Clinical Study On Acupuncture Combined With Cognitive Training In The Treatment Of Post-Stroke Cognitive Impairment

Objective:To explore the difference of therapeutic effect of acupuncture on cognitive impairment after stroke on the basis of conventional treatment,so as to understand the therapeutic effect and safety of acupuncture combined with cognitive function training,and to judge whether it is worth clinical application according to the experimental results.Material and methods:Taking the PSCIND diagnosis in the expert consensus on the management of cognitive impairment after stroke^[2]in 2017 as the inclusion criteria,60 patients with cognitive impairment after stroke who were treated in the Department of Acupuncture and Moxibustion of Hubei Provincial Hospital of Traditional Chinese Medicine from January 2018 to October 2019 were selected for the analysis.The patients were averagely divided into acupuncture combined with cognitive function training observation group and control group with random number table.The control group used conventional treatment methods,including drug treatment and rehabilitation training for basic diseases;the experimental group used scalp acupuncture combined with body acupuncture in the treatment of the control group.The selected acupoints were as follows:?1?scalp acupuncture:Baihui,Sishencong,shenting,frontotemporal oblique line,frontopateral line;?2?body acupuncture:Guanyuan,Shenmen,Neiguan,Zusanli,Sanyinjiao,Taixi.The matching points can be increased properly according to the dialectics.After the scalp acupuncture,it can rotate rapidly for 2-3 minutes,with the frequency of about 200 times/min,the angle and time of twisting can be adjusted according to the patient's tolerance.The needle can be kept for 60 minutes,during which,it can twist for 2-3 times.Rehabilitation training can be in progress at the same time.The body acupuncture adopts the method of flat tonic,flat diarrhea,30 minutes,once a day,six days a week,one day off,and one week as a course of treatment,There were6 courses.The subjects were assessed for the first time before treatment and for the second time after the end of 6 courses.The therapists and assessors are different doctors.After entering the group,the subjects'general personal data were recorded,and their cognitive function were assessed through the MMAE and MOCA scales.The two groups were tested after statistical analysis,which proves that there is comparability between the two groups The therapeutic effect was observed by comparing the scores of the scales before and after treatment.Results:All of 40 patients completed the courses during this study.After the treatment,the clinical symptoms of the patients were observed to improve,the cognitive function of the patients was evaluated by neuropsychological scale,and the activities of daily life were improved by Barthel.The results showed that:?1?In the aspect of neuropsychological scale,the MMSE score and MOCA score of the observation group and the control group were higher than those before treatment.Acupuncture combined with cognitive training and rehabilitation alone could improve the cognitive function of patients with cognitive impairment after stroke.After the treatment,the scores of the observation group and the control group were compared,the difference was statistically significant,indicating that the effect of the observation group to improve the cognitive impairment was better.Compared with simple cognitive training and drug treatment,acupuncture combined with rehabilitation cognitive training and basic drug treatment can improve the cognitive function of stroke patients,and the effect is better than simple rehabilitation treatment.?2?In the aspect of daily life ability:after the treatment,the MBI scores of the patients in the observation group and the control group were higher than before the treatment,and the improvement of the scores in the observation group was more significant,indicating that the treatment plan in the observation group was better than the control group in improving the ability of daily life.Conclusion:The results of this study suggest that the treatment effect of the observation group is significantly better than that of the control group in improving cognitive function and daily life ability.That is to say,the treatment method of acupuncture combined with rehabilitation cognitive training on the basis of basic treatment can significantly improve cognitive impairment after stroke,which can improve the living ability of patients,thus improve the quality of life of patients,and increase the confidence of patients in recovery,Reduce the burden of family and society.This kind of treatment is safe and effective,and has clinical significance.