天地饮联合针灸治疗急性脑卒中(风痰阻络)对照研究  

A Comparative Study of Tiandiyin Combined with Acupuncture and Moxibustion for Acute Stroke( Wind and Phlegm Obstructing Collaterals)

作　　者：朱海荣 王念 吴年宝 张海燕 朱正凯 ZHU Hairong;WANG Nian;WU Nianbao;ZHANG Haiyan;ZHU Zhengkai(Taizhou Affiliated Hospital of Nanjing University of Chinese Medicine,Taizhou 225300,Jiangsu,China)

机构地区：[1]南京中医药大学泰州附属医院

出　　处：《实用中医内科杂志》2019年第10期77-80,共4页Journal of Practical Traditional Chinese Internal Medicine

基　　金：泰州市科技支撑计划项目指令性计划项目(TS201807)

摘　　要：[目的]探讨分析天地饮联合针灸治疗急性缺血脑卒中(风痰阻络型)患者的临床疗效。[方法]选取纳入研究的72例急性脑卒中患者,依据随机平行对照法分为观察组(常规西药+天地饮+针灸)和对照组(常规西药),记录两组患者治疗前后神经功能、中医证候评分、认知功能和日常生活能力。治疗1疗程(2周),判定疗效。并且检测两组治疗前第1天、治疗后第3天、第14天血清基质金匮蛋白酶(MMP-9)及肿瘤坏死因子-α(TNF-α)含量。[结果]观察组和对照组治疗前各评分相比无显著差异,治疗后两组评分明显好于本组治疗前(均P<0.05);观察组的神经功能、中医证候评分、认知功能和日常生活能力显著好于同期对照组患者(P<0.05)。两组患者发病时血清MMP-9与TNF-α水平均明显高于健康人组(P<0.05);观察组在第3天、14天血清MMP-9与TNF-α水平均明显低于同期对照组,差异有显著性意义(P<0.05)。两组患者血清MMP-9与TNF-α水平均明显高于健康人组(P<0.05)。[结论]天地饮联合针灸治疗缺血性脑卒中成效显著,能够明显改善患者的神经功能、认知功能和日常生活能力,其机制可能与下调MMP-9表达及抑制炎症反应等相关,值得进一步临床应用。[Objective]To analyze the clinical efficacy of Tiandiyin combined with acupuncture in the treatment of patients with acute ischemic stroke(wind and phlegm obstructing collaterals).[Methods]Seventy-two patients with acute stroke were enrolled in the study.According to the randomized parallel control method,the observation group(conventional western medicine+Tiandiyin+acupuncture)and the control group(conventional western medicine)were recorded.The neurological function and TCM symptom scores,cognitive function and daily living ability of the two groups were recorded before and after treatment.After treatment for 1 course(2 weeks),we measured the efficacy.Serum MMP-9 and tumor necrosis factor-α(TNF-α)levels were measured on the first day before treatment and on the third and fourth day after treatment.[Results]There was no significant difference between the observation group and the control group before treatment.The scores of the two groups were significantly better than those before treatment(both P<0.05).The neurological function,TCM symptom score,cognitive function and daily living ability of the observation group were significantly better than those of the control group(P<0.05).The levels of serum MMP-9 and TNF-αin the two groups were significantly higher than those in the healthy group(P<0.05).The serum levels of MMP-9 and TNF-αwere significantly lower in the observation group on the3 rd and 14 th day.In the same period of the control group,the difference was significant(P<0.05).The serum levels of MMP-9 and TNF-αin the two groups were significantly higher than those in the healthy group(P<0.05).[Conclusion]Tiandiyin combined with acupuncture is effective in the treatment of ischemic stroke,which can significantly improve the neurological function,cognitive function and daily living ability of patients.The mechanism may be related to the down-regulation of MMP-9 expression and inhibition of inflammatory response,which is worthy of further clinical application.

关 键 词：天地饮 急性缺血脑卒中 基质金属蛋白酶-9 针刺 

分 类 号：R74[医药卫生—神经病学与精神病学]