针灸辨证治疗急性丘脑梗死疗效及对血清IL-18、LDL、Lp-PLA2和颈动脉硬化斑块的影响  

Effect of acupuncture and moxibustion on acute thalamic infarction and its influence on serum IL-18,LDL,LP-PLA2 and carotid arteriosclerotic plaque

作　　者：孔祥芳[1] 王彩娟[2] 樊丽芳 肖娟[1] KONG Xiangfang;WANG Caijuan;FAN Lifang;XIAO Juan(Dingzhou People’s Hospital,Dingzhou 073000,Hebei,China;Shijiazhuang Traditional Chinese Medicine Hospital,Shijiazhuang 050000,Hebei,China;Yangyuan County Hospital of Traditional Chinese Medicine Hospital,Yangyuan 075800,Hebei,China)

机构地区：[1]河北省定州市人民医院,河北定州073000 [2]河北省石家庄市中医院,河北石家庄050000 [3]河北省阳原县中医院,河北阳原075800

出　　处：《现代中西医结合杂志》2018年第32期3550-3553,共4页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：河北省中医药管理局科研计划课题(2018228)

摘　　要：目的观察针灸辨证治疗急性丘脑梗死疗效及对血清白细胞介素-18(IL-18)、低密度脂蛋白(LDL)、脂蛋白磷脂酶A2(Lp-PLA2)和颈动脉硬化斑块的影响。方法将75例急性丘脑梗死患者随机分为观察组38例及对照组37例。对照组给予西医神经内科常规治疗,主要包括改善脑部循环、抑制血小板聚集、改善脑代谢并保护脑神经等常规对症治疗,观察组在对照组治疗基础上加用针灸治疗,2周为1个疗程。观察2组治疗前后血清IL-18、LDL、Lp-PLA2水平和颈动脉硬化斑块大小、主要症状体征积分变化情况,并统计2组临床总有效率与不良反应发生情况。结果治疗2周后,2组血清IL-18、LDL、Lp-PLA2水平和偏瘫、昏迷、头痛、呕吐积分均显著降低(P均<0. 05),颈动脉硬化斑块缩小(P均<0. 05),且观察组上述指标改善程度均显著优于对照组(P均<0. 05);观察组临床总有效率显著高于对照组(P <0. 05); 2组均未出现明显不良反应。结论针灸辨证治疗急性丘脑梗死疗效更好,可明显降低血清IL-18、LDL、Lp-PLA2水平,并缩小颈动脉硬化斑块,有效改善患者临床症状,值得临床推广应用。Objective It is to observe the therapeutic effect of acupuncture and moxibustion on acute thalamic infarction and its effects on serum interleukin-18(IL-18),low density lipoprotein(LDL),lipoprotein phospholipase A2(Lp-PLA2)and carotid atherosclerotic plaque.Methods Seventy-five patients with acute thalamic infarction were randomly divided into observation group(n=38)and control group(n=37).The control group was given conventional treatment of western medicine,including improving brain circulation,inhibiting platelet aggregation,improving brain metabolism and protecting the brain and other conventional symptomatic treatments.The observation group was treated with acupuncture plus moxibustion on the basis of the control group.14 days was a course of treatment.The levels of serum IL-18,LDL,Lp-PLA2 and carotid atherosclerotic plaques,and the changes of main symptoms and signs were observed before and after treatment.The total effective rate and adverse reactions of the two groups were also counted.Results After 2 weeks of treatment,the levels of serum IL-18,LDL and Lp-PLA2 and the scores of hemiplegia,coma,headache and vomiting were significantly decreased(P<0.05),and carotid atherosclerotic plaques were reduced(P<0.05),and the improvements in the observation group were significantly better than those in the control group(P<0.05).The total clinical effective rate of the observation group was significantly higher than that of the control group(P<0.05).There was no obvious adverse reaction in the two groups.Conclusion Acupuncture and moxibustion has better curative effect on acute thalamic infarction,which can significantly reduce the levels of serum IL-18,LDL and Lp-PLA2,and reduce carotid atherosclerotic plaque,improve the clinical symptoms of patients.It is worthy of clinical application.

关 键 词：针灸 脑梗死 白细胞介素-18 低密度脂蛋白 脂蛋白磷脂酶A2 颈动脉硬化斑块 

分 类 号：R743.33[医药卫生—神经病学与精神病学]