Electroacupuncture at Jing-Well Points for Chronic Disorders of Consciousness: A Randomized Controlled Study With Multimodal Assessment

实验性的：电针组

在常规治疗基础上（与对照组相同），患者额外接受井穴电刺激。
采用华佗电针治疗仪（型号：SDZ-V）。
刺激双侧井穴，强度调整至引起轻微肢体运动。
每次治疗60分钟，每日1次，每周6次，连续3周。
电针每隔两天更换一次以防止感染。

其他：手十二井穴电刺激

使用华佗电针仪（型号：SDZ-V）。 刺激双侧井穴，强度以引起轻微肢体运动为准。 每次治疗持续60分钟，每日1次，每周6次，连续3周。 电针每两天更换一次以防感染。

其他：Waiting-treatment group

All patients received routine treatment, including neurotrophic therapy, hyperbaric oxygen therapy, conventional medication, and other general rehabilitation interventions, as well as management of complications: prevention of gastric mucosal lesions, blood glucose control, and prophylaxis against aspiration pneumonia, deep venous thrombosis of the lower extremities, pressure ulcers, etc.Electrostimulation treatment was administered to patients at the end of the follow-up period.

其他：手十二井穴电刺激

使用华佗电针仪（型号：SDZ-V）。 刺激双侧井穴，强度以引起轻微肢体运动为准。 每次治疗持续60分钟，每日1次，每周6次，连续3周。 电针每两天更换一次以防感染。

coma recovery scale-revised

The CRS-R scale consists of six subscales: auditory function, visual function, motor function, oromotor function, communication, and arousal level.It has a total score range of 0-23 points; a higher score indicates a less severe disorder of consciousness.

Full Outline of UnResponsiveness

The FOUR Score was developed as a supplement and refinement to the Glasgow Coma Scale (GCS), and is particularly suitable for assessing patients with severely impaired consciousness or those receiving sedation or intubation in intensive care settings. It consists of four assessment dimensions, evaluating neurological functions including eye response, motor response, brainstem reflexes, and respiratory pattern. Each dimension is scored up to 4 points, with a total score ranging from 0 to 16; lower scores indicate worse neurological status.

Glasgow Outcome Scale-Extended

GOSE scores were categorized into favorable outcome (GOSE score 4-8) and unfavorable outcome (GOSE score 1-3). Participants (or their informants) were asked to report dysfunction in six major life domains: independence at home, independence outside the home, work functioning, social/leisure functioning, relationship problems, and other problems affecting daily life.

Disability Rating Scale

The Disability Rating Scale (DRS) has a broader focus. It is designed to measure the severity of disability following brain injury and its changes over time, covering the entire continuum from coma to community reintegration. It consists of four assessment stages, which evaluate arousal, consciousness and responsiveness, cognitive abilities, functional dependence, and psychosocial adaptation in a staged manner. The total score ranges from 0 (no disability) to 29 (vegetative state) or 30 (death).

Mismatch Negativity

MMN (mismatch negativity) is an auditory evoked potential that reflects the brain's ability to automatically analyze and process sensory information, namely the pre-attentive processing. It can be used to assess the integrity of the brain's sensory processing system and help determine the conscious state and prognosis of patients with disorders of consciousness (DOC). Changes in its amplitude and latency are correlated with the likelihood of consciousness recovery, and patients with higher amplitude and shorter latency have a relatively greater chance of regaining consciousness.

P300

P300, like MMN, is also an event-related potential that does not require active movement from the patient, but reflects a higher-order attention-cognitive processing mechanism. Whereas MMN is responsible for pre-attentive automatic detection of deviant stimuli, P300 represents the engagement of conscious attentional resources and the updating of working memory. Therefore, in the assessment of patients with prolonged disorders of consciousness (pDoC), P300 provides information at the consciousness-related level rather than the pre-attentive level, and can be used to determine whether patients retain top-down cognitive processing abilities.

Neuron-Specific Enolase

NSE is a marker enzyme of neurons. Following craniocerebral injury, changes in serum levels of this biomarker can reflect damage and recovery of nerve cells. Monitoring protein levels of NSE may provide clues to the biological mechanisms underlying consciousness recovery.