经皮耳甲迷走神经刺激治疗慢性意识障碍临床观察OACSTPCD

Objective To observe the clinical effect of transcutaneous auricular vagus nerve stimulation(taVNS)in the treatment of prolonged disorders of consciousness(pDoC).Methods A total of 68 patients with pDoC admitted to the Third Hospital of Baoji were enrolled between June 2020 and December 2022.Through randomized controlled trial,the patients were divided into control group(n=34)and treatment group(n=34).The control group received conventional treatment,and the treatment group received taVNS treatment on the basis of the control group,both groups were treated for 4 weeks.The scores of Glasgow coma scale(GCS),coma recovery scale-revised(CRS-R),full outline of unresponsiveness(FOUR),safety and clinical efficacy were compared between the two groups.Results After treatment,the GCS single score(eye opening,verbal response and motor response)and total score,the CRS-R single score(auditory function scale,visual function scale,motor function scale,verbal function scale,communication scale and arousal scale)and total score and the FOUR single(eye response score,motor response score,brainstem reflexes score and respiration score)and total score in the two groups of patients were all increased(all P<0.05),and the GCS single score(eye opening and verbal response)and total score,the CRS-R single score(auditory function scale,visual function scale,verbal function scale,communication scale and arousal scale)and total score and the FOUR single(eye response score and brainstem reflexes score)and total score of the treatment group were better than those of the control group(all P<0.05),but the GCS single score(motor response),the CRS-R single score(motor function scale)and the FOUR single score(motor response score and respiration score)were not significantly different between the two groups(all P>0.05).No adverse events occurred in the two groups.The total effective rate in the treatment group(79.41%)was significantly higher than that in the control group(61.76%)(P<0.05).Conclusion taVNS has a certain curative effect in the treatment of pDoC,can improve the degree of disturbance of consciousness in patients,and it is safe and reliable.