盐酸纳美芬联合电针刺激治疗急性脑损伤患者的临床效果及其对血清D-二聚体、内源性阿片肽水平的影响  

Clinical Effect of Nalmefene Combined with Electroacupuncture Stimulation on Acute Brain Injury and the Impact on Serum Levels of D-dimer and Endogenous Opioid Peptide

作　　者：查海锋[1] 路楷[1] ZHA Haifeng;LU Kai(Department of Neurosurgery,Jiangyin Hospital of Traditional Chinese Medicine,Jiangyin 214400,China)

机构地区：[1]江苏省江阴市中医院神经外科

出　　处：《实用心脑肺血管病杂志》2019年第9期91-94,共4页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：江阴市科技计划项目(Z201506)

摘　　要：目的分析盐酸纳美芬联合电针刺激治疗急性脑损伤患者的临床效果及其对血清D-二聚体、内源性阿片肽水平的影响。方法选取2013—2018年江阴市中医院治疗的急性脑损伤患者91例,采用随机数字表法分为对照组(n=45)和观察组(n=46)。两组患者均给予常规治疗,对照组患者给予盐酸纳美芬治疗,观察组患者给予盐酸纳美芬+电针刺激治疗;两组患者均连续治疗2周。比较两组患者临床效果,治疗前后美国国立卫生研究院卒中量表(NIHSS)评分、血肿体积、水肿体积及血清β-内啡肽、强啡肽、D-二聚体、炎性因子〔包括白介素6(IL-6)、肿瘤坏死因子α(TNF-α)、白介素4(IL-4)、白介素10(IL-10)〕水平,并比较两组患者治疗期间不良反应发生率。结果 (1)观察组患者临床效果优于对照组(P<0.05)。(2)与对照组患者比较,观察组患者治疗前NIHSS评分及血肿体积、水肿体积相似,差异无统计学意义(P>0.05),而治疗后NIHSS评分降低,血肿体积、水肿体积减小(P<0.05)。(3)与对照组患者比较,观察组患者治疗前血清β-内啡肽、强啡肽、D-二聚体水平相似,差异无统计学意义(P>0.05),而治疗后血清β-内啡肽、强啡肽、D-二聚体水平降低(P<0.05)。(4)与对照组患者比较,观察组患者治疗前血清IL-6、TNF-α、IL-4和IL-10水平相似,差异无统计学意义(P>0.05),而治疗后血清IL-6、TNF-α水平降低,血清IL-4、IL-10水平升高(P<0.05)。(5)两组患者治疗期间不良反应发生率比较,差异无统计学意义(P>0.05)。结论盐酸纳美芬联合电针刺激可有效提高急性脑损伤患者的临床效果,改善患者神经功能,减小患者血肿、水肿体积,降低血清D-二聚体、内源性阿片肽水平,减轻炎性反应,且安全性较高。Objective To analyze the clinical effect of nalmefene combined with electroacupuncture stimulation on acute brain injury and the impact on serum levels of D-dimer and endogenous opioid peptide.Methods A total 91 patients with acute brain injury were selected in Jiangyin Hospital of Traditional Chinese Medicine from 2013 to 2018,and they were divided into control group(n=45)and observation group(n=46)according to random number table.Patients in control group received hydrochloride nalmefene based on the routine treatment,while patients in observation group were given electroacupuncture stimulation based on that of control group;both groups were continuously treated for 2 weeks.Clinical effect,pre-and posttreatment NIHSS score,hematomas volume,edema volume and serum levels of β-endorphin,dynorphin,D-dimer and inflammatory cytokines(including IL-6,TNF-α,IL-4 and IL-10)were compared between the two groups,as well as incidence of adverse reactions during treatment.Results(1)Compared with that in control group,clinical effect in observation group was better(P<0.05).(2)Compared with those in control group,NIHSS score,hematoma volume and edema volume in observation group were similar before treatment(P>0.05),while NIHSS score,hematoma volume and edema volume in observation group were lower after treatment(P<0.05).(3)Compared with those in control group,serumlevels of β-endopeptide,dynorphin and D-dimer in observation group were similar before treatment(P>0.05),while serumlevels of β-endopeptide,dynorphin and D-dimer in observation group were lower after treatment(P<0.05).(4)Comparedwith those in control group,observation group showed similar serum levels of IL-6,TNF-α,IL-4 and IL-10 before treatment(P>0.05),but lower serum levels of IL-6 and TNF-α,higher serum levels of IL-4 and IL-10 after treatment(P<0.05).(5)Compared with that in control group,incidence of adverse reactions in observation group was similar during treatment(P>0.05). Conclusion Nalmefene combined with electroacupuncture stimulation can effectively

关 键 词：脑损伤 纳美芬 电针 D-二聚体 阿片样肽类 治疗结果 

分 类 号：R651.15[医药卫生—外科学]