文章摘要
孙丹,李阳安,张逸,安嘉懿,张爱洁,康瑜,胥红梅,陈智,吴友霜,何双,朱晓玲,胡可慧.经颅重复针刺疗法同步高压氧改善一氧化碳中毒迟发性脑病认知障碍的研究[J].中国康复,2025,40(2):89-93
经颅重复针刺疗法同步高压氧改善一氧化碳中毒迟发性脑病认知障碍的研究
Recurrent transcranial acupuncture therapy with hyperbaric oxygen improves cognitive impairment in delayed encephalopathy due to carbon monoxide poisoning
  
DOI:10.3870/zgkf.2025.02.005
中文关键词: 一氧化碳中毒迟发脑病  经颅重复针刺刺激疗法  高压氧  脑电图
英文关键词: carbon monoxide poisoning delayed enc-ephalopathy  repeated transcranial acupuncture stimulation therapy  hyperbaric oxygen  electroencephalogram
基金项目:遂宁市中心医院院级科研课题(2022ypj42)
作者单位
孙丹 遂宁市中心医院康复医学科四川 遂宁 629000 
李阳安 遂宁市中心医院康复医学科四川 遂宁 629000 
张逸 遂宁市中心医院康复医学科四川 遂宁 629000 
安嘉懿 遂宁市中心医院康复医学科四川 遂宁 629000 
张爱洁 遂宁市中心医院康复医学科四川 遂宁 629000 
康瑜 遂宁市中心医院康复医学科四川 遂宁 629000 
胥红梅 遂宁市中心医院康复医学科四川 遂宁 629000 
陈智 遂宁市中心医院康复医学科四川 遂宁 629000 
吴友霜 遂宁市中心医院康复医学科四川 遂宁 629000 
何双 遂宁市中心医院康复医学科四川 遂宁 629000 
朱晓玲 遂宁市中心医院康复医学科四川 遂宁 629000 
胡可慧 遂宁市中心医院康复医学科四川 遂宁 629000 
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中文摘要:
  目的:观察一氧化碳(CO)中毒迟发性脑病采用经颅重复针刺刺激疗法同步高压氧治疗后的临床疗效。方法:将CO中毒迟发脑病患者作为研究对象,按照随机数字表法分为观察组(30例)和对照组(30例),观察组采用经颅重复针刺激疗法同步高压氧治疗,对照组采用高压氧治疗。连续治疗8周后,采用蒙特利尔认知评估量表(MoCA)、改良的Barthel指数(BI)、脑电图(EEG),分别对患者认知功能、日常生活能力、脑电图改变进行比较,检测血清S100钙结合蛋白B(S100B)水平,对S100B水平与MBI、MoCA评分进行相关性分析。结果:治疗后8周后,2组MoCA和MBI评分较治疗前升高(均P<0.01),且观察组MoCA及MBI评分较对照组显著升高(P<0.01);脑电图结果:对照组治疗前后,脑电图差异无统计学意义,观察组脑电图显示结果优于治疗前及对照组(P<0.01);治疗后,观察组血清S100B水平较治疗前及对照组治疗后均降低(P<0.01);相关性分析显示:观察组患者血清S100B与治疗后MBI及MoCA及呈正相关(P<0.01)。结论:经颅重复针刺刺激疗法同步高压氧治疗CO中毒迟发脑病,可以改善患者认知功能、提高日常生活能力,减轻脑电图异常,降低血清S100B水平;患者认知功能改善与血清S100B呈正相关,该指标在评估疗效及疾病预后有一定的价值。
英文摘要:
  Objective: To observe the clinical efficacy of delayed encephalopathy of carbon monoxide poisoning after synchronized hyperbaric oxygen therapy with transcranial repetitive needle stimulation therapy. Methods: The patients with delayed encephalopathy of carbon monoxide poisoning were divided into observation group (n=30) and control group (n=30) according to the randomized numerical table method. The observation group was treated with transcranial repetitive needle stimulation therapy synchronized with hyperbaric oxygen therapy, and the control group was treated with hyperbaric oxygen therapy. After 8 weeks of continuous treatment, Montreal Cognitive Assessment Scale (MoCA), modified Barthel index (MBI), electroencephalogram (EEG) and serum calcium-binding S100B were used to compare the cognitive function, daily living ability and EEG of the patients. The correlation between serum index S100B and GCS and MoCA scores of patients was analyzed. Results: After 8 weeks of treatment, MoCA and MBI scores in 2 groups were significantly higher than those before treatment (P<0.01), and MoCA and MBI scores in observation group were significantly higher than those in control group (P<0.01). There was no significant difference in EEG in the control group before and after treatment, while there was a statistically significant difference in EEG improvement in the observation group before and after treatment (P<0.01). After treatment, the EEG results in the observation group were better than those in the control group and those of the observation group (P<0.01). The serum S100B levels after treatment in the observation group were lower than those before treatment and control group (P<0.01). There was no correlation between serum S100B and GCS score in the observation group, and serum S100B was positively correlated with MoCA after treatment (P<0.01). Conclusion: Transcranial repeated acupuncture therapy with hyperbaric oxygen in the treatment of delayed encephalopathy caused by carbon monoxide poisoning can improve the cognitive function and the ability of daily living, alleviate the abnor-mal EEG, and reduce the level of serum S100B. With the progress of treatment, the improvement of patients’ cognitive function is positively correlated with serum S100B. The serum S100B has certain value in evaluating curative effect and prognosis of disease.
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