目的：探讨针刺、银杏达莫注射液联合脑蛋白水解物治疗脑卒中认知功能障碍患者的临床效果，以及其对患者认知功能、智力、日常生活能力的影响。方法选择2011年2月—2015年7月济宁市第一人民医院神经内科收治的脑卒中认知功能障碍患者96例，将其按照随机数字表法分为观察组和对照例，每组48例。对照组患者在常规治疗的基础上单纯给予脑蛋白水解物静脉滴注，观察组则在对照组基础上加用针刺、银杏达莫注射液联合治疗。连续治疗4周后，评价2组疗效，利用蒙特利尔认知评估量表（ MoCA）、简易智能状态量表（ MMSE）及日常生活能力量表（ ADL）分别对患者治疗前后的认知功能、智力、日常生活能力进行评分，并监测治疗前后血清神经元特异性烯醇化酶（NSE）、S100β蛋白水平变化。结果观察组的总有效率（89．6％）明显高于对照组（66．7％），2组比较差异具有统计学意义（χ2＝7．104， P ＜0．05）；2组患者治疗后的认知功能、智力、日常生活能力较治疗前均改善明显，MoCA、MMSE、ADL评分均升高，且观察组与对照组比较差异有统计学意义（ P ＜0．05）；2组患者治疗后NSE、S100β水平均显著低于治疗前，观察组的下降程度较对照组更为明显（ P ＜0．05）。结论针刺、银杏达莫注射液联合脑蛋白水解物治疗脑卒中认知功能障碍疗效肯定，能显著改善患者的认知功能，提高智力水平及日常生活能力，其机制与调控NSE、S100β二者水平从而改善神经功能缺损有一定相关性。%Objective To investigate the clinical efficacy of treating cognitive dysfunction in stroke patients with acu-puncture, ginkgo leaf extract and dipyridamole injection combined with brain protein hydrolysate, and explore the influence of cognitive function, intelligence and ability to daily life.Methods 96 cognitive dysfunction in stroke cases were randomly di-vided into a control group of 48 cases and an observation group of 48 cases from February 2011 to July 2015.Patients in the control group were treated with brain protein hydrolysate for intravenous drip;while patients in the observation group were trea-ted with acupuncture, ginkgo leaf extract and dipyridamole injection.The research was focus on comparing the clinical effect of two groups after 4 weeks of treatment, assessing the cognitive function, intelligence and ability to daily life with MoCA, MMSE and ADL scores before and after treatment, and monitoring the levels change of NSE and S100β.Results The effi-ciency of patients in the observation group was 89.6%, which was higher than that of the control group 66.7%(χ2 =7.104, P <0.05);The improvement of cognitive function, intelligence and ability to daily life of patients in the observation group was more obvious compared with the control group, and the MoCA, MMSE and ADL scores were higher than that of the control group( P <0.05);The levels of NSE and S100βfor the patients in two groups were lower clearly compared with before treat-ment, the degree of change in the observation group was more pronounced( P <0.05).Conclusion Treating cognitive dys-function in stroke patients with acupuncture, ginkgo leaf extract and dipyridamole injection combined with brain protein hydrol-ysate has certain curative effect.It can significantly improve the patient's cognitive function, the level of intelligence and abili-ty to daily life.The mechanism has certain relevance of regulation of NSE andS100βfor improving neurologic deficits, is wor-thy of clinical deep investigation.
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