标题：温针灸联合镜像疗法对老年脑梗死后偏瘫患者的功能恢复

      作者：及Hcy、BDNF的影响    贺强，樊乐，朱杰，廉腾腾西安市西电集团医院康复医学科，陕西 西安 710000

      卷次： 2023年34卷7期

      【摘要】 目的 探讨温针灸联合镜像疗法对老年脑梗死后偏瘫患者的功能恢复及同型半胱氨酸(Hcy)、脑源性神经营养因子(BDNF)的影响。方法 选择 2019年 5月至 2022年 5月西安市西电集团医院康复医学科收治的110例老年脑梗死后偏瘫患者进行研究，根据随机数表法分为观察组和对照组各55例。对照组患者采用镜像疗法治疗，观察组患者在对照组治疗的基础上联合温针灸治疗，两组患者均连续治疗1个月。比较两组患者治疗前、治疗1个月后的血清Hcy、BDNF水平、蒙特利尔认知评估量表(MoCA)评分、简易精神状态检查量表(MMSE)评分、肢体运动能力评分，并记录两组患者治疗期间的不良反应发生情况。结果 治疗后，观察组患者的血清Hcy水平为(9.10±1.15) μmol/L，明显低于对照组的(13.06±2.20) μmol/L，BDNF水平、MoCA、MMSE、上肢运动能力、下肢运动能力评分分别为(50.22±5.83) ng/mL、(24.72±2.25)分、(25.75±2.50)分、(55.60±6.45)分、(27.30±3.10)分，明显高于对照组的(41.75±5.50) ng/mL、(21.30±2.17)分、(22.62±2.31)分、(44.86±4.40)分、(22.71±2.08)分，差异均具有统计学意义(P<0.05)；治疗期间，观察组患者的不良反应总发生率为10.91%，略低于对照组的18.18%，但差异无统计学意义(P>0.05)。结论 温针灸联合镜像疗法能提高老年脑梗死后偏瘫患者的认知功能和肢体功能的恢复，改善血清Hcy、BDNF表达水平，具有临床应用价值。
      【关键词】 脑梗死；偏瘫；温针灸；镜像疗法；同型半胱氨酸；脑源性神经营养因子；肢体功能
      【中图分类号】 R743.33 【文献标识码】 A 【文章编号】 1003—6350（2023）07—0929—04

Effects of warm acupuncture combined with mirror therapy on functional recovery, homocysteine, andbrain-derived neurotrophic factor in elderly patients with hemiplegia after cerebral infarction.
HE Qiang, FAN Le,ZHU Jie, LIAN Teng-teng. Department of Rehabilitation Medicine, Xi'an Xidian Group Hospital, Xi'an 710000, Shaanxi,CHINA
【Abstract】 Objective To investigate the effects of warm acupuncture combined with mirror therapy on func-tional recovery, homocysteine (Hcy), and brain-derived neurotrophic factor (BDNF) in elderly patients with hemiple-gia after cerebral infarction. Methods A total of 110 elderly patients with hemiplegia after-cerebral infarction admit-ted to Department of Rehabilitation Medicine, Xi'an Xidian Group Hospital from May 2019 to May 2022 were select-ed for study. According to the random number table method, they were divided into an observation group and a controlgroup, with 55 patients in each group. The patients in the control group were treated with mirror therapy, while the pa-tients in the observation group were treated with warm acupuncture and moxibustion on the basis of the control group,for 1 month. The changes of serum Hcy, BDNF levels, Montreal Cognitive Assessment Scale (MoCA) score,Mini-Mental State Examination (MMSE) score, and limb motor ability scores were compared between the two groupsbefore treatment and after one month of treatment. The occurrence of adverse reactions in the two groups of patientsduring treatment were recorded. Results After treatment, the serum Hcy level in the observation group was (9.10±1.15) μmol/L,which was significantly lower than (13.06±2.20) μmol/L in the control group, and BDNF level, MoCA,MMSE, upper limb motor ability, and lower limb motor ability scores were (50.22±5.83) ng/mL, (24.72±2.25) points,(25.75±2.50) points, (55.60±6.45) points, (27.30±3.10) points, significantly higher than (41.75±5.50) ng/mL, (21.30±2.17) points, (22.62±2.31) points, (44.86±4.40) points, (22.71±2.08) points in the control group (P<0.05). During thetreatment period, the total incidence of adverse reactions in the observation group was 10.91%, which was slightly lowerthan 18.18% in the control group, but the difference was not statistically significant (P>0.05). Conclusion Warm acu-puncture combined with mirror therapy can improve the recovery of cognitive function and limb function in elderly pa-tients with hemiplegia after cerebral infarction, and improve the expression levels of serum Hcy and BDNF, which hashigh clinical application value.
      【Key words】 Cerebral infarction; Hemiplegia; Warm acupuncture; Mirror therapy; Homocysteine; Brain-derivedneurotrophic factor; Limb function