强制性运动疗法联合百会八阵穴子午捣臼刺法治疗脑梗死后偏侧忽略临床研究

Clinical Study on Constraint-Induced Movement Therapy Combined with Ziwu Daojiu Acupuncture at Baihui Bazhen Points for Hemispatial Neglect After Cerebral Infarction

摘要:

目的：观察强制性运动疗法联合百会八阵穴子午捣臼刺法治疗脑梗死后偏侧忽略的临床效果。 方法：回顾性选取2022年3月—2025年3月泰顺县中医院收治的脑梗死后偏侧忽略患者70例，根据治疗方法 不同分为针刺组31例和联合组39例。针刺组给予百会八阵穴子午捣臼刺法治疗，联合组在针刺组基础上给予 强制性运动疗法治疗。2组均治疗4周。比较2组脑电生理指标、血流动力学参数、偏侧忽略情况、认知功能、 肢体功能及日常活动能力。结果：治疗后，2 组P300 波幅、P1 波幅较治疗前均升高，且联合组高于针刺 组（P＜0.05）；2组P300潜伏期、P1潜伏期较治疗前均缩短，且联合组短于针刺组（P＜0.05）。治疗后，2组 大脑中动脉（MCA） 平均流速、大脑前动脉（ACA） 平均流速、颈总动脉舒张末期最低流速（EDV） 较治疗前 均加快，且联合组快于针刺组（P＜0.05）；2组颈总动脉阻力指数（RI） 较治疗前均降低，且联合组低于针刺 组（P＜0.05）。治疗后，2组中国行为性忽略测试-香港版量表（CBIT-HK） 常规测试、行为测试评分较治疗 前均升高，且联合组高于针刺组（P＜0.05）；2组凯瑟琳-波哥量表（CBS） 评分较治疗前均降低，且联合组低 于针刺组（P＜0.05）。治疗后，2组蒙特利尔认知评估量表（MoCA）、动作研究量表（ARAT）、独立性评定量 表（FIM） 评分较治疗前均升高，且联合组高于针刺组（P＜0.05）。结论：强制性运动疗法联合百会八阵穴子 午捣臼刺法可以改善脑梗死后偏侧忽略患者脑电生理水平及血流动力学，降低偏侧忽略程度，提高认知功能， 增强肢体功能及日常活动能力。

Abstract:

Abstract：Objective：To observe the clinical effects of constraint-induced movement therapy （CIMT） combined with Ziwu Daojiu acupuncture at Baihui Bazhen points in the treatment of hemispatial neglect after cerebral infarction. Methods： A retrospective study was conducted on 70 patients with hemispatial neglect after cerebral infarction admitted to Taishun Hospital of Chinese Medicine from March 2022 to March 2025. According to different treatment methods， they were divided into the acupuncture group （31 cases） and the combination group （39 cases）. The acupuncture group received Ziwu Daojiu acupuncture at Baihui Bazhen points， while the combination group was additionally given constraint-induced movement therapy on the basis of the acupuncture group. Both groups were treated for four weeks. The electroencephalophysiological indexes， hemodynamic parameters， hemispatial neglect， cognitive function， limb function， and activities of daily living were compared between the two groups. Results： After treatment，the amplitudes of P300 and P1 waves in both groups were significantly increased when compared with those before treatment，and those in the combination group were higher than those in the acupuncture group （P＜0.05）. The latencies of P300 and P1 waves in both groups were significantly shortened when compared with those before treatment， and those in the combination group were shorter than those in the acupuncture group （P＜0.05）. After treatment，the mean flow velocities of middle cerebral artery （MCA）， anterior cerebral artery （ACA）， and end-diastolic velocity （EDV） of common carotid artery in both groups were significantly accelerated when compared with those before treatment， and those in the combination group were faster than those in the acupuncture group （P＜0.05）. The resistance index （RI） of common carotid artery in both groups was significantly decreased when compared with that before treatment， and that in the combination group was lower than that in the acupuncture group （P＜0.05）. After treatment， the scores of conventional test and behavioral test of Chinese Behavioral Inattention Test-Hong Kong version （CBIT-HK） in both groups were significantly increased when compared with those before treatment，and those in the combination group were higher than those in the acupuncture group （P＜0.05）. The Catherine Bergego Scale （CBS） scores in both groups were significantly decreased when compared with those before treatment，and those in the combination group was lower than those in the acupuncture group （P＜0.05）. After treatment， the scores of Montreal Cognitive Assessment （MoCA）， Action Research Arm Test （ARAT）， and Functional Independence Measure（ FIM） in both groups were significantly increased when compared with those before treatment，and those in the combination group were higher than those in the acupuncture group （P＜0.05）. Conclusion： CIMT combined with Ziwu Daojiu acupuncture at Baihui Bazhen points can improve electroencephalophysiology and hemodynamics，reduce the degree of hemispatial neglect，enhance cognitive function，limb function，and activities of daily living in patients with hemispatial neglect after cerebral infarction.