Analysis The Clinical Efficacy And Prognostic Factors Of Acupuncture Combined Therapy Of Post-Stroke Cognitive Impairment Based On Real World

Objective: In order to analyze the basic clinical characteristics of patients with post-stroke cognitive impairment(PSCI)in the real clinical environment,as well as the influence of acupuncture comprehensive therapy on the cognitive function and nerve function of patients with different degrees of PSCI in the real diagnosis and treatment environment,and the influence of the number of acupuncture on the cognitive function and nerve function of patients with different degrees of PSCI,the influencing factors affecting the efficacy of acupuncture comprehensive treatment in PSCI patients were discussed.Methods: The data of this study is derived from the clinical research data management platform of the National Clinical Research Center of Traditional Chinese Medicine acupuncture,and the gender,age,smoking and drinking history,cultural level,family history,and other relevant information of patients with post-stroke cognitive impairment(PSCI)who meet the inclusion criteria are extracted from the post-stroke cognitive impairment(PSCI)at the time of admission and discharge.The number of strokes,stroke type,stroke site,number of acupuncture,blood uric acid level,homocysteine level,hypertension,diabetes mellitus,abnormal lipid metabolism,coronary heart disease,mm SE scale score,NIHSS scale score redefined.According to the scores of PSCI patients before and after treatment,cognitive function was classified as ineffective,effective and effective according to MMSE score,and neurological function was classified as ineffective and effective according to NIHSS scale score.The data were analyzed using SPSS 21.0 to group the population by sex and observe the basic clinical features of patients with post-stroke cognitive impairment;the MMSE scores before and after the comprehensive acupuncture treatment were compared to observe the cognitive function improvement of PSCI patients;the NIHSS scores before and after acupuncture comprehensive treatment were compared to observe the improvement of nerve function in PSCI patients;and the PSCI patients were divided into mild,moderate,and severe patients.The number of acupuncture was divided into 3 groups to compare the effect of acupuncture on the cognitive function and nerve function of PSCI patients,and the factors that may affect the prognosis of PSCI acupuncture were sorted out by consulting related articles,and logistic regression analysis was carried out to explore the factors that may affect the prognosis of PSCI acupuncture synthesis therapy.Results:(1)In this study,men accounted for 69.4% of the total number of PSCI patients and 30.6% of the total number of patients;the age of patients was 65.39 ± 9.89 years old,and the age of onset was earlier than that of women;the proportion of mild PSCI patients in the population included in this institute was the highest,accounting for about 62.6%;the level of education was mostly at the primary and secondary school level(53.8%),and 90.7% of the population included in this study was cognitive impairment after cerebral infarction;and the proportion of patients with hypertension was the highest,about 63.3%.(2)In this study,the patients’ cognitive function and nerve function were significantly improved after treatment by acupuncture comprehensive therapy(P<0.05);there were significant differences in the degree of cognitive function improvement after acupuncture comprehensive therapy treatment in patients with different degrees of PSCI(P <0.05),and the degree of neurological function improvement in patients with different degrees of PSCI after needle pricking comprehensive therapy treatment was not found significantly(P>0.05).Different amounts of acupuncture significantly affected the degree of cognitive function improvement in patients with PSCI(P<0.05),but no significant difference in the improvement of neural function was found(P >0.05).(3)Stroke recurrence(OR=0.522,95% CI =-1.110--0.189,P = 0.006),acupuncture < 14 times(OR=0.046,95% CI =-1.640-0.052,P = 0.046),hyperhomocysteinemia(OR=,95% CI =-0.990--0.038,P = 0.034),abnormal lipid metabolism(OR=0.527,95% CI=-1.192--0.089,P = 0.023)may hinder the degree of improvement in cognitive function of patients with acupuncture combination therapy;patients with severe PSCI may have a higher degree of improvement in cognitive function after treatment with acupuncture combination therapy(OR=12.428,95% CI=1.215-3.826,P<0.001/OR=8.10,95% CI=0.770-3.413,P=0.002).(4)Safety evaluation: In this study,one patient had bleeding from the acupuncture point after acupuncture in the left side of the Polar Spring Acupuncture Point,and completely resumed after suspending the Acupuncture point acupuncture for 2 days,and no obvious adverse reactions were present in others.Conclusion:(1)Acupuncture combination therapy can improve cognitive function and nerve function in patients with PSCI;(2)Acupuncture ≥ 15 times had the greatest degree of cognitive improvement in patients;the efficacy of acupuncture comprehensive treatment was positively correlated with the degree of cognitive impairment;(3)First stroke,recurrence,blood homocysteine,lipid metabolism level,and cultural level are related factors affecting the degree of cognitive improvement in patients with PSCI.The degree of improvement in cognitive function in patients with relapse was lower than that in the first patients;patients with hyper-homocysteinemia had a lower degree of improvement than patients with normal homocysteine levels;patients with abnormal lipid metabolism had a lower degree of improvement than patients with normal lipid metabolism;patients with low cultural level had lower improvement than patients with higher cultural levels.