远隔缺血适应联合双耳节拍音乐训练对脑梗死认知障碍的效果

doi:10.3969/j.issn.1006-9771.2025.09.009

Abstract

Abstract:

Objective To explore the effect of remote ischemic conditioning (RIC) combined with binaural beat music (BBM) training in patients with cognitive dysfunction after cerebral infarction.

Methods From June, 2024 to January, 2025, 200 patients with cognitive dysfunction after cerebral infarction in the Affiliated Hospital of North China University of Science and Technology were randomly divided into control group (n = 50), RIC group (n = 50), BBM group (n = 50) and combined group (n = 50). All the groups received standardized routine training, RIC group received RIC, BBM group received BBM, and the combined group received RIC+BBM, for 14 days. They were assessed with Montreal Cognitive Assessment (MoCA) and Stroke-Specific Quality of Life Scale (SS-QOL) at baseline, day 14, and day 90.

Results Two cases in the control group, four in RIC group, three in BBM group and three in the combined group dropped out. For MoCA scores, the inter-group effect, intra-group effect and interaction effect were all significant (F > 13.463, P < 0.001). After intervention, on both day 14 and day 90, the score of MoCA was higher in each intervention group than in the control group (P < 0.05), and was higher in the combined group than in both BBM and RIC groups (P < 0.05); and on day 90, it was higher in RIC group than in BBM group (P < 0.05). For SS-QOL, the score increased with time in all the groups (χ² > 75.182, P< 0.001). After intervention, there was significant difference at each time point among four groups (H > 18.260, P < 0.001). On day 14 and day 90, the score of SS-QOL was higher in the combined group than in the control and BBM groups (|Z| > 3.149, P < 0.05); on day 90, the score was higher in RIC group than in the control group (|Z| = 3.590, P < 0.05), and it was higher in the combined group than in RIC group (|Z| = 3.186, P < 0.05).

Conclusion RIC, BBM and their combination all improved cognitive function after cerebral infarction. RIC was superior to BBM, and the combined intervention yielded the greatest benefit. Both RIC and the combined intervention improved quality of life, with the combined approach being the most effective.

Key words: cerebral infarction, remote ischemic conditioning, binaural beat music, cognitive dysfunction, quality of life

CLC Number:

R743.3

XUE Xing, ZHAO Haiyan, YUE Shuling, CHENG Jie, TANG Qiqun, CHENG Xiaohua, GUO Zonghai, LIU Pingping. Effect of remote ischemic conditioning combined with binaural beat music training in patients with cognitive dysfunction after cerebral infarction[J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(9): 1057-1065.

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References 36

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组别	n	干预前		第14天		第90天
组别	n	均值	标准差	均值	标准差	均值	标准差
对照组	48	18.69	1.95	19.17	1.66	19.58	1.81
双耳节拍音乐组	47	18.91	2.03	20.11	2.24	20.77	2.23
远隔缺血适应组	46	18.24	2.41	20.78	1.95	22.48	2.46
联合组	47	19.13	2.31	21.74	1.88	24.00	1.97

效应	平方和	Greenhouse-Geisser矫正自由度	均方	F值	P值
时间	832.332	1.422	585.436	536.292	< 0.001
组间	463.922	3.000	154.641	13.463	< 0.001
时间×组间	257.242	4.265	60.312	55.249	< 0.001

时间	组别	组别	平均值差	P值	95% CI
时间	组别	组别	平均值差	P值	下限	上限
干预前	对照组	双耳节拍音乐组	-0.227	0.612	-1.110	0.655
	对照组	远隔缺血适应组	0.448	0.320	-0.439	1.335
	对照组	联合组	-0.440	0.326	-1.322	0.442
	双耳节拍音乐组	远隔缺血适应组	0.676	0.137	-0.216	1.567
	双耳节拍音乐组	联合组	-0.213	0.637	-1.100	0.674
	远隔缺血适应组	联合组	-0.889	0.051	-1.780	0.003
第14天	对照组	双耳节拍音乐组	-0.940	0.019	-1.726	-0.153
	对照组	远隔缺血适应组	-1.616	< 0.001	-2.406	-0.825
	对照组	联合组	-2.578	< 0.001	-3.364	-1.792
	双耳节拍音乐组	远隔缺血适应组	-0.676	0.095	-1.471	0.118
	双耳节拍音乐组	联合组	-1.638	< 0.001	-2.429	-0.848
	远隔缺血适应组	联合组	-0.962	0.018	-1.757	-0.167
第90天	对照组	双耳节拍音乐组	-1.183	0.007	-2.043	-0.322
	对照组	远隔缺血适应组	-2.895	< 0.001	-3.760	-2.030
	对照组	联合组	-4.417	< 0.001	-5.277	-3.556
	双耳节拍音乐组	远隔缺血适应组	-1.712	< 0.001	-2.582	-2.582
	双耳节拍音乐组	联合组	-3.234	< 0.001	-4.099	-4.099
	远隔缺血适应组	联合组	-1.522	< 0.001	-2.392	-0.652

组别	n	干预前	第14天	第90天	χ²值	P值
对照组	48	124.5(98.3, 133.5)	127.0(103.0, 136.0)	138.0(119.0, 155.0)	75.182	< 0.001
双耳节拍音乐组	47	119.0(109.0, 133.0)	131.0(109.0, 141.0)	150.0(129.0, 166.0)	84.500	< 0.001
远隔缺血适应组	46	112.5(95.0, 128.0)	135.0(116.5, 161.3)	158.0(141.8, 182.3)	80.376	< 0.001
联合组	47	115.0(94.0, 131.0)	153.0(117.0, 169.0)	186.0(168.0, 198.0)	87.256	< 0.001
H值		3.266	18.260	50.766
P值		0.352	< 0.001	< 0.001

时间	组别	组别	标准误差	Z值	P值
第14天	对照组	双耳节拍音乐组	11.164	-0.831	1.000
	对照组	远隔缺血适应组	11.225	-2.198	0.168
	对照组	联合组	11.164	-3.996	< 0.001
	双耳节拍音乐组	远隔缺血适应组	11.283	-1.365	1.000
	双耳节拍音乐组	联合组	11.223	-3.149	0.010
	远隔缺血适应组	联合组	11.283	-1.767	0.463
第90天	对照组	双耳节拍音乐组	11.165	-1.803	0.429
	对照组	远隔缺血适应组	11.226	-3.590	0.002
	对照组	联合组	11.165	-6.830	< 0.001
	双耳节拍音乐组	远隔缺血适应组	11.285	-1.788	0.443
	双耳节拍音乐组	联合组	11.224	-5.001	< 0.001
	远隔缺血适应组	联合组	11.285	-3.186	0.009

Effect of remote ischemic conditioning combined with binaural beat music training in patients with cognitive dysfunction after cerebral infarction

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项目		对照组 (n = 48)	双耳节拍音乐组 (n = 47)	远隔缺血适应组 (n = 46)	联合组 (n = 47)	χ²/F/H值	P值
性别/n	男	27	20	27	19	4.887^a	0.180
	女	21	27	19	28	4.887^a	0.180
年龄/岁		66.98±6.75	66.77±5.23	65.41±7.53	65.66±7.10	0.641^b	0.590
文化程度/n	小学及以下	18	11	17	19	1.776^c	0.620
	初中	23	25	16	13
	高中/中专	3	9	11	9
	大专及以上	4	2	2	6
婚姻状况/n	已婚	38	43	39	41	3.067^a	0.381
婚姻状况/n	未婚/丧偶	10	4	7	6	3.067^a	0.381
月经济收入/n	< 3000元	24	22	27	26	2.703^a	0.857
	3000~5000元	21	20	17	17
	> 5000元	3	5	2	4
慢性病疾病/n	高血压	32	30	40	36	20.920^a	0.051
	糖尿病	23	14	20	14
	冠心病	9	15	9	11
	高血脂	12	1	2	4
	其他	5	10	6	7
脑梗死部位/n	额部	41	44	39	43	21.795^a	0.933
	顶部	37	40	34	34
	枕部	15	27	17	22
	颞部	22	29	24	27
	岛叶	11	15	14	17
	基底节	31	27	26	26
	丘脑	15	15	13	11
	放射冠	15	12	10	7
	脑干	21	21	18	13
	小脑	6	7	7	5
	半卵圆中心	2	0	4	5
	胼胝体	7	2	3	3
脑梗死部位/n	< 3处	10	9	12	16	6.574^a	0.370
	3~5处	22	16	19	18
	> 5处	16	22	15	13
偏瘫部位/n	无	26	27	20	31	10.080^a	0.273
	左侧肢体	12	13	10	9
	右侧肢体	10	6	14	7
	双侧肢体	0	1	2	0

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