电针辅助高压氧在脑外伤后昏迷病人中的应用  

Application of electroacupuncture assisted with hyperbaric oxygen in coma patients after traumatic brain injury

作　　者：车轶[1] 蒋遥 林荔青[3] 孙清[1] 陆顺庠 CHE Yi;JIANG Yao;LIN Liqing;SUN Qing;LU Shunxiang(Hyperbaric Oxygen Therapy Group of Neurosurgery Department,Suzhou,Jiangsu 215007,China;Acupuncture Department,Suzhou,Jiangsu 215007,China;Neurosur-gery Department C,North District of Suzhou Municipal Hospital,Suzhou,Jiangsu 215007,China)

机构地区：[1]苏州市立医院北区神经外科高压氧治疗组,江苏苏州215007 [2]苏州市立医院北区针灸科,江苏苏州215007 [3]苏州市立医院北区神经外科,江苏苏州215007

出　　处：《安徽医药》2022年第10期2077-2081,共5页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨电针辅助高压氧对脑外伤后昏迷病人的神经营养指标、格拉斯哥昏迷指数(GCS)评分及生活质量的影响。方法选取2017年6月至2019年6月期间在苏州市立医院神经外科住院的脑外伤昏迷的病人90例,按照随机数字表法病人分为观察组(基础治疗+高压氧+手厥阴经经穴针刺)和对照组(基础治疗+高压氧),各45例。比较两组疗效及治疗前后的神经营养指标、GCS评分及生活质量评分。结果治疗后,观察组病人美国国立卫生研究院卒中量表(NIHSS)评分(10.2±0.9)分,低于对照组的(14.3±1.3)分;观察组总有效率93.3%,高于对照组的75.6%;治疗后,观察组病人神经生长因子(NGF)、脑源性神经营养因子(BDNF)、过氧化氢酶(CAT)、超氧物歧化酶(SOD)、总抗氧化能力(T-AOC)水平均高于对照组,且丙二醛(MDA)、脂质过氧化氢(LHP)、晚期氧化蛋白产物(AOPPs)水平均低于对照组;治疗后,观察组GCS评分高于对照组;治疗后,观察组认知功能(CF)、情绪功能(EF)、角色功能(RF)、社会功能(SF)、躯体功能(PF)评分均高于对照组(P<0.05)。结论电针辅助高压氧干预脑外伤后昏迷病人,有更好的促醒作用,可有效改善病人神经功能缺损、神经营养及氧化应激状态,提高临床疗效和改善病人的生活质量,值得推广。Objective To investigate the effects of electroacupuncture assisted with hyperbaric oxygen on neurotrophic index,Glasgow Coma Index(GCS)score and quality of life in patients with coma after traumatic brain injury.Methods Ninety patients with cerebral trauma coma who were hospitalized in Neurosurgery of Suzhou Municipal Hospital from June 2017 to June 2019 were enrolled.Patients were randomly divided into observation group(basic treatment+hyperbaric oxygen+hand sputum yin stimulation)and control group(basic treatment+hyperbaric oxygen)according to the random number table,with 45 cases in each group.The neurological,GCS,and quality of life scores were compared between the two groups.Results After treatment,the National Institutes of Health Stroke Scale(NIHSS)score of the observation group was 10.2±0.9,which was lower than that of the control group(14.3±1.3).The total effective rate of the observation group was 93.3%,which was higher than 75.6%of the control group.After treatment,the levels of nerve growth factor(NGF),brain-derived neurotrophic factor(BDNF),catalase(CAT),superoxide dismutase(SOD),total antioxidant capacity(T-AOC)in patients of the observation group were higher than those in the control group,and the levels of malondialdehyde(MDA),lipid hydrogen peroxide(LHP),advanced oxidized protein products(AOPPs)were lower than those in the control group.After treatment,the GCS score of the observation group was higher than that of the control group.After treatment,the scores of cognitive function(CF),emotional function(EF),role function(RF),social function(SF),physical function(PF)in the observation group were higher than those of the control group(P<0.05).Conclusion Hyperbaric oxygen combined with acupoint electrical stimulation can improve the patient's neurological deficit,neurotrophic and oxidative stress,improve the clinical efficacy and improve the quality of life of patients with coma after traumatic brain injury,which is worthy of promotion.

关 键 词：脑损伤 昏迷 高压氧 手厥阴经经穴 生活质量 疗效 

分 类 号：R651.15[医药卫生—外科学]