机构地区:[1]秦皇岛市中医医院手麻科,河北秦皇岛066000 [2]秦皇岛市中医医院脑外科,河北秦皇岛066000 [3]秦皇岛市中医医院康复科,河北秦皇岛066000 [4]秦皇岛市中医医院针灸科,河北秦皇岛066000
出 处:《临床和实验医学杂志》2022年第24期2591-2595,共5页Journal of Clinical and Experimental Medicine
基 金:秦皇岛市科学技术研究与发展计划(编号:202101A200);河北省中医药管理局科研计划(编号:2020374)。
摘 要:目的 研究通窍活血汤结合针刺对颅脑损伤致认知功能障碍患者的疗效及血清肥胖抑制素Obestatin、成纤维细胞生长因子23(FGF23)表达的影响。方法 前瞻性选取2019年4月至2022年2月秦皇岛市中医医院收治的颅脑损伤认知障碍患者90例,按照随机数字表法将患者分为常规组、对照组和研究组,各30例。常规组进行常规治疗,对照组同时进行电针治疗,每次进行30 min,每天1次,每周5次,连续进行8周。研究组在对照组的基础上给予通窍活血汤,水煎服至300 mL,分早晚2次服用,持续治疗8周。评估患者临床疗效。分别于治疗前及治疗结束后第2天,根据认知功能的成套测验(LOCTA)和简易智能状态表(MMSE)对患者的认知功能进行评价;通过依从性训练调查患者的诱发;采用全自动生化分析仪测定血清中Obestatin水平,采用酶联免疫吸附试验测定血清中FGF23水平。结果 常规组、对照组和研究组患者临床治疗总有效率分别为76.67%、80.00%和96.67%,研究组患者总有效率显著高于常规组、对照组,差异有统计学意义(P<0.05)。治疗后,3组患者MMSE评分、知觉、定向、思维运作和视运动LOCTA评分均显著增加,且研究组均显著高于常规组和对照组,差异均有统计学意义(P<0.05)。治疗后,3组患者潜伏期均较治疗前显著缩短,波幅均较治疗前显著变长,且研究组潜伏期和波幅较常规组和对照组变化更明显,差异均有统计学意义(P<0.05)。治疗后,3组患者血清Obestatin和FGF23水平均显著降低,且研究组Obestatin和FGF23水平分别为(10.58±1.36) ng/mL、(264.59±77.42) pg/mL,显著低于常规组[(14.87±1.11) ng/mL、(462.28±87.44) pg/mL]和对照组[(13.57±1.47) ng/mL、(384.29±89.48) pg/mL],差异均有统计学意义(P<0.05)。结论 通窍活血汤结合针刺对颅脑损伤致认知功能障碍患者的疗效有显著的改善作用,可以改善患者认知功能,降低血清Obestatin、FGF23表达水平。Objective To study the curative effect of Tongqiao Huoxue Decoction combined with acupuncture on patients with cognitive dysfunction caused by craniocerebral injury and the influence of serum Obestatin and fibroblast growth factor 23(FGF23) expression. Methods A total of 90 patients with cognitive impairment after craniocerebral injury admitted to Qinhuangdao Hospital of Traditional Chinese Medicine from April 2019 to February 2022 were prospectively selected. The patients were randomly divided into the conventional group, the control group and the study group using the random number table method, with 30 cases in each group. The conventional group received conventional treatment, while the control group received electroacupuncture for 30 min each time, once a day, 5 times a week, for 8 weeks. On the basis of the control group, the study group was given Tongqiaohuoxue decoction(decocted in water to 300 mL), twice in the morning and twice in the evening, for 8 weeks. Evaluate the clinical efficacy of the patients. The cognitive function of the patients was evaluated by Cognitive Function test(LOCTA) and Mini-Mental State Scale(MMSE) before treatment and the second day after treatment. The executive function of patients was investigated by compliance training. The Obestatin level in serum was determined by automatic biochemical analyzer, and the FGF23 level in serum was determined by enzyme-linked immunosorbent assay. Results The total clinical effective rates of patients in routine group, control group and research group were 76.67%, 80.00% and 96.67%, respectively, the total effective rate of patients in the study group was significantly higher than that in the conventional group and the control group, the difference was statistically significant(P<0.05). After treatment, the MMSE scores, perception, orientation, thinking operation and LOCTA scores of the three groups of patients were significantly higher than those before treatment, and the study group were significantly higher than those in the conventional gro
关 键 词:通窍活血汤 针刺 颅脑损伤 认知功能障碍 血清Obestatin 成纤维细胞生长因子23
分 类 号:R269[医药卫生—中西医结合]
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