基于双重差分法模型分析调任通督针对脑卒中后认知障碍患者的影响

邹宜桐; 程一升; 汪佩佩

doi:10.16766/j.cnki.issn.1674-4152.004115

基于双重差分法模型分析调任通督针对脑卒中后认知障碍患者的影响

doi: 10.16766/j.cnki.issn.1674-4152.004115

1.
温州市中西医结合医院高压氧科，浙江温州 325000
2.
温州市中西医结合医院神经内科

基金项目:

浙江省中医药科技计划项目 2020ZB241

温州市科技计划项目 Y20220556

详细信息

通讯作者:
邹宜桐，E-mail：774818741@qq.com

中图分类号: R743 R747.9
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- 文章访问数: 9
- HTML全文浏览量: 5
- PDF下载量: 1
- 被引次数: 0
出版历程
- 收稿日期: 2024-09-26
- 网络出版日期: 2025-10-31

Based on the model of double difference method, this paper analyzes the influence of Tiaoren Tongdu acupuncture on patients with cognitive impairment after stroke

1.
Department of Hyperbaric Oxygen, Wenzhou Hospital of Integrated Chinese and Western Medicine, Wenzhou, Zhejiang 325000, China

摘要

摘要: 目的分析调任通督针联合高压氧对脑卒中后认知障碍(PSCI)患者的治疗效果，并采用双重差分法(DID)模型分析调任通督针联合高压氧对患者认知功能的影响。方法按照随机数字表法将2020年5月—2023年7月温州市中西医结合医院收治的126例PSCI患者分为2组，常规组(57例)予以高压氧治疗，联合组(59例)在常规组的基础上予以调任通督针治疗。比较2组临床疗效、炎症因子水平、脑血流灌注以及认知功能。结果联合组总有效率(93.22%，55/59)高于常规组(80.70%，46/57，P＜0.05)；治疗2个月后，联合组白细胞介素(IL)-6、肿瘤坏死因子-α(TNF-α)、CRP、IL-10水平均低于常规组(P＜0.05)；联合组脑血流量(CBF)、脑血容量(CBV)高于常规组，平均通过时间(MTT)、达峰时间(TTP)低于常规组(P＜0.05)；治疗1周、治疗1个月、治疗2个月后及随访结束后，联合组蒙特利尔认知功能评分(MoCA)均高于常规组(P＜0.05)；DID回归模型显示，治疗后，患者认知功能占预计上升1 134.2%(P＜0.05)。结论将调任通督针联合高压氧用于PSCI患者治疗中可减轻炎症反应，调节脑血流灌注，改善认知功能，缓解临床症状。
- 脑卒中后认知障碍 /
- 调任通督针 /
- 高压氧 /
- 脑血流灌注
Abstract: Objective To evaluate the therapeutic effect of Tiaoren Tongdu acupuncture combined with hyperbaric oxygen on patients with post-stroke cognitive impairment (PSCI), and to analyze the influence on cognitive function of patients by the double difference method (DID) model. Methods According to the random number table method, 126 patients with PSCI admitted to Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from May 2020 to July 2023 were divided into two groups. The routine group (n=57) was given hyperbaric oxygen therapy, and the combined group (n=59) was Tiaoren Tongdu acupuncture therapy on the basis of the routine group. After the treatment, the clinical efficacy, inflammatory factor level, cerebral blood flow perfusion, and cognitive function were compared between the two groups. Results The total effective rate of the combined group (93.22%, 55/59) was higher than that of the routine group (80.70%, 46/57, P < 0.05). After two months of treatment, the levels of interleukin (IL)-6, tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), and IL-10 in the combined group were lower than those in the conventional group (P < 0.05). The cerebral blood flow (CBF) and cerebral blood volume (CBV) in the combined group were higher than those in the routine group, while the mean transit time (MTT) and time to peak (TTP) were lower than those in the routine group (P < 0.05). After 1 week of treatment, 1 month of treatment, 2 months of treatment, and the end of follow-up, the Montreal cognitive assessment score in the combined group was higher than that in the routine group (P < 0.05). The DID regression model showed that after treatment, the cognitive function of patients increased by 1 134.2% respectively (P < 0.05). Conclusion The Tiaoren Tongdu acupuncture combined with hyperbaric oxygen can reduce neuroinflammatory reaction, regulate cerebral blood flow, improve cognitive function, and relieve clinical symptoms in patients with cognitive impairment after stroke.
- Cognitive impairment after stroke /
- Tiaoren Tongdu acupuncture /
- Hyperbaric oxygen /
- Cerebral blood flow perfusion

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图 1 调任通督针对患者认知功能的平行趋势检验分析

Figure 1. Parallel trend test analysis of cognitive function of patients transferred to the governor

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表 1 2组PSCI患者总有效率比较[例(%)]

Table 1. Comparison of total effective rates between the two groups of patients with PSCI[cases (%)]

组别	例数	显效	有效	无效	总有效
联合组	59	34(57.63)	21(35.59)	4(6.78)	55(93.22)
常规组	57	27(47.37)	19(33.33)	11(19.30)	46(80.70)
注：2组总有效率比较，χ²=4.035，P=0.044。

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表 2 2组PSCI患者治疗前后炎症因子水平比较(x ±s)

Table 2. Comparison of inflammatory factors between two groups of patients with PSCI before and after treatment(x ±s)

组别	例数	TNF-α(ng/L)		t值	P值	CRP(mg/L)		t值	P值
组别	例数	治疗前	治疗2个月	t值	P值	治疗前	治疗2个月	t值	P值
联合组	59	20.25±6.89	10.02±3.42	10.154	＜0.001	19.95±6.57	9.91±2.54	11.289	0.005
常规组	57	19.51±5.47	12.26±4.44	8.933	＜0.001	21.31±7.61	12.16±4.49	6.816	＜0.001
统计量		0.642^a	5.005^b			1.029^a	5.394^b
P值		0.522	0.008			0.306	0.005

组别	例数	TIL-6(ng/L)		t值	P值	TIL-10(pg/mL)		t值	P值
组别	例数	治疗前	治疗2个月	t值	P值	治疗前	治疗2个月	t值	P值
联合组	59	6.31±1.45	3.41±1.01	13.792	＜0.001	15.34±4.97	10.32±2.02	7.578	＜0.001
常规组	57	6.28±1.47	4.04±1.27	9.068	＜0.001	16.34±5.71	11.41±3.03	4.177	＜0.001
统计量		0.111^a	2.951^b			1.005^a	14.840^b
P值		0.912	0.004			0.317	＜0.001
注：^a为t值，^b为F值。

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表 3 2组PSCI患者治疗前后脑血流灌注指标比较(x ±s)

Table 3. Comparison of indexes of cerebral blood perfusion between two groups of patients with PSCI before and after treatment(x ±s)

组别	例数	CBF[mL/(100 g·min)]		t值	P值	CBV(mL/100 g)		t值	P值
组别	例数	治疗前	治疗2个月	t值	P值	治疗前	治疗2个月	t值	P值
联合组	59	42.31±5.75	50.51±8.31	7.718	＜0.001	1.72±0.34	2.65±0.48	11.869	＜0.001
常规组	57	43.28±6.87	47.14±9.27	2.840	＜0.001	1.69±0.31	2.42±0.42	10.125	＜0.001
统计量		0.823^a	3.431^b			0.497^a	3.548^b
P值		0.412	0.036			0.620	0.034

组别	例数	MTT(s)		t值	P值	TTP(s)		t值	P值
组别	例数	治疗前	治疗2个月	t值	P值	治疗前	治疗2个月	t值	P值
联合组	59	7.25±1.68	4.52±0.82	12.019	0.001	10.25±2.07	3.55±0.77	22.110	＜0.001
常规组	57	7.81±1.71	5.06±1.04	8.026	＜0.001	10.71±2.61	4.01±0.41	15.615	＜0.001
统计量		1.779^a	14.985^b			1.049^a	4.392^b
P值		0.078	＜0.001			0.296	0.015
注：^a为t值，^b为F值。

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表 4 2组PSCI患者各时间点认知功能比较(x ±s, 分)

Table 4. Comparison of cognitive function between two groups of patients with PSCI at different time points before and after treatment(x ±s, Points)

组别	例数	治疗前	治疗1周	治疗1个月	治疗2个月	随访结束
联合组	59	18.42±1.23	19.92±2.35^a	20.52±2.13^ab	22.51±1.15^abc	23.45±2.11^abcd
常规组	57	18.41±1.21	19.08±2.12^a	19.59±1.14^ab	21.75±1.17^abc	22.50±1.42^abcd
F值		0.513	2.179	2.542	2.599	3.484
P值		0.609	0.031	0.012	0.011	0.001
注：与治疗前比较，^aP＜0.05；与治疗1周后比较，^bP＜0.05；与治疗1个月后比较，^cP＜0.05；与治疗2个月后比较，^dP＜0.05。

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表 5 调任通督针对患者认知功能的DID效应分析

Table 5. DID effect analysis of patients ' cognitive function by transferring to Tongdu

变量	系数估计值	标准误	t值	P值	95% CI
治疗	15.243	1.256	12.130	＜0.001	12.778~17.709
交互作用	2.974	1.596	1.860	0.063	-0.158~6.106

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