醒脑开窍针法联合依达拉奉治疗急性脑出血的疗效观察及对血清OPN、CGRP水平的影响  

Efficacy Observation of Xing Nao Kai Qiao Needling Combined with Edaravone for Acute Cerebral Hemorrhage and Its Effects on Serum OPN and CGRP

作　　者：王爱丽[1] 王雪 朱太卿 WANG Ai-li;WANG Xue;ZHU Tai-qing(People’s Hospital of Zhengzhou,Henan University of Chinese Medicine,Zhengzhou 450002,China)

机构地区：[1]河南中医药大学郑州人民医院,郑州450002

出　　处：《上海针灸杂志》2021年第8期913-919,共7页Shanghai Journal of Acupuncture and Moxibustion

基　　金：河南省医学科技攻关计划项目(2018062115)。

摘　　要：目的观察醒脑开窍针刺法联合依达拉奉治疗急性脑出血的临床疗效及其对患者血清骨桥蛋白(OPN)、降钙素基因相关肽(CGRP)水平的影响。方法将114例急性脑出血患者按随机数字表法分为联合组、对照A组和对照B组,每组38例。3组均予常规治疗,对照A组另予依达拉奉静脉滴注治疗,对照B组另予醒脑开窍针刺治疗,联合组另予醒脑开窍针刺联合依达拉奉静脉滴注治疗。比较3组临床疗效,观察3组治疗前后美国国立卫生研究院卒中量表(NIHSS)、格拉斯哥昏迷量表(GCS)和日常生活活动能力量表(BI)评分的变化,比较3组脑血流动力学参数[平均血流速度(Vm)、搏动指数(PI)、阻力指数(RI)]、血清炎症因子指标[超敏C反应蛋白(hs-CRP)、白细胞介素(IL)-1β、肿瘤坏死因子(TNF)-α]、氧化应激指标[丙二醛(MDA)、超氧化物歧化酶(SOD)]、OPN、CGRP水平。结果联合组治疗后总有效率为94.7%,高于对照A组、对照B组的76.3%、73.7%(P<0.05)。3组治疗后NIHSS评分与RI水平均较治疗前降低(P<0.05),且联合组低于对照A组、对照B组(P<0.05);3组治疗后GCS、BI评分与Vm、PI水平均较治疗前提高(P<0.05),且联合组高于对照A组、对照B组(P<0.05);3组治疗后血清hs-CRP、IL-1β、TNF-α、MDA、OPN水平均较治疗前降低(P<0.05),且联合组低于对照A组、对照B组(P<0.05);3组血清SOD、CGRP水平较治疗前提高(P<0.05),且联合组高于对照A组、对照B组(P<0.05)。结论醒脑开窍针刺法联合依达拉奉治疗急性脑出血可改善患者脑血流动力学,减轻炎症与氧化应激反应,调节血清OPN、CGRP水平,缓解神经功能缺损与昏迷程度,提升日常生活能力,疗效优于单纯醒脑开窍针刺或依达拉奉。Objective To observe the clinical efficacy of Xing Nao Kai Qiao(mind-refreshing and orifice-opening)needling method plus Edaravone in treating acute cerebral hemorrhage and its effects on the levels of serum osteopontin(OPN)and calcitonin gene-related peptide(CGRP).Method A total of 114 patients with acute cerebral hemorrhage were divided using random number table method into a joint group,control group A and control group B,with 38 cases in each group.Conventional treatment was offered to all three groups.In addition,control group A was given intravenous drip of Edaravone,control group B was given Xing Nao Kai Qiao needling,and the joint group was treated with Xing Nao Kai Qiao needling plus intravenous drip of Edaravone.Clinical efficacy of the three groups was compared.The scores of National Institute of Health stroke scale(NIHSS),Glasgow coma scale(GCS)and Barthel index(BI)were observed before and after treatment;the levels of cerebral hemodynamic parameters[mean blood flow velocity(Vm),pulsatility index(PI)and resistance index(RI)],serum inflammatory cytokines[high-sensitivity C-reactive protein(hs-CRP),interleukin(IL)-1βand tumor necrosis factor(TNF)-α],oxidative stress(OS)indicators[malondialdehyde(MDA)and superoxide dismutase(SOD)],OPN and CGRP were compared.Result After treatment,the total effective rate was 94.7%in the joint group,higher than 76.3%in control group A and 73.7%in control group B(P<0.05).The NIHSS score and RI level declined after treatment in all three groups(P<0.05),and were lower in the joint group than in control groups A and B(P<0.05);the GCS and BI scores and the levels of Vm and PI increased after treatment in all three groups(P<0.05),and were higher in the joint group than in control groups A and B(P<0.05);the levels of serum hs-CRP,IL-1β,MDA and OPN dropped after treatment in the three groups(P<0.05),and were lower in the joint group than in control groups A and B(P<0.05);the levels of serum SOD and CGRP increased after treatment in the three groups(P<0.05),and were higher in t

关 键 词：针刺疗法 醒脑开窍 脑出血 依达拉奉 骨桥蛋白 降钙素基因相关肽 

分 类 号：R246.6[医药卫生—针灸推拿学]