不同针刺方式刺激认知情感区对卒中后认知障碍患者脑电图微状态的影响

李慎微; 王东岩; 刘月; 张译尹; 霍宏; 张莹; 董旭; 冯丽媛; 崔乃松; 王益言; 赵东雪; 张虹岩

doi:10.13703/j.0255-2930.20250616-0007

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不同针刺方式刺激认知情感区对卒中后认知障碍患者脑电图微状态的影响

临床研究 | 更新时间：2026-06-24

- 不同针刺方式刺激认知情感区对卒中后认知障碍患者脑电图微状态的影响
- Effect on electroencephalogram microstate in patients with post-stroke cognitive impairment: a comparative study of acupuncture with different stimulation methods at cognitive-emotional area
- 中国针灸 2026年46卷第6期页码：853-860
- 作者机构：
  
  温州医科大学附属第一医院针推理疗科，浙江　温州　325035
  黑龙江中医药大学，哈尔滨　150040
  黑龙江中医药大学附属第二医院针灸科，哈尔滨　150001
- 作者简介：
  
  ✉王东岩，教授、主任医师。E-mail：doctwdy@163.com
- 基金信息：
  
  国家自然科学基金资助项目(82374601;81774426);黑龙江省自然科学基金联合引导项目(LH2019H113);黑龙江中医药大学创新团队建设项目(2017sit01);温州医科大学附属第一医院博士科研启动基金项目(2024QD028)
- DOI：10.13703/j.0255-2930.20250616-0007
  中图分类号：
- 收稿：2025-06-16，
  
  网络首发：2026-03-27，
  
  纸质出版：2026-06-12
- 稿件说明：
移动端阅览
李慎微, 王东岩, 刘月, 等. 不同针刺方式刺激认知情感区对卒中后认知障碍患者脑电图微状态的影响[J]. 中国针灸, 2026,46(6):853-860.

LI Shenwei, WANG Dongyan, LIU Yue, et al. Effect on electroencephalogram microstate in patients with post-stroke cognitive impairment: a comparative study of acupuncture with different stimulation methods at cognitive-emotional area[J]. Chinese Acupuncture & Moxibustion, 2026, 46(6): 853-860.
李慎微, 王东岩, 刘月, 等. 不同针刺方式刺激认知情感区对卒中后认知障碍患者脑电图微状态的影响[J]. 中国针灸, 2026,46(6):853-860. DOI： 10.13703/j.0255-2930.20250616-0007.

LI Shenwei, WANG Dongyan, LIU Yue, et al. Effect on electroencephalogram microstate in patients with post-stroke cognitive impairment: a comparative study of acupuncture with different stimulation methods at cognitive-emotional area[J]. Chinese Acupuncture & Moxibustion, 2026, 46(6): 853-860. DOI： 10.13703/j.0255-2930.20250616-0007.

摘要

目的：

观察不同针刺方式刺激认知情感区治疗卒中后认知障碍（PSCI）的疗效，并利用脑电图（EEG）微状态参数初步探讨其作用机制。

方法：

将108例PSCI患者随机分为试验一组（36例，脱落3例、剔除2例）、试验二组（36例，脱落3例、剔除3例）和对照组（36例，脱落4例、剔除2例）。各组均予常规针刺和基础治疗，在此基础上，各组均针刺认知情感区，试验一组采用经颅重复针刺法，试验二组采用电针（连续波，频率2 Hz），对照组仅做轻微捻转，每日1次，治疗6 d后休息1 d，4周为一疗程，共治疗2个疗程。分别于治疗前后比较各组患者简明精神状态量表（MMSE）、蒙特利尔认知量表（MoCA）、听觉词语学习测验（AVLT）评分和图形连线测验（STT）耗时量，采集EEG微状态参数[包括平均持续时间（Dur）、发生频率（Occ）、覆盖率（Cov）和微状态之间的转换概率（TP）]并进行分析，于治疗后比较各组患者的临床疗效。

结果：

治疗后，各组患者MMSE评分均较治疗前升高（

0.05），且试验一组、试验二组高于对照组（

0.05）。治疗后，各组患者MoCA总分和视空间、语言、定向力评分以及AVLT即刻回忆、再认评分均较治疗前升高（

0.01），STT-A耗时量均较治疗前降低（

0.05）；试验一组和试验二组MoCA注意力评分、AVLT短延时回忆和长延时回忆评分均较治疗前升高（

0.01），STT-B耗时量较治疗前降低（

0.05）。治疗后，试验一组和试验二组MoCA总分和各模块评分以及AVLT即刻回忆、短延时回忆、长延时回忆评分均高于对照组（

0.01），STT-A和STT-B耗时量均低于对照组（

0.05）；试验一组MoCA语言评分低于试验二组（

0.01），MoCA注意力评分、AVLT即刻回忆评分及STT-B耗时量高于试验二组（

0.01，

0.05）。治疗后，试验一组、试验二组患者微状态C、D的Dur、Occ、Cov以及微状态B→C、C→D、D→C的TP均高于对照组（

0.05），微状态A、B的Dur、Occ、Cov以及微状态C→B的TP均低于对照组（

0.05）；试验一组微状态D的Dur高于试验二组（

0.05），微状态C的Dur低于试验二组（

0.05）。试验一组有效率为93.6%（29/31），试验二组有效率为93.3%（28/30），均高于对照组的80.0%（24/30）。

结论：

不同针刺方式刺激认知情感区均能改善PSCI患者的认知功能，经颅重复针刺法与电针较常规针刺存在疗效优势，经颅重复针刺法在改善注意力和记忆方面效果更佳，而电针在改善语言和执行功能方面效果更佳。

Abstract

Objective

To observe the therapeutic effect on post-stroke cognitive impairment (PSCI) after acupuncture with different stimulation methods at cognitive-emotional area

and preliminarily explore its action mechanism using electroencephalogram (EEG) microstate parameters.

Methods

A total of 108 PSCI patients were randomized into a trial group No.1 (36 cases

3 cases dropped out and 2 cases were eliminated)

a trial group No.2 (36 cases

3 cases dropped out and 3 cases were eliminated)

and a control group (36 cases

4 cases dropped out and 2 cases were eliminated). Besides the conventional acupuncture and basic treatment

acupuncture was operated at the cognitive-emotional area in each group. The repetitive transcranial acupuncture stimulation (rTAS) was adopted in the trial group No.1

electroacupuncture was adopted in the trial group No.2

and minimal manual twisting was adopted in the control group. The intervention was operated once daily for 6 days

followed by 1 day of interval. One course of treatment consisted of 4 weeks and 2 courses were required. Before and after treatment

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

Montreal cognitive assessment (MoCA) and auditory verbal learning test (AVLT)

and the completion time of shape trail test (STT) were compared in each group. EEG microstate parameters (duration [Dur]

occurrence [Occ]

coverage [Cov] and transition probability [TP]) were adopted and analyzed. After treatment

the clinical effect was compared among groups.

Results

After treatment

MMSE scores increased when compared with the baseline in each group (

0.05)

and the scores in the trial groups No.1 and No.2 were higher than those in the control group (

0.05). In each group

the total scores in MoCA and the scores on visuospatial function

language and orientation

as well as the scores on immediate recall and recognition of AVLT were higher (

0.01)

and the completion time of STT-A was reduced (

0.05) when compared with the baseline. After treatment

in the trial groups No.1 and No.2

the scores on attention of MoCA and the scores on short-term delayed recall and long-term delayed recall of AVLT were elevated(

0.01)

and the completion time of STT-B was reduced (

0.05) in comparison with the baseline. After treatment

the total scores in MoCA and the scores on each domain

as well as the scores on immediate recall

short-term delayed recall and long-term delayed recall of AVLT in the trial groups No.1 and No.2 were all higher than those of the control group (

0.01)

and the completion time of STT-A and STT-B was shorter (

0.05); the score on language of MoCA in the trial group No.1 was lower than that in the trial group No.2 (

0.01)

and the score on attention of MoCA and the score on immediate recall of AVLT wer

e higher and the completion time of STT-B was longer when compared with those in the trial group No.2 (

0.01

0.05). After treatment

Dur

Occ and Cov in microstates C and D

as well as TP of microstates B→C

C→D and D→C in the trial groups No.1 and No.2 were superior to those in the control group (

0.05)

and Dur

Occ and Cov in microstates A and B

as well as TP of microstates C→B were inferior to those in the control group (

0.05); Dur in microstate D in the trial group No.1 was longer than that in the trial group No.2 (

0.05)

and Dur in the microstate C was shorter (

0.05). The total effective rate was 93.6% (29/31) in the trial group No.1 and was 93.3% (28/30) in the trial group No.2

higher than that (80.0%

24/30) in the control group.

Conclusion

Acupuncture at the cognitive-emotional area with different stimulation methods improves the cognitive function in PSCI patients. The rTAS and electroacupuncture obtain the superior advantage on the therapeutic effect when compared with conventional acupuncture. The rTAS presents the best effect on ameliorating attention and memory

while electroacupuncture is more effective on improving lanague and executive function.

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