头穴透刺对急性脑梗死患者血清超敏C反应蛋白及炎性反应因子水平的影响  

Effect of Scalp-acupuncture Treatment on Levels of Serum High-sensitivity C-reactive Protein,and Pro-inflammatory Cytokines in Patients with Acute Cerebral Infarction

作　　者：王金海[1] 赵敏[1] 鲍英存[1] 商俊芳[1] 鄢琦[2] 张振昶[2] 杜小正[3] 姜华[1] 张武德[1] 

机构地区：[1]兰州大学第二医院中医科,兰州730000 [2]兰州大学第二医院神经内科,兰州730000 [3]甘肃中医学院医学技术学院,兰州730000

出　　处：《针刺研究》2016年第1期80-84,共5页Acupuncture Research

摘　　要：目的:观察头穴透刺对急性脑梗死患者血清超敏C反应蛋白(hs-CRP)、肿瘤坏死因子(TNF)-α、白介素(IL)-6、IL-1β水平的影响,探讨头针治疗急性脑梗死的机制。方法:将符合纳入标准的61例急性脑梗死患者采用分层区组随机法分为头针组31例,对照组30例。对照组采用常规西医治疗,头针组在对照组治疗的基础上加用头穴透刺,取双侧顶颞前斜线、顶颞后斜线行透穴治疗,每日1次,共7d。于治疗前、第3天、第7天,ELISA法检测血清hs-CRP、TNF-α、IL-6、IL-1β水平;于治疗前、第7天采用脑卒中临床神经功能缺损程度评分量表(NDS)行神经功能缺损评分,评价临床疗效。结果:治疗后两组患者血清hs-CRP、TNF-α、IL-6、IL-1β水平均较治疗前明显降低(P<0.05,P<0.01),且第3天、第7天头针组血清hs-CRP、TNF-α、IL-6、IL-1β水平明显低于对照组(P<0.05,P<0.01)。血清hs-CRP水平与患者NDS评分呈正相关(r=0.497,P<0.01)。试验结束时两组患者NDS评分均明显低于治疗前(P<0.05,P<0.01),且头针组明显低于对照组(P<0.05)。临床有效率分别为头针组96.8%(30/31),对照组86.7%(26/30),头针组优于对照组(P<0.05)。结论:头针可降低急性脑梗死患者血清hs-CRP、TNF-α、IL-6和IL-1β水平,控制脑血管炎性反应。Objective To observe the influence of scalp acupuncture on levels of high-sensitivity C-reactive protein（hsCRP）,TNF-α,IL-6,and IL-1βlevels in patients with acute cerebral infarction（ACI）,so as to investigate its mechanism underlying improvement of ACI.Methods A total of 61 patients with ACI were randomly allocated to scalp acupuncture group（n=31）and control（medication）group（n=30）.The patients of the control group were routinely treated by administration of Aspirin,Danhong injection,Cytidine Diphosphate for neurotrophy,blood pressure-control and blood-fat lowering medicines,etc.,while those of the scalp acupuncture group were treated by routine treatment with the medicines mentioned above plus daily scalp acupuncture stimulation of bilateral Dingnieqianxiexian[MS 6,penetrative needling from Qianding（GV 21）to Xuanli（GB 6）]and Dingniehouxiexian[MS 7,from Baihui（GV 20）to Qubin（GB 7）].The treatment was conducted once daily for 7days.Serum hsCRP,TNF-α,IL-6,and IL-1βcontents were assayed by using enzyme linked immunosorbnent assay（ELISA）.The therapeutic effects of scalp acupuncture were evaluated by using clinical neurological disfunction scale（NDS,0-45 points for consciousness,gazing,facial palsy,speech,myodynamia,walking-ability）.Results（1）Of the 30 and 31cases in the control and scalp acupuncture groups,5（16.7%）and 8（25.8%）were basically controlled,9（30.0%）and 16（51.6%）experienced remarkable improvement in their symptoms,12（40.0%）and 6（19.4%）were improved,4（13.3%）and 1（3.2%）failed,with the effective rates being 86.7% and 96.8%,respectively.The increased levels of serum hs-CRP,TNF-α,IL-6and IL-1βin ACI patients were reversed on the 3rd and 7th day after scalp acupuncture treatment（P〈0.05,P〈0.01）.（2）A positive correlation existed between the NDS score and the serum levels of hs-CRP（r=0.497,P〈0.01）.（3）NDS scores were obviously decreased in both groups on the 7th day after the treatment compared with their baseline

关 键 词：头针 急性脑梗死 超敏C反应蛋白 肿瘤坏死因子-α 白介素-6 白介素-1Β 

分 类 号：R245.321[医药卫生—针灸推拿学]