刘全生，张雯凌，刘超，孙于晴（川北医学院附属医院神经内科，四川南充637000）

·综述·

针刺督脉对一氧化碳中毒迟发性脑病认知功能障碍的影响

刘全生，张雯凌，刘超，孙于晴
（川北医学院附属医院神经内科，四川南充637000）

目的观察针刺督脉治疗一氧化碳中毒迟发性脑病（DEACMP）认知功能障碍的临床疗效，为临床治疗该病提供新的方法。方法选取2011年10月至2014年4月该科收治的DEACMP患者50例，将其随机分为针刺治疗组和常规治疗组，各25例。对照组给予高压氧及激素、脑保护等常规治疗，针刺组在常规治疗基础上给予针刺督脉治疗，每周治疗6 d，休息1 d，连续8周；治疗前后分别对两组采用简易智力量表（MMSE）及蒙特利尔量表（MoCA）评分及事件相关电位（P300）评价其认知功能状况。结果两组患者治疗后均能提高MMSE和MoCA评分，差异均有统计学意义（P＜0.05），且治疗组优于对照组，差异有统计学意义（P＜0.05）。两组患者治疗后P300潜伏期明显缩短及波幅明显增高，差异均有统计学意义（P＜0.05），且治疗组优于对照组，差异有统计学意义（P＜0.05）。针刺组治疗总有效率为88.00%（22/25），对照组为68.00%（17/25），两组比较，差异有统计学意义（P＜0.05）。结论针刺督脉能改善DEACMP认知功能障碍；P300可作为DEACMP认知功能障碍的评价指标，针刺督脉是一种简便、有效的治疗DEACMP认知功能障碍的方法，值得在临床上推广应用。

穴位，督脉；一氧化碳中毒；痴呆；缺氧，脑；认知障碍

【Abstract】Objective To observe the clinicaleffect of acupuncture atDu Meridian on the cognitive dysfunction in delayed encephalopathy afteracute carbonmonoxide poisoning（DEACMP）to provide a new method for treating this disease.M ethods Fifty cases of DEACMP in our hospital from October 2011 to April 2014 were selected and random ly divided into the treatment group and controlgroup，25 cases in each group.The control group was treated with the routine therapy of hyperbaric oxygen，hormone and cerebral protection，while on this basis the treatment group was given the acupuncture at Du Meridian.The treatment in the two groups lasted for continuous 8 weeks，with 6 d treatmentand 1 d restperweek；the Mini-Mental State Examination（MMSE），Montreal Cognitive Assessment（MoCA）and latent period and amplitude of P300 were adopted to evaluate their cognition status after and before treatment．Results The scores of MMSE and MoCA after treatment in both groups were increased significantly，and the difference was statistically significant（P＜0.05），moreover the treatmentgroup was superior to the control group with statistical difference（P＜0.05）.The latentperiod ofP300 after treatmentin the two groups was significantly short ened，and thewave amplitude was significantly increased，the difference was statistically significant（P＜0.05），moreover the treatment group was superior to the control group with statistical difference（P＜0.05）.The totaleffective rate in the acupunc ture group was 88.00%（22/25），which in the controlgroup was 68.00%（17/25），the difference between the two groups was statistically sign ificant（P＜0.05）.Conclusion Acupuncture at Du Meridian can improve the cognitive dysfunction in DEA CMP，P300 can serve asan evaluation index of cognitive dysfunction in DEACMP.Acupuncture at Du Meridian is a simple and effect method for treating DEACMP and is worthy of being clinically promoted and applied.

【Key words】Points，covernor vessel；Carbon monoxide poisoning；Dementia；Hypoxia，brain；Cognition disorders

一氧化碳中毒迟发性脑病（delayed encephalopathy after carbonmonoxidepoisoning，DEACMP）是指急性一氧化碳中毒患者经高压氧等抢救治疗，在急性中毒症状消失后，经过数天或数周患者表现正常或接近正常的“假愈期”，再次出现以急性痴呆为主的一组神经精神症状综合征；……