醒脑开窍针刺联合高压氧对急性脑梗死介入溶栓术后神经功能恢复及氧化应激水平的影响  

Effects of Xing Nao Kai Qiao Needling Combined with Hyperbaric Oxygen on Neurological Function Recovery and Oxidative Stress Level After Interventional Thrombolytic Therapy for Acute Cerebral Infarction

作　　者：张黎雪 王洁[1] 孙军[1] ZHANG Li-xue;WANG Jie;SUN Jun(Nanyang City Center Hospital,Nanyang 473300,China)

机构地区：[1]南阳市中心医院,南阳473300

出　　处：《上海针灸杂志》2021年第7期807-813,共7页Shanghai Journal of Acupuncture and Moxibustion

基　　金：河南省科技发展项目(192102310349)。

摘　　要：目的观察醒脑开窍针刺联合高压氧对急性脑梗死(ACI)介入溶栓术后神经功能恢复及氧化应激水平的影响。方法将102例接受介入溶栓术的ACI患者随机分为研究组、对照A组、对照B组,每组34例。3组均接受介入溶栓术,于此基础上对照A组予以醒脑开窍针刺,对照B组予以高压氧,研究组采取醒脑开窍针刺联合高压氧,3组均治疗2周。比较3组临床疗效、不良反应发生率及治疗前后美国国立卫生研究院卒中量表(NIHSS)评分、日常生活活动能力(ADL)量表评分、血液流变学指标(全血低切黏度、全血高切黏度、红细胞聚集指数、红细胞压积)、炎症因子指标[肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)]、氧化应激指标[丙二醛(MDA)、超氧化物歧化酶(SOD)、总抗氧化能力(TAC)]水平。结果研究组总有效率为94.1%,高于对照A组和对照B组的73.5%、70.6%(P<0.05)。3组治疗后NIHSS评分较治疗前降低,且研究组低于对照A组、对照B组;ADL量表评分较治疗前增高,且研究组高于对照A组、对照B组;全血低切黏度、全血高切黏度、红细胞聚集指数、红细胞压积与血清TNF-α、IL-1β、MDA水平较治疗前降低,且研究组低于对照A组、对照B组;血清SOD、TAC水平较治疗前增高,且研究组高于对照A组、对照B组,差异有统计学意义(P<0.05)。3组不良反应发生率比较,差异无统计学意义(P>0.05)。结论ACI介入溶栓术后应用醒脑开窍针刺联合高压氧可改善血液流变学情况,减轻机体炎症与氧化应激反应,促进神经功能恢复,提升日常生活能力,疗效显著。Objective To observe the effects of Xing Nao Kai Qiao(mind-refreshing and orifice-opening)needling plus hyperbaric oxygen on neurological function recovery and oxidative stress level after interventional thrombolytic therapy for acute cerebral infarction(ACI).Method A total of 102 ACI patients undergoing interventional thrombolytic therapy were randomized into a research group,control group A and control group B,with 34 cases in each group.The three groups all received interventional thrombolytic therapy.In addition,control group A was given Xing Nao Kai Qiao needling,control group B received hyperbaric oxygen,and the research group was given Xing Nao Kai Qiao needling together with hyperbaric oxygen,all for 2 weeks.Clinical efficacy and adverse reaction rate were compared among the three groups,as well as the scores of National Institute of Health stroke scale(NIHSS)and activities of daily living(ADL),and the levels of hemorheological parameters[low-shear whole blood viscosity(WBV),high-shear WBV,erythrocyte aggregation index(EAI)and hematocrit(HCT)],inflammatory cytokines[tumor necrosis factor-α(TNF-α)and interleukin-1β(IL-1β)]and oxidative stress indicators[malondialdehyde(MDA),superoxide dismutase(SOD)and total antioxidant capacity(TAC)].Result The total effective rate was 94.12%in the research group,higher than 73.5%in control group A and 70.6%in control group B(P<0.05).The NIHSS score dropped after treatment in the three groups,and was lower in the research group than in both control groups A and B;the ADL score increased after intervention,and was higher in the research group than in control groups A and B;the levels of low-shear WBV,high-shear WBV,EAI,HCT,and serum TNF-α,IL-1βand MDA declined after treatment,and were lower in the research group than in control groups A and B;the serum levels of SOD and TAC increased after treatment,and were higher in the research group than in control groups A and B,with statistical significance(P<0.05).There were no significant differences in the adverse reaction r

关 键 词：针刺疗法 高压氧 醒脑开窍 脑梗死 氧化应激 美国国立卫生研究院卒中量表 日常生活活动能力 

分 类 号：R246.6[医药卫生—针灸推拿学]