循经灸联合温和灸对缺血性脑卒中患者康复的影响  

Effect of Meridian Moxibustion Combined with Warming Moxibustion on the Rehabilitation of Ischemic Stroke Patients

作　　者：周琳 郭秀君[2] 吴琼[2] 戴彦祺 黄莉 姚瑶 惠振[3] ZHOU Lin;GUO Xiu-jun;WU Qiong;DAI Yan-qi;HUANG Li;YAO Yao;HUI Zhen(School of Nursing, Nanjing University of Chinese Medicine, Nanjing 210023, China;Nursing Department, Nanjing TCM Hospital, Nanjing 210001, China;Encephalopathy Department, Nanjing TCM Hospital, Nanjing 210001, China)

机构地区：[1]南京中医药大学护理学院,江苏南京210023 [2]南京市中医院护理部,江苏南京210001 [3]南京市中医院脑病科,江苏南京210001

出　　处：《南京中医药大学学报》2022年第1期59-63,共5页Journal of Nanjing University of Traditional Chinese Medicine

基　　金：国家自然科学基金青年科学基金项目(81703975);南京中医药大学江苏护理学优势学科第三期开放课题(2019YSHL099);世界中医药联合会护理专业委员会开放课题(SZLHLA-1902)。

摘　　要：目的观察循经灸联合温和灸对缺血性脑卒中患者康复的影响。方法将92例缺血性脑卒中患者随机分为对照组和试验组各46例。对照组给予常规治疗(抗血小板聚集、降压、降糖、降脂和脑保护),试验组在此基础上给予循经灸联合温和灸干预。分别于治疗前(T_(0))、治疗7天(T_(1))、治疗14天(T_(2))、治疗28天(T_(3))采用美国国立卫生研究院卒中量表(NIHSS评分)、日常生活活动能力评分(BI评分)、简化Fugl-Meyer运动功能评分(FMA评分)对2组患者进行疗效评定。治疗前后ELISA法检测血清血管内皮生长因子(Vascular endothelial growth factor,VEGF)、血管生成素1(Angiopoietin-1,Ang-1)含量,免疫透射比浊法检测高敏C反应蛋白(Hypersensitive C reactive protein,hs-CRP)含量。结果治疗后,对照组T_(2)、T_(3)时间点及试验组T_(1)、T_(2)、T_(3)时间点NIHSS评分明显降低(P<0.05,P<0.01),对照组T_(1)、T_(2)、T_(3)时间点及试验组T_(2)、T_(3)时间点BI评分显著增加(P<0.01),试验组T_(2)、T_(3)时间点NIHSS评分、BI评分优于对照组(P<0.05,P<0.01);2组患者FMA评分均显著增加(P<0.01),试验组优于对照组(P<0.05,P<0.01);2组患者血清VEGF、Ang-1均升高,血清hs-CRP均降低(P<0.05,P<0.01),试验组血清VEGF水平高于对照组(P<0.01),hs-CRP水平低于对照组(P<0.05)。结论循经灸联合温和灸可改善缺血性脑卒中患者神经功能,提高日常生活活动能力,促进肢体康复,可能与调节血管生长因子表达、降低炎症反应有关。OBJECTIVE To observe the effect of meridian moxibustion on the rehabilitation of patients with ischemic stroke.METHODS A total of 92 patients with ischemic stroke were randomly divided into a control group and a treatment group of 46 cases each.The control group was given conventional treatment(anti-platelet aggregation,antihypertensive,glucose-reducing,lipid-lowering and cerebral protection),while the experimental group was given the meridian moxibustion intervention on top of this.The efficacy of the treatment was evaluated in both groups before(T_(0)),7 days after(T_(1)),14 days after(T_(2))and 28 days after(T_(3))using the National Institutes of Health Stroke Scale(NIHSS),activities of daily living(BI index)and simplified Fugl-Meyer motor assessments(FMA).Besides,serum levels of vascular endothelial growth factor(VEGF)and angiopoietin 1(Ang-1)were measured by ELISA and high-sensitivity c-reactive protein(hs-CRP)by immunity transmission turbidity before and after treatment.RESULTS After treatment,The NIHSS score decreased with statistical differences in the control group at time points of T_(2),T_(3) and in the treatment group at time points of T_(1),T_(2),T_(3)(P<0.05,P<0.01).The BI score increased significantly in the control group at time points of T_(1),T_(2),T_(3) and in the treatment group at time points of T_(2),T_(3)(P<0.01).At time points of T_(2) and T_(3),Better NIHSS score and BI score were seen in the treatment group than those in the control group with statistically significant differences(P<0.05,P<0.01).Both groups had significantly increased FMA scores(P<0.01)and the treatment group was better than the control group(P<0.05,P<0.01).In addition,serum VEGF and Ang-1 were increased and serum hs-CRP was decreased in both groups(P<0.05,P<0.01),the serum VEGF level in the treatment group was higher than that in the control group(P<0.01),and the hs-CRP level was lower than that in the control group(P<0.05).CONCLUSION Meridian moxibustion can improve neurological function,enhance the ability of daily li

关 键 词：缺血性脑卒中 循经灸 温和灸 康复 

分 类 号：R255.2[医药卫生—中医内科学]