Clinical Observation Of Electric Nape Acupuncture Combined With Cognitive Rehabilitation Training In The Treatment Of Post-Stroke Cognitive Impairment

Objective:The subject adopted a randomized controlled trial to compare and analyze the Neuropsychological Tests,and serum biomarker of patients with post-stroke cognitive impairment before and after treatment,observe the clinical application value of electric nape acupuncture therapy combined with cognitive rehabilitation training in the treatment of post-stroke cognitive impairment.Methods:According to the random number table,82 subjects who met the criteria were randomly divided into treatment group(electric napkin acupuncture+cognitive rehabilitation training)and control group(cognitive rehabilitation training),with 41 cases in each group.All patients received basic drug treatment,cognitive rehabilitation training and acupuncture treatment for stroke.On this basis,the treatment group was given electric nape acupuncture,mainly taking the acupoints of Fengchi(GB 20),Tianzhu(BL 10),Gongxue,Yifeng(SJ 17),Fengfu(DU 16).After the acupuncture manipulation is completed,Fengchi(GB 20)and Yifeng(SJ 17)on the same side are connected with a set of wires,and Tianzhu(BL 10)and Gongxue on the same side are connected with a set of wires.The current adopts dilatational wave with a frequency of 20/100 Hz.The current intensity depends on the patient’s tolerance.Retaining needle is 30 min.Both groups received treatment six days a week with one day off,for four weeks as a cycle of treatment,for a total of two courses of treatment.Before and after treatment,the subjects performed the Mini-mental state examination,Montreal Cognitive Assessment,Modified Barthel Index,Trail Making Test,Auditory Verb Learning Test,Digit Symbol Test,and the score of TCM syndromes of stroke.And test serum biomarkers(Hcy and hs-CRP).Finally the results were analyzed by statistical software.Results:1.A total of 82 PSCI patients were included in this study,including 4patients who did not complete the experiment,and 78 effective patients,including 39 in each group.2.Baseline data:Prior to treatment,age,gender,type of stroke,course of illness,education,level scale score,and serum biomarkers did not significantly difference between the two groups between the two groups.3.Outcome indicators(1)MMSE:After intervention,the two groups’ MMSE scores were greater than their prior to therapy scores,and the result was statistically significant(P<0.01).After receiving treatment,the treatment group’s scores considerably outperformed those of the control group(P=0.033<0.05).(2)Mo CA:The Mo CA scores of the two groups before and after treatment were significantly higher than those before treatment(P<0.01).After therapy,the treatment group’s scores increased relative to the control group’s,which difference was statistically different.(P=0.038<0.05).(3)MBI:The MBI scores of the two groups before and after treatment were significantly higher than those before treatment(P<0.01).There was not a significant distinction between the two groups’ MBI ratings after treatment(P=0.511>0.05).(4)TMT:The time of the two groups after treatment was significantly lower than that before treatment(P<0.05).The therapy group required significantly less time following treatment than the control group,and this difference was statistically significant(P<0.01).(5)AVLT-H:Following therapy,the results of immediate recall,short delayed recall and long delayed recall in both groups were higher than pre-treatment results,with statistically differences(P<0.05).Following treatment,the treatment group’s improvement rate was higher than the control group’s with statistically significant difference(P<0.01).(6)DS:The scores of the two groups after treatment were higher than those before treatment,and the difference was statistically significant(P<0.01).After the treatment,the scores of the treatment group were higher than those of the control group,and the difference was statistically significant(P<0.01).The scores of the two groups improved after treatment,and the difference was statistically significant(P<0.01).The treatment group’s scores were higher than the control group’s after the therapy,and the difference was statistically significant(P<0.01).(7)The score of TCM syndromes:Both groups of patients had lower scores after treatment than before treatment,and the difference was statistically significant(P<0.05).When comparing between the two groups at the end of treatment,the decrease in the value of the treatment group was higher and better than that of the control group,and the difference was statistically significant(P=0.028<0.05).(8)Serum biological markers:Serum Hcy decreased in both groups after therapy compared to before treatment,which was statistically significant(P<0.05).After the end of treatment,the Hcy level declined more in the treatment group,which was better than that in the control group,and the difference was statistically significant(P<0.01).When compared between the two groups at the end of treatment,the serum hs-CRP level decreased more in the treatment group,which was better than that in the control group,and the difference was statistically significant(P<0.01).The serum hs-CRP decreased in both groups before and after treatment,which was statistically significant(P<0.05).(9)Total effective rate:The treatment group’s overall effective rate was89.74%(35/39)and was significantly higher than the control group’s 74.35%(29/39)(P<0.05).(10)Safety evaluation:During the whole study,the patient’s vital signs were good and without abnormalities.One patient in the treatment group had needle stagnation during the treatment period,and there was no discomfort after symptomatic treatment.No obvious discomfort was found in the control group during the treatment.Conclusion:1.Both the electric nape acupuncture combined with cognitive rehabilitation training group and the cognitive rehabilitation training group may benefit PSCI patients with their cognition,executive function,attention,and memory.2.Both the electric nape acupuncture combined with cognitive rehabilitation training group and the cognitive rehabilitation training group can enhance patients with PSCI’s capacity for daily life and their overall clinical symptoms.3.Both the electric nape acupuncture combined with cognitive rehabilitation training group and the cognitive rehabilitation training group lower the levels of Hcy and hs-CRP..4.The results of the electric nape acupuncture and cognitive rehabilitation training are superior than those of the control group.