【摘要】 目的 探讨升清益髓开窍针法联合地黄饮子对缺血性脑卒中后轻度认知功能障碍（mild cognitive impairment,MCI）患者血清同型半胱氨酸（homocysteine,Hcy）的影响。方法 选取2023年1月—2024年8月在泰安市中医医院康复科住院或门诊就诊且辨证为肾虚血瘀型患者120例，使用随机数字表将病例分为3组，分别是针药并用组（简称针药组）、针刺组和对照组，每组40例。治疗前后比较3组患者同型半胱氨酸（Hcy）水平，以及改良Barthel指数（MBI）评分、蒙特利尔认知评估（MoCA）评分和汉密顿抑郁量表-17项（HAMD-17）评分和临床总有效率。结果 治疗后，针药组患者Hcy水平较针刺组、对照组显著降低（P<0.05）;MBI评分、MoCA评分、HAMD-17评分较针刺组、对照组显著提高（P<0.05）；针药组总有效率为92.5%(37/40)，高于针刺组77.5%(31/40)和对照组67.5%(27/40)，差异有统计学意义（P<0.05）。结论 对缺血性脑卒中后MCI患者实施升清益髓开窍针法联合地黄饮子治疗方案，可降低其Hcy水平，效果显著，值得临床借鉴。更多还原

【Abstract】 Objective To investigate the effect of Shengqing Yishui Kaiqiao acupuncture method combined with Dihuang Yinzi (地黄饮子) on homocysteine(Hcy) in patients with mild cognitive impairment(MCI)after ischemic stroke. Methods To select 120 patients who were hospitalized or outpatient at the rehabilitation department of Taian hospital of traditional Chinese medicine from January 2023 to August 2024 and diagnosed with kidney deficiency and blood stasis type. Using a random number table,divide the cases into each group:the acupuncture and medication combination group,the acupuncture group,and the control group,with 40 cases in each group. To compare and analyze the changes in homocysteine(Hcy)levels in each group before and after treatment,and evaluate the patients’ activities of daily living modified Barthel index(MBI)scores,Montreal cogntive assessment(MoCA) scores,Hamilton depression scale-17 items(HAMD-17) scores and the total effective rate. Results After treatment,the Hcy levels of patients in the acupuncture and medication combination group were significantly lower than those in the acupuncture group and the control group(P<0.05);The MBI scores,MoCA scores,and HAMD-17 scores were significantly improved compared to the acupuncture group and the control group(P<0.05);The total effective rate of the acupuncture and medication combination group was 92.5%(37/40),which was higher than the acupuncture group’s 77.5%(31/40)and the control group’s 67.5%(27/40),and the difference was statistically significant(P<0.05). Conclusion The implementation of the Shengqing Yishui Kaiqiao acupuncture method combined with Dihuang Yinzi treatment plan for MCI patients after ischemic stroke can significantly reduce their Hcy levels and is worthy of clinical reference.更多还原