益气聪明汤联合康复训练干预脑卒中后认知功能障碍的临床疗效观察

Clinical Efficacy Observation of Yiqi Congming Decoction Combined with Rehabilitation Training for Post-Stroke Cognitive Impairment

摘要: 目的：观察益气聪明汤联合认知康复训练对脑卒中后认知功能障碍(PSCI)患者认知水平、日常生活能力的影响，为PSCI的中西医结合临床干预提供参考。方法：选取2025年12月~2026年6月就诊于黑龙江省哈尔滨市阿城区中医医院收治的92例气虚清阳不升型PSCI患者为研究对象，采用随机数字表法分为对照组与观察组，各46例。对照组给予脑卒中常规内科治疗联合认知康复训练，观察组在对照组基础上加服益气聪明汤加减，两组均连续干预8周。比较干预前后两组简易精神状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)评分、Barthel指数(BI)评分，评价临床疗效并监测不良反应。结果：干预前两组各项基线指标差异无统计学意义(P > 0.05)；干预8周后，观察组总有效率89.13%，显著高于对照组的71.74% (P < 0.05)；且观察组改善幅度显著优于对照组(P < 0.05)。两组均未出现严重不良反应，肝肾功能等安全性指标无明显异常。结论：益气聪明汤联合康复训练可通过益气升阳、通窍健脑改善PSCI患者认知功能，提升日常生活能力，安全性良好，值得临床推广应用。

Abstract: Objective: To observe the effects of Yiqi Congming Decoction combined with cognitive rehabilitation training on cognitive function and activities of daily living in patients with post-stroke cognitive impairment (PSCI), so as to provide evidence for integrated traditional Chinese and Western medicine intervention for PSCI. Methods: A total of 92 PSCI patients with syndrome of qi deficiency and failure of clear yang ascent admitted to Acheng District Hospital of Traditional Chinese Medicine in Harbin, Heilongjiang Province from December 2025 to June 2026 were enrolled as research subjects. The patients were divided into a control group and an observation group via random number table method, with 46 cases in each group. The control group received routine internal medical treatment for stroke combined with cognitive rehabilitation training, while the observation group was additionally treated with modified Yiqi Congming Decoction on the basis of the control group. Both groups received continuous intervention for 8 weeks. The scores of Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA) and Barthel Index (BI) before and after intervention were compared between the two groups, the clinical efficacy was evaluated, and adverse reactions were monitored. Results: There were no statistically significant differences in all baseline indicators between the two groups before intervention (P > 0.05). After 8 weeks of intervention, the total effective rate of the observation group was 89.13%, which was markedly higher than 71.74% of the control group (P < 0.05). Besides, the improvement degree of the observation group was obviously superior to that of the control group (P < 0.05). No severe adverse reactions occurred in either group, and no obvious abnormalities were found in safety indicators such as liver and kidney function. Conclusion: Combined rehabilitation training with Yiqi Congming Decoction can improve cognitive function and activities of daily living of PSCI patients by replenishing qi, ascending clear yang, dredging orifices and nourishing the brain, with favorable safety profile, which is worthy of clinical promotion and application.