针刺与康复训练不同干预次序对脑梗死患者临床疗效及TNF-α、IL-1β的影响  

Effects of Different Interference Orders of Electroacupuncture and Exercise Therapy on the TNF-α, IL-1β and Clinical Efficacy of Patients with Cerebral Infarction

作　　者：符再立 赵艳玲[2] 李文纯 黄娟[1] 谭玲琼 

机构地区：[1]湖南中医药大学,湖南长沙410208 [2]湖南中医药大学第一附属医院,湖南长沙410007 [3]佛山市顺德区中医院,广东佛山528000

出　　处：《湖南中医药大学学报》2014年第11期57-60,共4页Journal of Hunan University of Chinese Medicine

基　　金：湖南省自然科学基金资助项目(12JJ3096)

摘　　要：目的初步探讨针刺与康复不同干预组合与脑梗死恢复期患者临床疗效、肿瘤坏死因子-α(TNF-α)、白介素-1β(IL-1β)的相关性。方法将60例患者随机分为先针刺后康复训练组、先康复训练后针刺组,各30例。比较其治疗0 d、14 d及28 d神经功能缺损评分、Barthel指数评分,治疗0 d、14 d观察TNF-α、IL-1β水平。结果治疗14 d后,先针刺后康复组对降低患者的神经功能缺损评分优于先康复后针刺组(P<0.05);两组患者血清中TNF-α和IL-1β的含量均有下降,Barthel指数评分均有升高,组内比较均有差异(P<0.05),两组间比较差异无统计学意义(P>0.05);治疗28 d后,两种不同的治疗方案对患者的疗效相当(P>0.05)。结论针刺与康复训练不同干预次序的两种治疗方案均可促进脑卒中偏瘫恢复期患者神经功能的恢复,改善其生活状态,提高其生活能力。治疗14天后,先针灸后康复组对患者的神经功能的改善优于先康复后针刺组,说明在恢复早期有因针刺、康复干预次序不同而产生疗效差异,故临床上对中风恢复早期的患者可以采取先针刺后康复的治疗次序。Objective To make a preliminary discussion of TNF-α、IL-1β and therapeutic effect and of patients with cerebral infarction by different interference orders of electroacupuncture and exercise. Methods Sixty cases of cerebral infarction patients were randomly divided into acupuncture-rehabilitation group （30 cases） and rehabilitation-acupuncture group（30 cases）. The neural function defect scale and the Barthel index score were compared at 0 d, 14 d and 28 d. The TNF-α and IL-1βlevels were observed at 0 d and 14 d after treatment. Results Atter treatment tor 14 days,the neural function defect scale in acupuncture-rehabilitation group was superior to that in rehabilitation-acupuncture group （P〈0.05）; The serum TNF-α and IL-1β of patients in both group decreased （P〈0.05）; There has no significant difference between two groups （P〉0.05）. After treatment for 28 days, the curative effects in both group are equivalent. Conclusion Both of the different interference orders treatments could improve the neural function, living conditions and life quality of the cerebral infarction patients. However, after treatment for 14 days, the neural function in acupuncture -rehabilitation group was better than that in rehabilitation - acupuncture group, which showed that the treatment orders have different efficacy during the recovery period. Therefore, the cerebral infarction patients at early recovery period should be treated with acupuncture-rehabilitation order.

关 键 词：脑梗死 针刺 康复训练 干预次序 神经功能缺损评分 肿瘤坏死因子-α 白介素-1Β 临床观察 

分 类 号：R246[医药卫生—针灸推拿学]