功能及神经炎症因子的影响。 方法 将40例VCI患者按照随机数字表法分为对照组和试验组，每组20例。2组患者均接受常规治疗，对照组在此基础上采用rTMS治疗，试验组采用rTMS联合针灸治疗，其中rTMS频率为10 Hz，强度为90%的运动阈值（MT）。治疗前及治疗4周后（治疗后），采用蒙特利尔认知评估量表（MoCA）、简易精神状态量表（MMSE）和改良Barthel指数（MBI）对2组患者开展评估，同时利用酶联免疫吸附法（ELISA）检测患者外周血清白细胞介素-6（interleukin-6,IL-6）和肿瘤坏死因子α(TNF-α)水平。 结果 治疗后，2组患者的MoCA、MMSE、MBI评分及外周血清IL-6、TNF-α水平均有所改善（P<0.05）。治疗组治疗后的MoCA子项评分［视空间与执行功能（4.50±0.61）分、注意力（4.85±0.99）分、延迟回忆（4.35±0.67）分］及总分［（27.30±2.45）分］，MMSE评分［（27.45±2.37）分］、MBI评分［（80.25±14.55）分］均较对照组显著增加（P<0.05），外周血清IL-6水平［（1.34±0.57）pg/ml］和TNF-α水平［（2.39±1.52）pg/ml］较对照组低（P<0.05）。Pearson相关分析结果显示，2组患者的MoCA、MMSE改善值与IL-6、TNF-α降低值之间均呈正相关关系(P<0.05)。 结论 rTMS联合针灸治疗可有效改善VCI患者的认知功能，提高其生活自理能力，其作用机制可能与降低神经炎症因子IL-6和TNF-α水平有关。 |
| 英文摘要: |
| Objective To explore the effect of combining transcranial magnetic stimulation (rTMS) with acupuncture in the treatment of patients with vascular cognitive impairment (VCI). Methods A total of 40 VCI patients were randomly assigned to either the control group or the experimental group (n=20 per group) using a random number table. Both groups received routine treatment and rTMS, while the experimental group was additionally provided with acupuncture for four weeks. The rTMS was at 10Hz at 90% of the motor threshold. Before and after the treatment, both groups′ cognition was evaluated using the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE). Ability in the activities of daily living (ADL) was quantified using the modified Barthel Index (MBI). Serum levels of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) were measured using enzyme-linked immunosorbent assays. Results Significant improvement was observed in both groups′ average MoCA, MMSE, and MBI scores, along with reductions in peripheral serum IL-6 and TNF-α levels. The experimental group exhibited significantly higher MoCA subdomain scores in the visuospatial and executive function, attention, and delayed recall subdomains, as well as a higher total MoCA score compared to the control group. The average MMSE and MBI scores were significantly higher in the experimental group than the control group, and that group′s serum IL-6 and TNF-α levels were significantly lower, on average. Pearson correlation analysis demonstrated a positive correlation between the improvements in MoCA and MMSE scores and the reductions in IL-6 and TNF-α levels in both groups. Conclusions rTMS combined with acupuncture effectively improves cognition and ADL ability among VCI patients. The underlying mechanism may be associated with the reduction of neuroinflammatory factors IL-6 and TNF-α. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
