摘要目的:探讨高压氧（HBO）联合“智三针”治疗脑卒中后血管性认知障碍（VCI）的临床疗效。方法:选择山西医科大学第一医院2019年7月至2020年12月收治的脑卒中后VCI患者196例，采用随机数字表法将患者分为观察组和对照组，每组98例。对照组接受常规治疗和康复性训练，并联合HBO治疗，观察组在对照组治疗基础上联合“智三针”治疗。比较2组患者治疗前、治疗28 d后的血清指标［视锥蛋白样蛋白-1（VILIP-1）、促胰岛素样生长因子（IGF-1）、同型半胱氨酸（Hcy）、脑源性神经营养因子（BDNF）］、氧化应激指标［8-羟基脱氧鸟苷（8-OHdG）、丙二醛（MDA）］，以及认知功能情况［蒙特利尔认知评估量表（MoCA）、Loewenstein认知功能评定表（LOTCA）、事件相关电位P300］和睡眠情况［匹斯堡睡眠质量指数（PSQI）、阿森斯失眠量表（AIS）］，评估2组患者治疗28 d后的并发症发生情况。结果:治疗28 d后，2组患者IGF-1、BDNF、事件相关电位P300波幅水平，以及MoCA、LOTCA得分明显高于治疗前，且观察组高于对照组，差异均有统计学意义（ P<0.05）；2组患者VILIP-1、Hcy、8-OHdG、MDA水平、事件相关电位P300潜伏期时长，PSQI、AIS得分明显低于治疗前，且观察组低于对照组，差异均有统计学意义（ P<0.05）。治疗28 d后2组患者并发症发生情况差异无统计学意义（ P>0.05）。 结论:采用HBO联合“智三针”治疗脑卒中后VCI患者临床疗效良好，能改善认知功能，调节睡眠状态，且安全性较好。

abstractsObjective:To explore the clinical effects of hyperbaric oxygen（HBO）combined with the acupuncture therapy of Zhisanzhen in treating vascular cognitive impairment（VCI）after stroke.Methods:A total of 196 patients with VCI after stroke admitted to the Department of Rehabilitation Medicine of the First Hospital of Shanxi Medical University between July 2019 and December 2020 were selected，and they were divided into observation group and control group by using the random number table method，with 98 cases in each group. The control group was given conventional treatment，rehabilitation training，and HBO therapy；the observation group was given the acupuncture therapy of Zhisanzhen on the basis of the treatments in the control group. Before treatment and one month after treatment，serum indicators，such as visinin-like protein-1（VILIP-1），insulin-like growth factor 1（IGF-1），homocysteine（Hcy），and brain-derived neurotrophic factor（BDNF），in the two groups were compared. Oxidative stress indicators，such as 8-hydroxy-2'-deoxyguanosine（8-OHdG）and malondialdehyde（MDA），were also compared. The patients’ cognitive functions were measured by using the Montreal Cognitive Assessment（MoCA），Loewenstein Occupational Therapy Cognitive Assessment（LOTCA），and event-related potential P300. Their sleep qualities were assessed by the Pittsburgh Sleep Quality Index（PSQI）and Athens Insomnia Scale（AIS）. The occurrences of complications in the two groups were evaluated one month after treatment.Results:One month after treatment，the serum levels of IGF-1 and BDNF，the cognitive function indicators like the amplitude of P300，the scores of MoCA and LOTCA in both groups were significantly higher than those before treatment，and the above indicators of the observation group were significantly higher than those of the control group（ P < 0.05）. The serum levels of VILIP-1 and Hcy，the oxidative stress indicators like 8-OHdG and MDA，the P300 latency，and the scores of PSQI and AIS for sleep quality were significantly decreased compared with those before treatment，and the above indicators were significantly lower in the observation group than those in the control group（ P < 0.05）. There was no statistically significant difference in the occurrence of complications between the two groups one month after treatment（ P > 0.05）. Conclusion:HBO combined with the acupuncture therapy of Zhisanzhen has a good clinical effect on patients with VCI after stroke by improving the patients’ cognitive function and regulating their sleep state，and the therapy has good safety.