头针结合计算机辅助训练对脑卒中后记忆障碍的效果

doi:10.3969/j.issn.1006-9771.2025.07.014

《中国康复理论与实践》 ›› 2025, Vol. 31 ›› Issue (7): 862-868.doi: 10.3969/j.issn.1006-9771.2025.07.014

• 应用研究 • 上一篇

头针结合计算机辅助训练对脑卒中后记忆障碍的效果

刘兰群^1a^,², 李艳丽^1a^,², 梁家琦^1a, 陈爽^1b, 刘慧林³()

1.中国康复研究中心北京博爱医院，a.中医康复科；b.病案统计室，北京市 100068
2.首都医科大学康复医学院，北京市 100068
3.首都医科大学附属北京中医医院针灸科，北京市 100010

收稿日期:2025-03-28 修回日期:2025-06-01 出版日期:2025-07-25 发布日期:2025-07-30
通讯作者: 刘慧林，E-mail： 947639780@qq.com
作者简介:刘兰群(1981-)，女，汉族，湖南常德市人，博士研究生，副主任医师，主要研究方向：脑卒中的中西医结合康复。
基金资助:
中国康复研究中心科研课题(2021zx-26)

Effect of scalp acupuncture combined with computer-assisted training on memory impairment after stroke

LIU Lanqun^1a^,², LI Yanli^1a^,², LIANG Jiaqi^1a, CHEN Shuang^1b, LIU Huilin³()

1a. Department of Traditional Chinese Medicine Rehabilitation; b. Medical Records and Statistics Office, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China
2. Capital Medical University School of Rehabilitation Medicine, Beijing 100068, China
3. Department of Acupuncture, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, China

Received:2025-03-28 Revised:2025-06-01 Published:2025-07-25 Online:2025-07-30
Contact: LIU Huilin, E-mail: 947639780@qq.com
Supported by:
China Rehabilitation Research Center Project(2021zx-26)

摘要/Abstract

摘要：

目的观察头针(神庭、本神、四神聪)结合计算机辅助训练对脑卒中后记忆障碍的效果。

方法 2023年5月至2024年12月，北京博爱医院住院康复的脑卒中后记忆障碍患者62例，随机分为对照组(n = 31)和观察组(n = 31)。对照组接受常规治疗和计算机辅助训练，观察组在此基础上加用头针治疗，共4周。分别于治疗前后采用蒙特利尔认知功能评估(MoCA)、听觉记忆广度和改良Barthel指数(MBI)进行评价。

结果所有患者在治疗过程中均无不良反应。治疗后，两组MoCA总分和记忆分值、听觉记忆广度均显著改善(|t| > 3.838, P < 0.001)，观察组增加值均优于对照组(|t| > 2.160, P < 0.05)；两组MBI评分均显著增加(|t| >7.471, P < 0.001)，但两组间比较无显著性差异(P > 0.05)。

结论计算机辅助训练能改善脑卒中后记忆障碍患者的认知功能，尤其是记忆功能，结合头针能进一步提高疗效。

关键词: 脑卒中, 头针, 计算机辅助训练, 记忆障碍, 听觉记忆广度

Abstract:

Objective To observe the effect of scalp acupuncture points including Shenting (GV24), Benshen (GB13) and Sishencong (EX-HN1) combined with computer-assisted training on memory impairment after stroke.

Methods From May, 2023 to December, 2024, 62 patients with post-stroke memory dysfunction who received rehabilitation treatment in Beijing Bo'ai Hospital were selected and divided into control group (n = 31) and observation group (n = 31) randomly. Both groups received conventional treatment and computer-assisted training, while the observation group received additional scalp acupuncture treatment, for four weeks. They were evaluated with Montreal Cognitive Assessment (MoCA), auditory memory span, and modified Barthel Index (MBI) before and after treatment.

Results No adverse reaction occured during treatment. After treatment, the total score of MoCA and the memory dimension score, and auditory memory span score improved in both groups (|t| > 3.838, P < 0.001), and the d-value was more in the observation group than in the control group (|t| > 2.160, P < 0.05); the score of MBI improved in both groups (|t| >7.471, P < 0.001), however, there was no significant difference between two groups (P > 0.05).

Conclusion Computer-assisted training could significantly improve the cognitive function of patients with post-stroke memory dysfunction, especially the memory function, and is more effective while combining with scalp acupuncture.

Key words: stroke, scalp acupuncture, computer-assisted training, memory impairment, auditory memory span

中图分类号:

R743.3

刘兰群, 李艳丽, 梁家琦, 陈爽, 刘慧林. 头针结合计算机辅助训练对脑卒中后记忆障碍的效果[J]. 《中国康复理论与实践》, 2025, 31(7): 862-868.

LIU Lanqun, LI Yanli, LIANG Jiaqi, CHEN Shuang, LIU Huilin. Effect of scalp acupuncture combined with computer-assisted training on memory impairment after stroke[J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(7): 862-868.

图/表 4

表1

表2

两组治疗前后MoCA总分和记忆分值比较"

变量	组别	n	测试	$x - ± s$	t值	P值
MoCA	对照组	31	前测	14.87±5.43	-17.600	< 0.001
			后测	17.81±5.80
	观察组	31	前测	14.65±5.72	-12.898	< 0.001
			后测	19.42±5.26
	治疗前两组均值差			-0.23±8.56	0.159	0.874
	治疗后两组均值差			1.61±8.54	-1.147	0.256
	对照组增加值			2.94±0.93	-4.529	< 0.001
	观察组增加值			4.77±2.06
记忆分值	对照组	31	前测	1.39±5.43	-5.043	< 0.001
			后测	1.94±1.44
	观察组	31	前测	1.32±1.49	-7.019	< 0.001
			后测	2.42±1.36
	治疗前两组均值差			-0.10±2.33	0.265	0.792
	治疗后两组均值差			0.48±1.98	-1.362	0.178
	对照组增加值			0.52±0.57	-3.108	0.003
	观察组增加值			1.10±0.87

表2

表3

两组治疗前后听觉记忆广度(正向和反向)比较"

变量	组别	n	测试	$x - ± s$	t值	P值
听觉广度(正向)	对照组	31	前测	5.13±1.91	-5.043	< 0.001
			后测	5.65±1.91
	观察组	31	前测	5.06±1.79	-3.838	< 0.001
			后测	6.32±1.94
	治疗前两组均值差			-0.06±2.42	0.137	0.891
	治疗后两组均值差			0.68±3.24	-1.387	0.171
	对照组增加值			0.52±0.57	-2.160	0.038
	观察组增加值			1.26±1.83
听觉广度(反向)	对照组	31	前测	2.58±1.31	-4.728	< 0.001
			后测	3.06±1.15
	观察组	31	前测	2.55±1.23	-5.780	< 0.001
			后测	3.45±1.36
	治疗前两组均值差			-0.03±1.91	0.100	0.921
	治疗后两组均值差			0.39±1.98	-1.208	0.232
	对照组增加值			0.48±0.57	-2.245	0.028
	观察组增加值			0.90±0.87

表3

表4

两组治疗前后MBI评分比较"

组别	n	测试	$x - ± s$	t值	P值
对照组	31	前测	37.26±6.69	-7.471	< 0.001
		后测	45.48±8.88
观察组	31	前测	37.42±6.31	-11.333	< 0.001
		后测	48.39±10.20
治疗前两组均值差			0.16±9.17	-0.098	0.923
治疗后两组均值差			2.90±12.03	-1.195	0.237
对照组增加值			8.23±6.13	-1.871	0.066
观察组增加值			10.97±5.39

表4

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组别	n	性别/n		年龄/岁	病程/周	脑卒中类型/n		文化程度/n
组别	n	男	女	年龄/岁	病程/周	出血	梗死	大学/大专及以上	高中/中专	初中及以下
对照组	31	16	15	57.52±9.26	11.0(8.5,15.0)	11	20	9	10	12
观察组	31	18	13	58.61±8.83	10.5(8.5,12.0)	13	18	8	12	11
χ²/t/Z值		0.261		0.477	-0.474	0.272		0.284
P值		0.610		0.635	0.635	0.602		0.868

头针结合计算机辅助训练对脑卒中后记忆障碍的效果

Effect of scalp acupuncture combined with computer-assisted training on memory impairment after stroke

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