【目的】 观察头针联合益智醒脑方治疗脑卒中后轻度认知障碍（PSMCI）的临床疗效。【方法】 选取 2022 年 1 月至 2024 年 12 月上海市第二康复医院中医康复科病房及门诊收治的114例明确诊断为PSMCI的患者为研究对象。按随机数字表将患 者随机分为观察组和对照组，每组各57例。2组患者入院后均给予常规治疗。对照组给予系统化康复训练，观察组在对照组 的基础上，给予头针联合益智醒脑方治疗。连续治疗2个月。治疗2个月后，评价2组临床疗效。观察2组患者治疗前后简 易智力状态检查量表（MMSE）、蒙特利尔认知评估量表（MoCA）评分、日常生活活动能力量表（ADL）评分的变化情况，以及 血清C反应蛋白（CRP）、白细胞介素6（IL-6）、肿瘤坏死因子α（TNF-α）水平的情况。比较2组患者治疗前后颈动脉血流阻力 指数（RI）的变化情况。并评价 2组的安全性及不良反应的发生情况。【结果】（1）研究过程中，对照组失访 1例。最终观察组 57例、对照组56例纳入疗效统计。（2）治疗后，2组患者的MMSE、MoCA、ADL评分均明显改善（P＜0.05），且观察组在改善 MMSE、MoCA、ADL 评分方面明显优于对照组，差异有统计学意义（P＜0.05）。（3）治疗后，2 组患者的血清 CRP、IL-6、 TNF-α水平均明显改善（P＜0.05），且观察组在改善血清 CRP、IL-6、TNF-α 水平方面明显优于对照组，差异有统计学意 义（P＜0.05）。（4）治疗后，2组患者的颈总动脉RI值、颈内动脉RI值均明显改善（P＜0.05），且观察组在改善颈总动脉RI值、 颈内动脉 RI 值方面明显优于对照组，差异有统计学意义（P＜0.05）。（5）观察组总有效率为 96.49％（55/57），对照组为 80.36%（45/56）。观察组疗效优于对照组，差异有统计学意义（P＜0.05）。（6）观察组不良反应发生率为3.51%（2/57），对照组 为 1.79%（1/56）。观察组与对照组的不良反应发生率比较，差异无统计学意义（P＞0.05）。【结论】 头针联合益智醒脑方治疗 PSMCI，可明显改善患者的认知功能，减轻炎症因子水平，从而提高患者的生活质量，临床效果显著，且安全性良好。

Objective To observe the clinical efficacy of scalp acupuncture combined with Yizhi Xingnao Formula in treating post-stroke mild cognitive impairment （PSMCI）. Methods A total of 114 patients definitively diagnosed with PSMCI and admitted to the wards or outpatient clinic of the Department of Traditional Chinese Medicine Rehabilitation at Shanghai Second Rehabilitation Hospital from January 2022 to December 2024 were selected as the study subjects. Patients were randomly divided into an observation group and a control group using a random number table， with 57 cases in each group. Both groups received conventional treatment after admission. The control group received systematic rehabilitation training，while the observation group received scalp acupuncture combined with Yizhi Xingnao Formula in addition to the control group ’s treatment. The treatment lasted for 2 consecutive months. After 2 months of treatment，the clinical efficacy of the two groups was evaluated. Changes in scores on the Mini-Mental State Examination （MMSE）， Montreal Cognitive Assessment （MoCA）， and Activities of Daily Living （ADL） scale， as well as serum levels of C-reactive protein （CRP）， interleukin-6 （IL-6），and tumor necrosis factor-alpha （TNF-α），were observed before and after treatment. Changes in the carotid artery resistance index （RI） were compared between the two groups before and after treatment. The safety and occurrence of adverse reactions in both groups were also evaluated. Results （1） During the study，1 case in the control group was lost to follow-up. Ultimately，57 cases in the observation group and 56 cases in the control group were included in the efficacy analysis. （2）After treatment， MMSE， MoCA， and ADL scores were significantly improved in both groups （P＜0.05）， and the observation group showed significantly greater improvement than the control group， with statistically significant differences （P＜0.05）.（3） After treatment， serum levels of CRP， IL-6， and TNF- α were significantly improved in both groups（P＜0.05）， and the observation group showed significantly greater improvement than the control group， with statistically significant differences （P＜0.05）.（4）After treatment，the common carotid artery RI and internal carotid artery RI values were significantly improved in both groups（P＜0.05）， and the observation group showed significantly greater improvement than the control group，with statistically significant differences （P＜0.05）.（5） The total effective rate was 96.49%（55/57） in the observation group and 80.36% （45/56） in the control group. The efficacy of the observation group was superior to that of the control group，with a statistically significant difference （P＜0.05）. （6） The incidence of adverse reactions was 3.51%（2/57） in the observation group and 1.79%（1/56） in the control group. There was no statistically significant difference in the incidence of adverse reactions between the observation group and the control group （P＞0.05）. Conclusion Scalp acupuncture combined with Yizhi Xingnao Formula in the treatment of PSMCI can significantly improve patients’ cognitive function， reduce levels of inflammatory factors，thereby enhancing patients’ quality of life. The clinical effect is significant，and the treatment demonstrates a good safety profile，indicating high clinical application value.

R246.9

上海市卫生健康委员会“十四五”中医特色专科和中医急诊能力提升（第一批）资助项目（编号：ZYTSZK2-7）