针刺颈夹脊穴联合推拿对主观认知下降患者认知功能的影响

张宇; 尹曦; 刘朝阳; 杨清峰; 韩蓄; 徐祎迪; 卢笑晖

doi:10.13703/j.0255-2930.20230726-0004

您当前的位置：

首页 >

文章列表页 >

针刺颈夹脊穴联合推拿对主观认知下降患者认知功能的影响

临床研究 | 更新时间：2024-06-03

- 针刺颈夹脊穴联合推拿对主观认知下降患者认知功能的影响
- Effect of acupuncture at neck-Jiaji (EX-B 2) and tuina on the cognitive function in the patients with subjective cognitive decline
- 中国针灸 2023年43卷第12期页码：1379-1383
- 作者机构：
  
  1.山东中医药大学附属医院，老年医学中心，济南250014
  2.山东中医药大学附属医院，保健推拿门诊，济南250014
  3.山东中医药大学第一临床学院
- 作者简介：
  
  卢笑晖，教授、主任医师。E-mail：lxhtcm@126.com
- 基金信息：
  
  国家中医药管理局中医药事业传承与发展中央补助资金项目(YWC2022ZYYSY001);山东省卫生健康委员会齐鲁医派中医学术流派传承项目(lp2022-01)
- DOI：10.13703/j.0255-2930.20230726-0004
  中图分类号： R246.6
- 收稿：2023-07-26，
  
  网络首发：2023-09-15，
  
  纸质出版：2023-12-12
- 稿件说明：
移动端阅览
张宇,尹曦,刘朝阳等.针刺颈夹脊穴联合推拿对主观认知下降患者认知功能的影响[J].中国针灸,2023,43(12):1379-1383.

ZHANG Yu,YIN Xi,LIU Zhao-yang,et al.Effect of acupuncture at neck-Jiaji (EX-B 2) and tuina on the cognitive function in the patients with subjective cognitive decline[J].Chinese Acupuncture & Moxibustion,2023,43(12):1379-1383.
张宇,尹曦,刘朝阳等.针刺颈夹脊穴联合推拿对主观认知下降患者认知功能的影响[J].中国针灸,2023,43(12):1379-1383. DOI： 10.13703/j.0255-2930.20230726-0004.

ZHANG Yu,YIN Xi,LIU Zhao-yang,et al.Effect of acupuncture at neck-Jiaji (EX-B 2) and tuina on the cognitive function in the patients with subjective cognitive decline[J].Chinese Acupuncture & Moxibustion,2023,43(12):1379-1383. DOI： 10.13703/j.0255-2930.20230726-0004.

摘要

目的

在生活方式健康宣教、元记忆训练基础上，观察针刺颈夹脊穴联合推拿对主观认知下降（SCD）患者认知功能、睡眠质量、血流动力学指标的影响。

方法

将60例SCD患者随机分为观察组（30例，脱落1例）和对照组（30例，脱落3例）。对照组予生活方式健康宣教和元记忆训练，每天训练2次，每次15 min，每周5 d，连续4周；在对照组基础上，观察组采用针刺颈夹脊穴联合推拿治疗，先使用一指禅偏锋推法结合拨法分别沿足太阳膀胱经和督脉按摩颈部10~15 min，然后针刺双侧C

-C

颈夹脊穴，留针30 min，每日1次，每周5次，连续4周。于治疗前后，观察两组简易智能精神状态量表（MMSE）评分、韦克斯勒记忆量表第四版（WMS-Ⅳ）评估的总记忆商（FSMQ）评分、匹兹堡睡眠质量指数（PSQI）评分，采用经颅多普勒超声检测两组患者血流动力学指标［左侧椎动脉（LVA）、右侧椎动脉（RVA）、基底动脉（BA）的平均血流速度（Vm）和血管搏动指数（PI）］。

结果

治疗后，两组患者MMSE、FSMQ评分较治疗前升高（

0.05，

0.001），观察组PSQI评分较治疗前降低（

0.05），观察组BA的Vm值较治疗前升高（

0.001）；观察组MMSE、FSMQ评分以及BA的Vm值均高于对照组（

0.05，

0.001），PSQI评分低于对照组（

0.05）。

结论

针刺颈夹脊穴联合推拿在改善SCD患者认知功能、缓解慢性情绪应激和改善睡眠状态方面更具优势，其作用机制可能是改善BA的供血。

Abstract

Objective

To observe the effects on cognitive function

sleep quality and hemodynamics in the patients with subjective cognitive decline (SCD) after treated with acupuncture at neck-Jiaji (EX-B 2) and

tuina

on the base of healthy lifestyle education and meta-memory training.

Methods

Sixty SCD patients were randomly divided into an observation group (30 cases

1 case dropped out) and a control group (30 cases

3 cases dropped out). In the control group

the healthy lifestyle education and meta-memory training was performed

twice daily

15 min each time; the 5-day intervention was delivered a week

lasting consecutively 4 weeks. On the base of the intervention as the control group

in the observation group

acupuncture at neck-Jiaji (EX-B 2) and

tuina

was conducted. First

one-finger pushing and plucking method of

tuina

was exerted on the neck region along the running courses of the bladder meridian of foot-

taiyang

and the governor vessel

for 10 min to 15 min; afterwards

acupuncture was delivered at bilateral neck-Jiaji (EX-B 2)

from C

to C

; and the needles were retained for 30 min. This intervention was given once daily

5 times a week

for consecutive 4 weeks. Before and after treatment

the score of the mini-mental state examination (MMSE)

the score of full scale memory quotient (FSMQ) were assessed by Wechsler memory scale-fourth edition (WMS-Ⅳ) and the score of the Pittsburgh sleep quality index (PSQI) was compared between the two groups. Using transcranial Doppler ultrasound

the hemodynamic indexes (the mean velocity [Vm

]

and pulsatility index [PI

]

of the left vertebral artery [LVA

]

the right vertebral artery [RVA

]

and the basilar artery [BA

]

) were determined in the two groups.

Results

After treatment

the scores of MMSE and FSMQ increased compared with those before treatment in the two groups (

0.05

0.001)

PSQI score was lower (

0.05) and Vm of BA was higher (

0.001) in the observation group when compared with those before treatment. The scores of MMSE and FSMQ

as well as Vm

of BA were higher (

0.05

0.001)

and PSQI score was decreased (

0.05) in the observation group when compared with the control group.

Conclusion

The combined therapy of acupuncture at neck-Jiaji (EX-B 2) and

tuina

is more advantageous to improving cognitive function

relieving chronic emotional stress and ameliorating sleeping quality in the patients with subjective cognitive decline

which may be achieved by improving the blood supply of the basilar artery.

关键词

Keywords

references

Alzheimer's Association . 2016 Alzheimer's disease facts and figures [J ] . Alzheimers Dement , 2016 , 12 ( 4 ): 459 - 509 .

国家统计局 . 第七次全国人口普查公报(第五号) [EB/OL ] .( 2021-05-11 )[ 2023-07-05 ] . http://www.stats.gov.cn/sj/tjgb/rkpcgb/qgrkpcgb/202302/t20230206_1902005.html http://www.stats.gov.cn/sj/tjgb/rkpcgb/qgrkpcgb/202302/t20230206_1902005.html .

Clay E , Zhou JW , Yi ZM , et al . Economic burden for Alzheimer's disease in China from 2010 to 2050: a modelling study [J ] . J Mark Access Health Policy , 2019 , 7 ( 1 ): 1667195 .

任汝静 , 殷鹏 , 王志会 , 等 . 中国阿尔茨海默病报告2021 [J ] . 诊断学理论与实践 , 2021 , 20 ( 4 ): 317 - 337 .

Rabin LA , Smart CM , Amariglio RE . Subjective cognitive decline in preclinical Alzheimer's disease [J ] . Annu Rev Clin Psychol , 2017 , 13 : 369 - 396 .

Innes KE , Selfe TK , Brundage K , et al . Effects of meditation and music-listening on blood biomarkers of cellular aging and Alzheimer's disease in adults with subjective cognitive decline: an exploratory randomized clinical trial [J ] . J Alzheimers Dis , 2018 , 66 ( 3 ): 947 - 970 .

仉会玉 , 秦晓光 , 雒明栋 . 华佗夹脊穴临床应用研究进展 [J ] . 中医药学报 , 2020 , 48 ( 1 ): 67 - 71 .

程黛静 . 针刺颈夹脊穴和五泉穴对脑卒中后血管性痴呆患者精神状态和认知功能的影响 [J ] . 河南医学研究 , 2020 , 29 ( 15 ): 2828 - 2829 .

王振垚 . 针刺颈夹脊穴对卒中后血管性痴呆患者血清BDNF、VEGF、MMP-9水平的影响 [J ] . 上海针灸杂志 , 2019 , 38 ( 8 ): 842 - 847 .

韩璎 . 中国阿尔茨海默病临床前期主观认知下降的诊治策略 [J ] . 中国临床医学影像杂志 , 2018 , 29 ( 8 ): 534 - 538 .

Kim J , Shin E , Han K , et al . Efficacy of smart speaker-based metamemory training in older adults: case-control cohort study [J ] . J Med Internet Res , 2021 , 23 ( 2 ): e20177 .

Li HZ , Jia JP , Yang ZQ . Mini-mental state examination in elderly Chinese: a population-based normative study [J ] . J Alzheimers Dis , 2016 , 53 ( 2 ): 487 - 496 .

王健 , 邹义壮 , 崔界峰 , 等 . 韦克斯勒记忆量表第四版中文版(成人版)的修订 [J ] . 中国心理卫生杂志 , 2015 , 29 ( 1 ): 53 - 59 .

Han QQ , Liu B , Lin SM , et al . Pittsburgh sleep quality index score predicts all-cause mortality in Chinese dialysis patients [J ] . Int Urol Nephrol , 2021 , 53 ( 11 ): 2369 - 2376 .

任哲 , 韩立婷 , 巩姝彤 , 等 . 磁共振弥散张量成像的阿尔茨海默病脑白质特征 [J ] . 复旦学报(医学版) , 2022 , 49 ( 6 ): 869 - 876 .

李红娟 , 许春燕 , 黄宏强 , 等 . 主观认知下降中医证型分布特点研究 [J ] . 新中医 , 2020 , 52 ( 14 ): 61 - 64 .

田金洲 , 时晶 . 阿尔茨海默病的中医诊疗共识 [J ] . 中国中西医结合杂志 , 2018 , 38 ( 5 ): 523 - 529 .

Sun QQ , Xu SR , Guo SA , et al . Effects of combined physical activity and cognitive training on cognitive function in older adults with subjective cognitive decline: a systematic review and meta-analysis of randomized controlled trials [J ] . Evid Based Complementary Altern Med , 2021 , 2021 : 1 - 14 .

杨欢 , 殷召雪 . 睡眠障碍与认知障碍和痴呆关系的研究进展 [J ] . 中国健康教育 , 2023 , 39 ( 2 ): 157 - 160 .

方俊霖 , 张昌云 , 谭奇纹 . 夹脊穴临床应用研究(2010-2019年)知识图谱分析 [J ] . 山东中医杂志 , 2021 , 40 ( 7 ): 733 - 738, 758 .

姚斐 , 赵毅 , 蒋诗超 , 等 . 从足太阳膀胱经论治慢性疲劳综合征的理论依据 [J ] . 中国针灸 , 2015 , 35 ( 3 ): 295 - 298 .

杨帆 , 罗开涛 , 杨喜兵 , 等 . 百会长留针治疗气虚血瘀型中风后认知功能障碍临床观察 [J ] . 中国针灸 , 2018 , 38 ( 11 ): 1151 - 1156 .

杨松 , 孟灵 , 钟青华 , 等 . 电针颈夹脊穴对神经根型颈椎病神经病理性疼痛模型大鼠脊髓背角GFAP、NF-κB及炎性细胞因子表达的影响 [J ] . 针灸临床杂志 , 2022 , 38 ( 1 ): 70 - 75 .

黄霞 , 粟胜勇 , 陈舒 , 等 . 基于ERK信号通路探讨电针对神经根型颈椎病模型大鼠镇痛机制的研究 [J ] . 中华中医药学刊 , 2020 , 38 ( 2 ): 195 - 198, 291 .

王勇 , 陈茜 . 针刺颈痛穴、颈夹脊穴治疗神经根型颈椎病临床观察 [J ] . 湖北中医药大学学报 , 2020 , 22 ( 3 ): 96 - 98 .

浏览量

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

环颅底穴位化裁针刺治疗卒中后轻度认知障碍：随机对照试验

电针对老年维持性血液透析患者睡眠质量、认知功能及脑血流动力学的影响

“升清降浊”法针刺治疗脓毒症胃肠功能障碍：随机对照试验

火针治疗膝骨关节炎的远期临床疗效观察

电针调控mTOR/SREBP1信号通路促进肥胖小鼠白色脂肪棕色化的机制研究