Effect of Interactive Dynamic Scalp Acupuncture on Post-Stroke Cognitive Function, Depression, and Anxiety:A Multicenter, Randomized, Controlled Trial

Shao-hua ZHANG; Yu-long WANG; Chun-xia ZHANG; Chun-ping ZHANG; Peng XIAO; Qian-feng LI; Wei-rong LIANG; Xiao-hua PAN; Ming-chao ZHOU

doi:10.1007/s11655-021-3338-1

Your Location：

Home >

Browse articles >

Effect of Interactive Dynamic Scalp Acupuncture on Post-Stroke Cognitive Function, Depression, and Anxiety:A Multicenter, Randomized, Controlled Trial

Original Article | Updated：2022-02-22

- Effect of Interactive Dynamic Scalp Acupuncture on Post-Stroke Cognitive Function, Depression, and Anxiety:A Multicenter, Randomized, Controlled Trial
- Effect of Interactive Dynamic Scalp Acupuncture on Post-Stroke Cognitive Function, Depression, and Anxiety:A Multicenter, Randomized, Controlled Trial
- Chinese Journal of Integrative Medicine 2022年28卷第2期页码：106-115
- Affiliations：
  
  1.Department of Rehabilitation Medicine, Dapeng New District Nan'ao People's Hospital, Shenzhen, Guangdong Province(518121), China
  2.Department of Rehabilitation Medicine,Shenzhen Second People's Hospital, Shenzhen, Guangdong Province (518037), China
  3.Department of Rehabilitation Medicine, Shenzhen Hospital of Guangzhou University of Chinese Medicine, Shenzhen, Guangdong Province (518034), China
- Author bio：
  
  Prof. WANG Yu-long, E-mail: ylwang66@126.com
- Funds：
  
  the Medical and Health Research Fund Project of Medical and Health Group in Dapeng New District, Shenzhen,Guangdong, China(2019JTYM004)
- DOI：10.1007/s11655-021-3338-1
  中图分类号：
- 纸质出版日期：2022-02-01，
  
  网络出版日期：2021-12-07，
  
  录用日期：2020-06-19
Scan for full text
Shao-hua ZHANG, Yu-long WANG, Chun-xia ZHANG, 等. Effect of Interactive Dynamic Scalp Acupuncture on Post-Stroke Cognitive Function, Depression, and Anxiety:A Multicenter, Randomized, Controlled Trial[J]. Chinese Journal of Integrative Medicine, 2022,28(2):106-115.

Shao-hua ZHANG, Yu-long WANG, Chun-xia ZHANG, et al. Effect of Interactive Dynamic Scalp Acupuncture on Post-Stroke Cognitive Function, Depression, and Anxiety:A Multicenter, Randomized, Controlled Trial[J]. Chinese Journal of Integrative Medicine, 2022,28(2):106-115.
Shao-hua ZHANG, Yu-long WANG, Chun-xia ZHANG, 等. Effect of Interactive Dynamic Scalp Acupuncture on Post-Stroke Cognitive Function, Depression, and Anxiety:A Multicenter, Randomized, Controlled Trial[J]. Chinese Journal of Integrative Medicine, 2022,28(2):106-115. DOI： 10.1007/s11655-021-3338-1.

Shao-hua ZHANG, Yu-long WANG, Chun-xia ZHANG, et al. Effect of Interactive Dynamic Scalp Acupuncture on Post-Stroke Cognitive Function, Depression, and Anxiety:A Multicenter, Randomized, Controlled Trial[J]. Chinese Journal of Integrative Medicine, 2022,28(2):106-115. DOI： 10.1007/s11655-021-3338-1.

摘要

目的:

比较互动式头针(IDSA)、简单联合疗法(SCT)和传统头针(TSA)对脑卒中后认知功能障碍患者认知功能、抑郁、焦虑的影响.

方法:

选取2017年5月至2020年5月在深圳市大鹏新区南澳人民医院康复科、深圳市第二人民医院康复科、广州中医药大学深圳医院住院的660例脑卒中后认知障碍患者

按入院先后顺序随机分为IDSA组(218例)、SCT组(222例)和TSA组(220例). 所有患者均接受常规脑卒中药物治疗和运动康复训练. IDSA组同时进行头针和计算机认知训练(computer-based cognitive training

CBCT)

而SCT组分别在上午和下午进行头针和计算机认知训练. TSA组患者接受传统的头针治疗

但未接受CBCT. 疗程为8周. 治疗前(M0)、治疗后1、2个月(M1、M2)及随访1、2个月(M3、M4)采用简易精神状态检查量表(MMSE)和蒙特利尔认知评估量表(MoCA)评估患者认知功能; 采用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、匹兹堡睡眠质量指数(PSQI)和改良Barthel指数(MBI)分别对患者的抑郁、焦虑、睡眠质量和自理能力进行评估. 在本试验中

所有不良事件(AEs)均被准确记录.

结果:

三组治疗前MMSE、MoCA、HAMD、HAMA、PSQI及MBI评分比较

差异均无统计学意义(

0.05). IDSA组M2、M3、M4时点MMSE、MoCA评分均显著高于SCT组和TSA组(均

0.01); M2-M0、M4-M0评分变化显著高于SCT组和TSA组(均

0.01); 而在M2、M3、M4时点

IDSA组HAMD、HAMA、PSQI评分均显著低于SCT组和TSA组(均

0.01)

而IDSA组MBI评分均显著高于SCT组和TSA组(均

0.01).

结论:

IDSA不仅能显著改善患者的认知功能

还能减轻患者的抑郁、焦虑

最终提高患者的自理能力

且IDSA组的疗效明显优于SCT组和TSA组. (中国临床实验中心注册号: ChiCTR1900027206).

Abstract

Objective:

To compare the clinical effects of interactive dynamic scalp acupuncture (IDSA)

simple combination therapy (SCT)

and traditional scalp acupuncture (TSA) on cognitive function

depression and anxiety in patients with post-stroke cognitive impairment.

Methods:

A total of 660 patients with post-stroke cognitive impairment who were admitted to 3 hospitals in Shenzhen City between May 2017 and May 2020 were recruited and randomly assigned to the IDSA (218 cases)

SCT (222 cases) and TSA groups (220 cases) according to a random number table. All the patients received conventional drug therapy for cerebral stroke and exercise rehabilitation training. Scalp acupuncture and computer-based cognitive training (CBCT) were performed simultaneously in the IDSA group

but separately in the morning and in the afternoon in the SCT group. The patients in the TSA group underwent scalp acupuncture only. The course of treatment was 8 weeks. Before treatment (M0)

1 (M1) and 2 months (M2) after treatment

as well as follow-up at 1 (M3) and 2 months (M4)

the cognitive function of patients was assessed using the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment Scale (MoCA) Scales; depression

anxiety

sleep quality

and self-care ability of patients were assessed using Hamilton Depression Rating Scale (HAMD)

Hamilton Anxiety Rating Scale (HAMA)

Pittsburgh Sleep Quality Index (PSQI)

and Modified Barthel Index (MBI)

respectively. During this trial

all adverse events (AEs) were accurately recorded.

Results:

There were no significant differences in the MMSE

MoCA

HAMD

HAMA

PSQI

and MBI scores among the 3 groups at M0 (all

0.05). In the IDSA group

the MMSE

MoCA and MBI scores from M2 to M4 were significantly higher than those in the SCT and TSA groups

while the HAMD

HAMA and PSQI scores were significantly reduced (all

0.01). The changes of all above scores (M2–M0

M4–M0) were significantly superior to those in the SCT and TSA groups (all

0.01

except M4–M0 of HAMD). At M2

the severity of MMSE

HAMD

HAMA

PSQI and MBI in the IDSA group was significantly lower than that in the SCT and TSA groups (all

0.01). There was no serious AE during this trial.

Conclusions:

IDSA can not only significantly improve cognitive function

but also reduce depression

anxiety

which finally improves the patient's self-care ability. The effect of IDSA was significantly better than SCT and TSA. (Trial registration No. ChiCTR1900027206)

关键词

Keywords

interactive dynamic scalp acupuncturestrokecognitive functiondepressionanxietyrandomized controlled trialChinese medicine

references

Li L, Yiin GS, Geraghty OC, Schulz UG, Kuker W, Mehta Z, et al. Incidence, outcome, risk factors, and long-term prognosis of cryptogenic transient ischaemic attack and ischaemic stroke: a population-based study. Lancet Neurol 2015;14:903-913.

Liu S, Zhang X, Wang J, Yang H, Jiang Y, Qiu C, et al. Analysis of plasma autoantibodies for inflammatory cytokines in patients with first-episode schizophrenia among a Chinese population. J Neuroimmunol 2020;4:341:577165.

Strong K, Mathers C, Bonita R. Preventing stroke: saving lives around the world. Lancet Neurol 2007;6:182-187.

Krishnamurthi RV, Feigin VL, Forouzanfar MH, Mensah GA,Connor M, Bennett DA, et al. Global and regional burden of first-ever ischaemic and haemorrhagic stroke during 1990–2010: findings from the Global Burden of Disease Study 2010. Lancet Glob Health 2013;1:e259-e281.

Sun H, Zou X, Liu L. Epidemiological factors of stroke: a survey of the current status in China. J Stroke 2013;15:109-114.

Robinson CA, Shumway-Cook A, Matsuda PN, Ciol MA.Understanding physical factors associated with participation in community ambulation following stroke. Disabil Rehabil 2011;33:1033-1042.

Barbay M, Taillia H, Nédélec-Ciceri C, Bompaire F, Bonnin C, Varvat J, et al. Prevalence of poststroke neurocognitive disorders using National Institute of Neurological Disorders and Stroke-Canadian Stroke Network, VASCOG Criteria(Vascular Behavioral and Cognitive Disorders), and Optimized Criteria of Cognitive Deficit. Stroke 2018;49:1141-1147.

Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry 1960;23:56-62.

Knapp P, Dunn-Roberts A, Sahib N, Cook L, Astin F, Kontou E, et al. Frequency of anxiety after stroke:an updated systematic review and meta-analysis of observational studies. Int J Stroke 2020;15:244-255.

Havlikova E, van Dijk JP, Nagyova I, Rosenberger J,Middel B, Dubayova T, et al. The impact of sleep and mood disorders on quality of life in Parkinson's disease patients. J Neurol 2011;258:2222-2229.

Yaffe K, Falvey CM, Hoang T. Connections between sleep and cognition in older adults. Lancet Neurol 2014;13:1017-1028.

Tárraga L, Boada M, Modinos G, Espinosa A, Diego S, Morera A, et al. A randomised pilot study to assess the efficacy of an interactive, multimedia tool of cognitive stimulation in Alzheimer's disease. J Neurol Neurosurg Psychiatry 2006;77:1116-1121.

Bordignon A, Trevisan C, Devita M, Bizzotto M, Celli S, Girardi A, et al. Fibrinogen levels and the risk of cerebrovascular events in older adults with both depressive symptoms and cognitive impairment: a prospective study. J Geriatr Psychiatry Neurol 2020;33:282-288.

Everson SA, Roberts RE, Goldberg DE, Kaplan GA.Depressive symptoms and increased risk of stroke mortality over a 29-year period. Arch Intern Med 1998;158:1133-1138.

Zhou M, Wang H, Zeng X, Yin P, Zhu J, Chen W, et al. Mortality, morbidity, and risk factors in China and its provinces, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2019;394:1145-1158.

Yang S, Ye H, Huang J, Tao J, Jiang C, Lin Z, et al. The synergistic effect of acupuncture and computer-based cognitive training on post-stroke cognitive dysfunction: a study protocol for a randomized controlled trial of 2×2 factorial design. BMC Complement Altern Med 2014;14:290.

Wu P, Zhou YM, Liao CX, Tang YZ, Li YX, Qiu LH, et al. Structural changes induced by acupuncture in the recovering brain after ischemic stroke. Evid Based Complement Alternat Med 2018;2018:5179689.

Wang J, Pei J, Cui X, Sun KX, Ni HH, Zhou CX, et al.Interactive dynamic scalp acupuncture combined with occupational therapy for upper limb motor impairment in stroke: a randomized control trial. Chin Acupunct Moxibust(Chin) 2015;35:983-989.

Zhuang Y, Lu JJ, Meng FP, Sun KX, Zhan Q. Rehabilitation evaluation of interactive scalp acupuncture therapy for post-stroke gait in hemiplegia. J Neurol Neurorehabil 2016;12:71-75.

Liu JP. Calculation of sample size in clinical trials. Chin J Integr Med 2003;23:57-59.

Listed N. A standard international acupuncture nomenclature: memorandum from a WHO meeting. Bull World Health Organ 1990;68:165-169.

Jiang C, Yang SL, Huang J, Tao J, Lin ZC, Ye HC, et al. The effect of computer-assisted cognitive training on cognitive function recovery in stroke patients and its mechanism: a fMRI study. Chin J Rehabil Med 2015;30:911-914.

Folstein MF, Folstein SE, McHugh PR. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189-198.

Nasreddine ZS, Phillips NA, Bédirian V, Charbonneau S, Whitehead V, Collin I, et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc 2005;53:695-699.

Williams JB. Structured interview guides for the Hamilton Rating Scales. Psychopharmacol Ser 1990;9:48-63.

Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR,Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 1989;28:193-213.

Shah S, Vanclay F, Cooper B. Improving the sensitivity of the Barthel Index for stroke rehabilitation. J Clin Epidemiol 1989;42:703-710.

Zhao N, Zhang J, Qiu M, Wang C, Xiang Y, Wang H, et al. Scalp acupuncture plus low-frequency rTMS promotes repair of brain white matter tracts in stroke patients: a DTI study. J Integr Neurosci 2018;17:61-69.

Zhang J, Tang L, Hu J, Wang Y, Xu Y. Uric acid is associated with cognitive impairment in the elderly patients receiving maintenance hemodialysis-a two-center study.Brain Behav 2020;10:e01542.

Yang F, Luo K, Yang X, Ren H, Gao F, Qian L. Clinical observation of long-time needle retaining at Baihui (GV 20)on post-stroke cognitive disorder of qi deficiency and blood stasis. Chin Acupunct Moxibust (Chin) 2018;38:1151-1156.

Xiong J, Zhang Z, Ma Y, Li Z, Zhou F, Qiao N, et al. The effect of combined scalp acupuncture and cognitive training in patients with stroke on cognitive and motor functions.NeuroRehabilitation 2020;46:75-82.

Bayazit H, Dulgeroglu D, Selek S. Brain-derived neurotrophic factor and oxidative stress in Cannabis dependence. Neuropsychobiology 2020;79:186-190.

Pullela M, Agaoglu MN, Joshi AC, Agaoglu S, Coats DK, Das VE. Neural plasticity following surgical correction of strabismus in monkeys. Invest Ophthalmol Vis Sci 2018;59:5011-5021.

Chen SB. Complementary dynamic acupuncture therapy.Acupunct Res (Chin) 2002;27:159-161.

Chen SQ, Cai DC, Chen JX, Yang H, Liu LS. Altered brain regional homogeneity following contralateral acupuncture at Quchi (LI 11) and Zusanli (ST 36) in ischemic stroke patients with left hemiplegia: an fMRI study. Chin J Integr Med 2020;26:20-25.

Zhang SH, Zhang TF, Wang YL, Xiao P. Effect of interactive dynamic scalp acupuncture on plantar pressure distribution during walking in stroke patients with hemiplegia. J Basic Chin Med 2018;24:1109-1112.

Zhang K, Tang Q, Zhao C. Traditional manual acupuncture combined with rehabilitation therapy for shoulder hand syndrome after stroke within the Chinese healthcare system. Clin Rehabil 2019;33:1699-1700.

Zhang H, Zhao L, Yang S, Chen Z, Li Y, Peng X, et al.Clinical observation on effect of scalp electroacupuncture for mild cognitive impairment. J Tradit Chin Med 2013;33:46-50.

Yu CC, Ma CY, Wang H, Kong LH, Zhao Y, Shen F, et al.Effects of acupuncture on Alzheimer's disease: evidence from neuroimaging studies. Chin J Integr Med 2019;25:631-640.

Liu C, Xi H, Wu W, Wang X, Qin S, Zhao Y, et al. Placebo effect of acupuncture on insomnia: a systematic review and meta-analysis. Ann Palliat Med 2020;9:19-29.

More>

浏览量

Downloads

CSCD

文章被引用时，请邮件提醒。

Submit

工具集

关联资源

A Randomized Controlled Trial of Mindfulness in Recovery from Colorectal Cancer

Efficacy of Yangyin Yiqi Huoxue Granule (养阴益气活血颗粒) in Treatment of Ischemic Stroke Patients with Qi-Yin Deficiency and Blood Stasis Syndrome: A Randomized, Double-Blind, Multicenter, Phase-2 Clinical Trial^*

Effect and Safety of Herbal Medicine Foot Baths in Patients with Diabetic Peripheral Neuropathy: A Multicenter Double-Blind Randomized Controlled Trial

Reyanning Mixture on Asymptomatic or Mild SARS-CoV-2 Infection in Children and Adolescents:A Randomized Controlled Trial

Efficacy of Biejiajian Pill on Intestinal Microbiota in Patients with Hepatitis B Cirrhosis/Liver Fibrosis:A Randomized Double-Blind Controlled Trial