高压氧联合井穴放血对脑卒中患者预后的影响  

Effect of hyperbaric oxygen therapy combined with Jing acupoints bloodletting on prognosis and telomere length of hemorrhagic stroke patients

作　　者：沈彤 张景童 刘洋[3] Tong Shen;Jing-tong Zhang;Yang Liu(Department of Massage,the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300193,China;the Second Bridge of Logistics College of PAP,Tianjin 300162,China;Department of Neurology,the Fourth People’s Hospital of Shanghai,Shanghai 200081,China)

机构地区：[1]天津中医药大学第一附属医院推拿科,天津300193 [2]武警后勤学院二大队,天津300162 [3]上海市第四人民医院神经内科,上海200081

出　　处：《中国现代医学杂志》2019年第14期36-39,共4页China Journal of Modern Medicine

基　　金：上海市虹口区卫计委医学科研项目(No:虹卫1802-06);同济大学中央高校基本科研业务费专项资金项目(No:22120180282)

摘　　要：目的探讨井穴放血联合高压氧治疗对出血性脑卒中患者预后及端粒长度的影响。方法将120例研究对象随机分为井穴放血组、联合组(井穴放血+高压氧)及对照组,每组40例。其中,井穴放血组经血肿清除术后,在常规内科治疗基础上给予井穴放血治疗;联合组在井穴放血治疗方案基础上同时给予高压氧治疗;对照组进行常规内科治疗。比较3组患者入院当日与治疗后36d美国国立卫生研究院卒中量表(NHISS)、Fusl-Meyer运动功能评定量表评分(FMA)、格拉斯哥昏迷量表评分(GCS)、认知功能评分(MMSE)、日常生活能力评分(ADL)及临床疗效;实时荧光定量聚合酶链反应检测患者入院当日及治疗后36d时外周血白细胞端粒长度变化。结果3组患者入院当日NHISS、FMA、GCS、MMSE及ADL评分比较,差异无统计学意义(P>0.05)。3组患者治疗后36d治疗总有效率比较,差异有统计学意义(P<0.05)。3组患者治疗前后NHISS、FMA、GCS、MMSE及ADL评分差值比较,差异有统计学意义(P<0.05),联合组FMA、GCS及MMSE高于井穴放血组(P<0.05)。3组患者治疗前后端粒长度差值比较,差异有统计学意义(P<0.05),井穴放血组和联合组端粒长度长于对照组(P<0.05)。结论井穴放血疗法联合高压氧治疗能改善出血性脑卒中患者的预后,促进受损端粒的修复。Objective To explore the effect of Jing acupoints bloodletting combined with hyperbaric oxygen therapy on the nerve function and telomere length of patients with hemorrhagic stroke. Methods Totally 120 subjects were randomly divided into three groups: Jing acupoints bloodletting group, Jing acupoints bloodletting+hyperbaric oxygen group (combined group) and control group (40 cases for each group). After the evacuation of hematoma, the Jing acupoints bloodletting group was given bloodletting treatment on the basis of routine medical treatment;the combined group was given hyperbaric oxygen treatment on the basis of the Jing acupoints bloodletting group;the control group received routine medical treatment. Nerve function was evaluated on the day of admission and 36 days after treatment, which includes National Institute of Health stroke scale (NHISS) score, Fusl-Meyer motor function assessment scale (FMA), Glasgow Coma Scale (GCS), Mini-mental State Examination (MMSE) score, daily life ability score (ADL). Clinical efficacy was evaluated as well. Real-time PCR was used to detect telomere length in peripheral blood of patients on the day of admission and 36 days after treatment. Results There were no significant differences in NHISS, FMA, GCS, MMSE and ADL scores among the three groups on the day of admission (P > 0.05). 36 days after treatment, the difference of the total effective rate of treatment among the control group, the bloodletting group and the combined group was statistically significant (P < 0.05);the differences in NHISS, FMA, GCS, MMSE and ADL scores changes among the control group, the bloodletting group and the combined group were statistically significant (P < 0.05), and FMA, GCS, MMSE in combined group were higher than those in Jing acupoints bloodletting group;the differences in telomere length changes among the control group, the bloodletting group and the combined group were statistically significant (P < 0.05), and telomere length increased in Jing acupoints bloodletting group and combined grou

关 键 词：卒中 放血 高压氧 端粒 治疗结果 

分 类 号：R543.6[医药卫生—心血管疾病]