基于穴位调控的脑部电场疗法治疗卒中后认知障碍的关键技术研究

注册号:

Registration number:

ITMCTR2025000986

最近更新日期:

Date of Last Refreshed on:

2025-05-14

注册时间:

Date of Registration:

2025-05-14

注册号状态:

Registration Status:

预注册

Prospective registration

注册题目:

基于穴位调控的脑部电场疗法治疗卒中后认知障碍的关键技术研究

Public title:

Study on the key technology of acupoint modulation-based brain electric field therapy for the treatment of post-stroke cognitive impairment

注册题目简写:

English Acronym:

研究课题的正式科学名称:

基于穴位调控的脑部电场疗法治疗卒中后认知障碍的关键技术研究

Scientific title:

Study on the key technology of acupoint modulation-based brain electric field therapy for the treatment of post-stroke cognitive impairment

研究课题的正式科学名称简写:

Scientific title acronym:

研究课题代号(代码):

Study subject ID:

2025C02200

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

陈博文

研究负责人:

马睿杰

Applicant:

Bowen Chen

Study leader:

Ruijie Ma

申请注册联系人电话:

Applicant telephone:

13967988987

研究负责人电话:

Study leader's telephone:

18057102851

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

cbwwjj@163.com

研究负责人电子邮件:

Study leader's E-mail:

maria7878@sina.com

申请单位网址(自愿提供):

Study leader's website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website
(voluntary supply):

申请注册联系人通讯地址:

浙江省杭州市西湖区莫干山路219号

研究负责人通讯地址:

浙江省杭州市西湖区莫干山路219号

Applicant address:

No.219 Moganshan Road Xihu District Hangzhou Zhejiang

Study leader's address:

No.219 Moganshan Road Xihu District Hangzhou Zhejiang

申请注册联系人邮政编码:

Applicant postcode:

研究负责人邮政编码:

Study leader's postcode:

申请人所在单位:

浙江中医药大学附属第三医院

Applicant's institution:

The Third Affiliated Hospital of Zhejiang Chinese Medical University

是否获伦理委员会批准:

Approved by ethic committee:

伦理委员会批件文号:

Approved No. of ethic committee:

ZSLL-KY-2025-008-01

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件

批准本研究的伦理委员会名称:

浙江中医药大学附属第三医院伦理委员会

Name of the ethic committee:

Ethics Committee of The Third Affiliated Hospital of Zhejiang Chinese Medical University

伦理委员会批准日期:

Date of approved by ethic committee:

2025/1/15 0:00:00

伦理委员会联系人:

闫坤

Contact Name of the ethic committee:

Kun Yan

伦理委员会联系地址:

浙江省杭州市西湖区莫干山路219号浙江中医药大学附属第三医院

Contact Address of the ethic committee:

No.219 Moganshan Road Xihu District Hangzhou Zhejiang

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 28 8542 4855

伦理委员会联系人邮箱:

Contact email of the ethic committee:

zslunli@163.com

研究实施负责(组长)单位:

浙江中医药大学附属第三医院

Primary sponsor:

The Third Affiliated Hospital of Zhejiang Chinese Medical University

研究实施负责(组长)单位地址:

浙江省杭州市西湖区莫干山路219号

Primary sponsor's address:

No.219 Moganshan Road Xihu District Hangzhou Zhejiang

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

浙江

市(区县):

杭州

Country:

China

Province:

Zhejiang

City:

Hangzhou

单位(医院):

浙江中医药大学附属第三医院

具体地址:

浙江省杭州市西湖区莫干山路219号

Institution
hospital:

The Third Affiliated Hospital of Zhejiang Chinese Medical University

Address:

No.219 Moganshan Road Xihu District Hangzhou Zhejiang

经费或物资来源:

课题经费(政府、本单位)

Source(s) of funding:

Research funds (government and the hospital)

研究疾病:

卒中后认知障碍

研究疾病代码:

Target disease:

Post-Stroke Cognitive Impairment

Target disease code:

研究类型:

Study type:

干预性研究

Interventional study

研究设计:

Study design:

随机平行对照

randomized controlled trial(parallel group design)

研究所处阶段:

Study phase:

探索性研究/预试验

Pilot clinical trial

研究目的:

(1)观察脑部电针干预卒中后认知障碍后认知的改善情况。 (2)基于卒中后认知障碍中医证候资料、临床评估、生化指标、颅脑磁共振、脑电图等多模态数据中任务相关信息解析与分析方法,建立系统的证候诊断及临床评价标准,系统阐明卒中中医证候演变规律,建立个体化、精准治疗方案,并以多中心、大样本的临床随机对照研究为基础,探索建立卒中后认知障碍中医精准诊疗规范。 (3)基于多模态的卒中后认知障碍中医证候演变规律人工智能大数据模型构建,探索建立基于四诊信息、主观评分到多模态数据的客观化疗效评价体系。

Objectives of Study:

(1) To observe the improvement of cognition after brain electroacupuncture intervention for post-stroke cognitive impairment. (2) To establish systematic diagnostic and clinical evaluation criteria based on the analysis and analysis of task-related information in multimodal data of post-stroke cognitive impairment in Chinese medicine clinical assessment biochemical indexes cranial magnetic resonance electroencephalogram and other data to systematically elucidate the evolution pattern of Chinese medicine symptoms in stroke to establish an individualized and precise treatment plan and to explore the establishment of precise diagnostic and treatment standards of post-stroke cognitive impairment in Chinese medicine based on a multicenter and large-sample randomized controlled clinical study. Based on multi-centre and large-sample clinical randomized controlled study we will explore the establishment of precise diagnosis and treatment standard of post-stroke cognitive impairment in TCM. (3) Constructing an artificial intelligence big data model based on multimodal evolution of Chinese medicine symptoms of post-stroke cognitive impairment and exploring the establishment of an objective efficacy evaluation system based on the four diagnostic information subjective scores and multimodal data.

药物成份或治疗方案详述:

Description for medicine or protocol of treatment in detail:

纳入标准:

(1)符合西医诊断标准依据中国卒中学会血管性认知障碍分会制定的《中国血管性认知障碍诊治指南(2024版)》中血管性认知障碍的西医诊断标准。1)存在认知相关主诉,且神经心理学测定也存在1个或多个认知域受损;2)存在血管性脑损伤的证据:包括血管危险因素、卒中病史、脑血管损伤神经症候群、脑血管损伤的影像学证据,以上各项不一定同时具备;3)血管性脑损伤在认知障碍中占主导地位:尤其在合并痴呆病理表现时,应明确血管性脑损伤在认知障碍中的主导作用,临床特征需要符合下列情况:突发起病,认知障碍的发生在时间上与1次或多次卒中事件相关,呈阶梯式或波动样进展,且认知障碍在卒中事件后6个月以内出现;(2)符合《血管源性轻度认知障碍中医诊疗指南(2024)》中血管性认知障碍的中医诊断标准;(3)简易精神状态量表(Mini-Mental State Examination ,MMSE)评分在16-24分,蒙特利尔认知评估量表(Montreal Cognitive Assessment,MoCA)评分在<24分;存在认知障碍但未达严重痴呆程度;美国国立卫生院卒中量表(NIH Stroke Scale, NIHSS)评分≤5分;(4)年龄在40-80岁之间;(统计分析写上按年龄分层)(5)具备基本的沟通能力,语种以普通话为主(沟通语言即可),并有至少一名稳定的照料者;(6)首次发病;且本次发病前未有认知功能损害、精神疾病等;(7)签署知情同意书。

Inclusion criteria

Evidence of vascular brain injury: including vascular risk factors history of stroke neurological syndromes of cerebrovascular injury and imaging evidence of cerebrovascular injury but not necessarily all at the same time. 3) Dominance of vascular brain injury in cognitive deficits: the predominance of vascular brain injury in cognitive deficits should be clearly identified particularly in the setting of dementia and the clinical features need to be: sudden onset of the disease the development of cognitive deficits temporally associated with one or more strokes a stepwise or fluctuating pattern of cognitive deficits and a pattern of cognitive impairment. (1) the onset of cognitive impairment is sudden the onset of cognitive impairment is temporally related to one or more stroke events the cognitive impairment progresses in a stepwise or fluctuating manner and the cognitive impairment occurs within 6 months after the stroke events; (2) the Chinese medicine diagnostic criteria for vascular cognitive impairment in the Guidelines for Chinese Medicine in Mild Cognitive Disorders of Vascular Origin (2024) are met; (3) the score of Mini-Mental State Examination (MMSE) is between 16 and 24; and the Montreal Cognitive Assessment Scale (MCS) is between 16 and 24. (3) Montreal Cognitive Assessment (MoCA) score <24; cognitive impairment but not severe dementia; NIH Stroke Scale (NIHSS) score ≤5; (4) age between 40-80 years old; (Statistical analyses were written in stratified by age); (5) have basic communication skills with Mandarin as the main language (communication language is sufficient) and have at least one stable caregiver; (6) have a first onset of illness; and do not have cognitive impairment psychiatric disorders etc. prior to this onset of illness; and (7) sign an informed consent form.

排除标准:

(1)合并心、肝、肾等脏腑以及内分泌系统和造血系统等严重原发性慢性疾病、严重的心脑血管疾病,体表局部易出现疱疹、溃烂等皮肤疾病或瘢痕体质,脑部或是颈部植入DBS等相关手术者;(2)本次发病前已有认知障碍者,癫痫、痴呆、语言理解有严重障碍、精神病患者;(3)患有各种出血倾向疾病者;(4)蛛网膜下腔出血、短暂性脑缺血发作,或合并其他颅内病变如颅内肿瘤、动脉瘤、血管畸形、脑囊虫病、脑内血吸虫病、脑炎、脑膜炎、脑积水、脑外伤后遗症者;(5)妊娠或者哺乳期妇女;(6)不符合纳入标准,不按规定治疗依从性差,无法判断疗效或资料不全等影响疗效判断及不适合临床观察的患者;(7)近3个月参与相关临床研究者;(8)首次诊断认知障碍前3个月内存在明确的中毒病史或药物、酒精的滥用/依赖。

Exclusion criteria:

(1) Combined heart liver kidney and other organs as well as the endocrine system and haematopoietic system and other serious primary chronic diseases serious cardiovascular and cerebrovascular diseases the surface of the body is prone to local herpes ulcers and other skin diseases or keloid brain or neck implantation of DBS and other related surgeries; (2) before the onset of the current cognitive disorders epilepsy dementia language understanding of serious disorders psychiatric patients; (3) suffering from (3) People with various bleeding tendency diseases; (4) People with subarachnoid hemorrhage transient ischemic attack or other intracranial pathologies such as intracranial tumors aneurysms vascular malformations cerebral cysticercosis intracerebral schistosomiasis encephalitis meningitis hydrocephalus and sequelae of traumatic brain injury; (5) Pregnant or breastfeeding women; (6) People who did not meet the inclusion criteria did not comply with the prescribed treatment were unable to determine the effectiveness of the treatment or had incomplete data that affected the judgment of the effectiveness of the treatment and the data. Incomplete and other patients that affect the judgement of efficacy and are not suitable for clinical observation; (7) Participants in related clinical research in the last 3 months; (8) A clear history of intoxication or drug or alcohol abuse/dependence in the 3 months prior to the first diagnosis of cognitive impairment.

研究实施时间:

Study execute time:

From 2025-01-01

To      2026-12-31

征募观察对象时间:

Recruiting time:

From 2025-06-01

To      2026-08-31

干预措施:

Interventions:

组别:

普通针刺组

样本量:

170

Group:

General Acupuncture Group

Sample size:

干预措施:

普通针刺

干预措施代码:

Intervention:

General Acupuncture

Intervention code:

组别:

电针组

样本量:

170

Group:

Electroacupuncture group

Sample size:

干预措施:

普通针刺基础上采用电针治疗仪治疗

干预措施代码:

Intervention:

Treatment with electro-acupuncture device on the basis of ordinary needling

Intervention code:

样本总量 Total sample size : 340

研究实施地点:

Countries of recruitment
and research settings:

国家:

中国

省(直辖市):

浙江

市(区县):

杭州

Country:

China

Province:

Zhejiang

City:

Hangzhou

单位(医院):

浙江省人民医院

单位级别:

三甲

Institution/hospital:

Zhejiang Provincial People's Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

浙江

市(区县):

杭州

Country:

China

Province:

Zhejiang

City:

Hangzhou

单位(医院):

浙江大学医学院附属第二医院

单位级别:

三甲

Institution/hospital:

The Second Affiliated Hospital Zhejiang University School of Medicine

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

浙江

市(区县):

杭州

Country:

China

Province:

Zhejiang

City:

Hangzhou

单位(医院):

浙江中医药大学附属第三医院

单位级别:

三甲

Institution/hospital:

The Third Affiliated Hospital of Zhejiang Chinese Medical University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

浙江

市(区县):

杭州

Country:

China

Province:

Zhejiang

City:

Hangzhou

单位(医院):

浙江省中医院

单位级别:

三甲

Institution/hospital:

Zhejiang Provincial Hospital of Chinese Medicine

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

浙江

市(区县):

杭州

Country:

China

Province:

Zhejiang

City:

Hangzhou

单位(医院):

杭州市中医院

单位级别:

三甲

Institution/hospital:

Hangzhou Hospital of Traditional Chinese Medicine

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

脑卒中专门化生活质量量表

指标类型:

次要指标

Outcome:

Stroke-Specific Quality of Life Scale

Type:

Secondary indicator

测量时间点:

治疗前、治疗后第8周、治疗结束后12周、治疗结束后24周

测量方法:

Measure time point of outcome:

Pre-treatment, 8th week post-treatment, 12 weeks post-treatment, 24 weeks post-treatment

Measure method:

指标中文名:

中医证候积分评定

指标类型:

次要指标

Outcome:

Chinese Medicine Score Assessment

Type:

Secondary indicator

测量时间点:

治疗前、治疗后第8周、治疗结束后12周、治疗结束后24周

测量方法:

Measure time point of outcome:

Pre-treatment, 8th week post-treatment, 12 weeks post-treatment, 24 weeks post-treatment

Measure method:

指标中文名:

日常生活活动能力评定

指标类型:

次要指标

Outcome:

Activity of Daily Living

Type:

Secondary indicator

测量时间点:

治疗前、治疗后第8周、治疗结束后12周、治疗结束后24周

测量方法:

Measure time point of outcome:

Pre-treatment, 8th week post-treatment, 12 weeks post-treatment, 24 weeks post-treatment

Measure method:

指标中文名:

汉密尔顿抑郁量表

指标类型:

次要指标

Outcome:

Hamilton Depression Scale

Type:

Secondary indicator

测量时间点:

治疗前、治疗后第8周、治疗结束后12周、治疗结束后24周

测量方法:

Measure time point of outcome:

Pre-treatment, 8th week post-treatment, 12 weeks post-treatment, 24 weeks post-treatment

Measure method:

指标中文名:

脑电图

指标类型:

次要指标

Outcome:

electroencephalogram

Type:

Secondary indicator

测量时间点:

治疗前、治疗后第8周

测量方法:

Measure time point of outcome:

Pre-treatment, 8th week post-treatment

Measure method:

指标中文名:

近红外光谱测定

指标类型:

次要指标

Outcome:

Near-infrared spectroscopy

Type:

Secondary indicator

测量时间点:

治疗前、治疗后第8周

测量方法:

Measure time point of outcome:

Pre-treatment, 8th week post-treatment

Measure method:

指标中文名:

匹兹堡睡眠质量指数量表

指标类型:

次要指标

Outcome:

Pittsburgh sleep quality index

Type:

Secondary indicator

测量时间点:

治疗前、治疗后第8周、治疗结束后12周、治疗结束后24周

测量方法:

Measure time point of outcome:

Pre-treatment, 8th week post-treatment, 12 weeks post-treatment, 24 weeks post-treatment

Measure method:

指标中文名:

蒙特利尔认知评估量表

指标类型:

主要指标

Outcome:

Montreal Cognitive Assessment

Type:

Primary indicator

测量时间点:

治疗前、治疗后第8周、治疗结束后12周、治疗结束后24周

测量方法:

Measure time point of outcome:

Pre-treatment, 8th week post-treatment, 12 weeks post-treatment, 24 weeks post-treatment

Measure method:

指标中文名:

简易精神状态检查表

指标类型:

主要指标

Outcome:

Mini-Mental State Examination

Type:

Primary indicator

测量时间点:

治疗前、治疗后第8周、治疗结束后12周、治疗结束后24周

测量方法:

Measure time point of outcome:

Pre-treatment, 8th week post-treatment, 12 weeks post-treatment, 24 weeks post-treatment

Measure method:

指标中文名:

磁共振成像

指标类型:

次要指标

Outcome:

Magnetic Resonance Imaging

Type:

Secondary indicator

测量时间点:

治疗前、治疗后第8周

测量方法:

Measure time point of outcome:

Pre-treatment, 8th week post-treatment

Measure method:

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

组织:

Sample Name:

None

Tissue:

人体标本去向

其它

说明

Fate of sample 

Others

Note:

征募研究对象情况:

尚未开始

Not yet recruiting

年龄范围:

最小 40
Min age years
最大 80
Max age years

Recruiting status:

Participant age:

性别:

Gender:

男女均可

Both

随机方法(请说明由何人用什么方法产生随机序列):

本研究采用中央随机(Central Randomization System)的方法,随机顺序由浙江中医药大学附属第三医院生成的随机盲盒中抽取。申请者通过联系浙江中医药大学附属第三医院两位随机员,告知其受试者信息后,随机员查找随机结果,并将患者的组别信息告知申请者。随机员不参加本研究的干预操作、数据收集及统计分析。本研究的随机方案的盲底由随机方案产生人员负责保管,该人员不参与本研究。

Randomization Procedure (please state who generates the random number sequence and by what method):

In this study a central randomisation (Central Randomization System) method was used and the random order was drawn from a random blind box generated by the Third Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine (ZJUTCM). After the applicant contacted two randomisers at the Third Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine with information about the subjects the randomisers looked up the randomisation results and informed the applicant of the patients' group information. The randomisers did not participate in the intervention operation data collection and statistical analysis of this study. The blinded bottom of the randomisation protocol of this study was kept by the person who generated the randomisation protocol who was not involved in this study.

盲法:

本研究由于针刺、常规药物治疗等环节不能较好地进行双盲法操作,故本研究采用单盲(对患者进行盲法)设计。在整个研究过程中,实行三分离原则:对操作人员、疗效评价人员、统计分析人员三方人员进行了分离,三方人员在研究全过程中不能进行研究数据、实施情况等相关内容的交流。即由不知分组情况的第三方专业统计学人员进行疗效评价和结果数据统计分析,以尽量避免因单盲造成的数据结果偏倚。

Blinding:

This study used a single-blind (blinded to the patient) design because the acupuncture and conventional medication could not be better operated in a double-blind method. In the whole research process the principle of three separations was implemented: the three parties of operators efficacy evaluators and statistical analysts were separated and the three parties could not exchange research data implementation and other related contents during the whole process of the study. That is to say the third-party professional statisticians who did not know the grouping situation carried out the efficacy evaluation and statistical analysis of the result data in order to try to avoid the bias of the data results caused by single blinding.

是否共享原始数据:

IPD sharing:

No

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

None

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

研究者需根据研究方案要求把收集的数据填入病例报告表并用EXCEL软件进行数据的记录和管理。

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

Researchers need to fill in the collected data in the Case Report Form according to the research protocol requirements and use EXCEL software for data record and manage.

数据管理委员会:

Data Managemen Committee:

暂未确定

Not yet

研究计划书或研究结果报告发表信息
(杂志名称、期、卷、页,时间;或网址):

Publication information of the protocol/research results report
(name of the journal, volume, issue, pages, time; or website):

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