头穴透刺联合丁苯酞对大脑中动脉狭窄脑灌注炎性反应及血管活性物质的影响  

Effects of scalp point penetration acupuncture on immune inflammatory response and vasoactive substances after cerebral perfusion in middle cerebral artery stenosis

作　　者：马宇[1] 马龙 崔友祥[2] 孙云川[3] MA Yu;MA Long;CUI Youxiang;SUN Yunchuan(Imaging Center,Hebei Cangzhou Integrated Traditional Chinese and Western Medicine Hospital,Cangzhou Hebei 1061001,China;Department of Neurology,Hebei Cangzhou Integrated Traditional Chinese and Western Medicine Hospital,Cangzhou Hebei 1061001,China;Radiotherapy Center,Hebei Cangzhou Integrated Traditional Chinese and Western Medicine Hospital,Cangzhou Hebei 1061001,China)

机构地区：[1]河北省沧州中西医结合医院影像中心,河北沧州061001 [2]河北省沧州中西医结合医院神经内科,河北沧州061001 [3]河北省沧州中西医结合医院放疗中心,河北沧州061001

出　　处：《新疆医科大学学报》2022年第5期559-563,共5页Journal of Xinjiang Medical University

基　　金：河北省中医药管理局科研计划项目(2022227)。

摘　　要：目的探讨头穴透刺联合丁苯酞对大脑中动脉狭窄脑灌注患者炎性反应及血管活性物质相关指标的影响。方法选择2019年8月-2021年5月河北省沧州中西医结合医院脑血管科就诊的104例大脑中动脉狭窄患者,采用随机数字表法分为2组,每组52例,对照组患者给予常规抗凝、降脂、降压治疗,研究组患者在对照组基础上给予丁苯酞口服结合头穴透刺治疗。对比分析两组患者治疗前后脑灌注扫描的脑血流量(Cerebral blood flow,CBF)、脑血容量(Cerebral blood volume,CBV)、平均通过时间(Mean transit time,MTT)、最大峰值时间(Time to peak,TTP)的相对值(rCBF、rCBV、rMTT、rTTP)以及血清炎性反应递质、血管活性物质水平的变化。结果治疗后,两组患者的rCBF、rCBV及一氧化氮(Nitric oxide,NO)、血管内皮生长因子(Vascular endothelial growth factor,VEGF)水平均高于治疗前,且研究组高于对照组;rTTP、rMTT值及内皮功能指标内皮素-1(Endothelin-1,ET-1)、血栓素B2(Thromboxane B2,TXB2)、血管紧张素-Ⅱ(Angiotensin-Ⅱ,Ang-Ⅱ)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、细胞间黏附分子-1(Intercellular adhesion molecule-1,ICAM-1)、转化生长因子-β_(1)(Transforming growth factor-β_(1),TGF-β_(1))水平低于治疗前,且研究组低于对照组,差异均有统计学意义(P<0.05)。研究组患者治疗后不良反应总发生率显著低于对照组(χ2=4.308,P=0.038)。结论头穴透刺联合丁苯酞治疗能够有效改善大脑中动脉狭窄脑灌注患者脑血流情况,有效抑制血管炎性反应并促进血管生成,且治疗后不良反应发生率低,值得临床推广运用。Objective To investigate the effects of scalp point penetration acupuncture on immune inflammatory response and vasoactive substances after cerebral perfusion in middle cerebral artery stenosis.Methods 104 patients with middle cerebral artery stenosis in the cerebrovascular Department of the hospital from August 2019 to may 2021 were analyzed.The patients were randomly divided into the two groups with 52 cases in each group.The patients in the reference group were treated with routine anticoagulant,lipid-lowering and antihypertensive treatment,and the patients in the study group were treated with oral butylphthalide combined with scalp point penetration acupuncture.The changes of cerebral blood flow(CBF),cerebral blood volume(CBV),mean transit time(MTT)and maximum peak time(TTP),serum inflammatory transmitters and vasoactive substances were observed before and after the treatment.Results The rCBF,rCBV,RTTP and rmtt values of the two groups after the treatment were significantly better than those before the treatment,and the cerebral perfusion values of the study group were significantly better than those of the reference group after the treatment(P<0.05);The levels of ET-1,no,TXB2,Ang-Ⅱand VEGF in the two groups after the treatment were significantly better than those before the treatment.There was significant difference between the study group and the reference group after the treatment(P<0.05);TNF in all patients after the treatment-α、TGF-β_(1) and ICAM-1 level index were decreased significantly.After the treatment,the improvement effect of each index in the study group was significantly better than that in the reference group(P<0.05);The total incidence of adverse reactions in the study group was significantly lower than that in the reference group(χ2=4.308,P=0.038).Conclusion Butylphthalide combined with scalp point penetration can improve cerebral perfusion in middle cerebral artery stenosis,inhibit serum inflammatory transmitters and vasoactive substances,and it reduce adverse reactions.It is worthy

关 键 词：头穴透刺 大脑中动脉狭窄 脑灌注 炎性反应 血管活性物质 

分 类 号：R245.3[医药卫生—针灸推拿学]