醒脑开窍针刺法联合阿替普酶对急性脑梗死患者神经功能、脑血流动力及S-100β蛋白的影响  

Effect of Xingnao Kaiqiao Acupuncture Method Combined with Alteplase on Nerve Function,Cerebral Hemodynamics and S-100βProtein in Patients with Acute Cerebral Infarction

作　　者：曹改杰 王静敏 丁震环 CAO Gaijie;WANG Jingmin;DING Zhenhuan

机构地区：[1]鹤壁市人民医院,河南鹤壁458030

出　　处：《新中医》2020年第5期114-117,共4页New Chinese Medicine

基　　金：河南省科学技术厅2017年省重点研发计划项目(2017YDS-29891)。

摘　　要：目的:观察醒脑开窍针刺法联合阿替普酶对急性脑梗死患者神经功能、脑血流动力及S-100β蛋白的影响。方法:选取108例急性脑梗死患者,按照随机数字表法分为对照组和治疗组各54例。对照组在常规治疗基础上使用注射用阿替普酶溶栓治疗,治疗组在对照组基础上采用醒脑开窍针刺法治疗,观察治疗前后神经功能缺损、脑血流动力指标及血清S-100β蛋白含量的变化,并评价临床效果。结果:治疗后,2组美国国立卫生研究院脑卒中量表(NIHSS)评分均较治疗前降低(P<0.05);治疗组NIHSS评分低于对照组(P<0.05)。治疗后,2组大脑中动脉峰值流速(Vp)、大脑中动脉平均流速(Vm)均较治疗前升高(P<0.05),峰流速对称性差值(DVp)及平均流速对称性差值(DVm)均较治疗前下降(P<0.05);治疗组Vp、Vm高于对照组(P<0.05),DVp、DVm低于对照组(P<0.05)。治疗后,2组脉动指数(PI)均较治疗前降低(P<0.05),脑血管储备能力(CVR)均较治疗前升高(P<0.05);治疗组PI低于对照组(P<0.05),CVR高于对照组(P<0.05)。治疗后,2组血清S-100β水平均较治疗前下降,治疗组血清S-100β水平比对照组下降更明显,差异均有统计学意义(P<0.05)。治疗组总有效率90.74%,高于对照组的75.93%,差异有统计学意义(P<0.05)。结论:醒脑开窍针刺法联合注射用阿替普酶治疗急性脑梗死,可以改善患者的神经功能缺损症状、脑血流动力学等指标,有助于改善预后。Objective:To observe the effect of Xingnao Kaiqiao acupuncture method combined with alteplase on nerve function,cerebral hemodynamics and S-100βprotein in patients with acute cerebral infarction.Methods:A total of 108 cases of patients with acute cerebral infarction were divided into the control group and the treatment group according to the random number table method,54 cases in each group.Based on routine treatment,the control group was additionally treated with alteplase thrombolysis by injection,and the treatment group was additionally treated with Xingnao Kaiqiao acupuncture method based on the treatment of the control group.The changes of neurologic impairment,indexes of cerebral hemodynamics and content of S-100βprotein in serum before and after treatment were observed.The clinical effect was evaluated.Results:After treatment,the scores of National Institutes of Health Stroke Scale(NIHSS)in the two groups were decreased when compared with those before treatment(P<0.05);the score in the treatment group was lower than that in the control group(P<0.05).After treatment,peak velocity(Vp)and mean velocity(Vm)in the middle cerebral artery in the two groups were increased when compared with those before treatment(P<0.05);symmetrical difference in peak velocity(DVp)and symmetrical difference in mean velocity(DVm)were decreased when compared with those before treatment(P<0.05);in the treatment group,Vp and Vm were higher than those in the control group(P<0.05),and DVp and DVm were lower than those in the control group(P<0.05).After treatment,pulsatility indexes(PI)in the two groups were decreased when compared with those before treatment(P<0.05),and cerebrovascular reactivity(CVR)was increased when compared with those before treatment(P<0.05);in the treatment group,PI was lower than that in the control group(P<0.05),and CVR was higher than that in the control group(P<0.05).After treatment,the levels of S-100βin serum in the two groups were decreased when compared with those before treatment,and the decrease in th

关 键 词：急性脑梗死 醒脑开窍针刺法 阿替普酶 神经功能 脑血流动力学 血清S-100Β蛋白 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R246[医药卫生—临床医学]