针刺对急性缺血性脑卒中溶栓患者神经功能及血清炎性因子的影响  

Effects of acupuncture on neurologic function and serum inflammatory factors after thrombolysis in acute ischemic stroke

作　　者：占道伟[1] 钱华 杨喜兵[3] 白允建 茅利玉[2] 罗开涛[3] ZHAN Dao-wei;QIAN Hua;YANG Xi-bing;BAI Yun-jian;MAO Li-yu;LUO Kai-tao(Department of Rehabilitation,Jiaxing Hospital of TCM Affiliated to Zhejiang Chinese Medical University,Jiaxing 314001,China;Department of Encephalopathy,Jiaxing Hospital of TCM Affiliated to Zhejiang Chinese Medical University,Jiaxing 314001,China;Department of Acupuncture and Moxibustion,Jiaxing Hospital of TCM Affiliated to Zhejiang Chinese Medical University,Jiaxing 314001,China)

机构地区：[1]浙江中医药大学附属嘉兴市中医医院康复科,嘉兴314001 [2]浙江中医药大学附属嘉兴市中医医院脑病科,嘉兴314001 [3]浙江中医药大学附属嘉兴市中医医院针灸科,嘉兴314001

出　　处：《中国针灸》2023年第5期489-492,共4页Chinese Acupuncture & Moxibustion

基　　金：浙江省科技厅项目:LGF20H270003;浙江省沈来华名老中医专家传承工作室建设项目:GZS2021036;2021年嘉兴市沈来华名中医传承工作室建设项目:嘉卫办[2021]28号;嘉兴市公益性研究计划项目:2020AD30026。

摘　　要：目的:观察针刺对急性缺血性脑卒中(AIS)溶栓患者神经功能及血清炎性因子水平的影响。方法:将102例发病至进行溶栓的治疗时间(OTT)≤3 h的AIS患者随机分为观察组和对照组,每组51例。对照组采用溶栓与内科常规治疗;在对照组治疗基础上,观察组予针刺治疗,穴取水沟、中脘、气海、内关等,每次30 min,每日1次,两组均治疗2周。比较两组患者治疗前后美国国立卫生研究院卒中量表(NIHSS)、改良Rankin量表(mRS)、改良Barthel指数(MBI)评分及血清同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CRP)水平,并评定两组临床疗效。结果:治疗后,两组患者NIHSS、mRS评分及血清Hcy、hs-CRP水平均较治疗前降低(P<0.05),MBI评分较治疗前升高(P<0.05);观察组患者NIHSS、mRS评分及血清Hcy、hs-CRP水平均低于对照组(P<0.05,P<0.01),MBI评分高于对照组(P<0.01)。观察组总有效率为88.2%(45/51),高于对照组的70.6%(36/51,P<0.05)。结论:针刺可促进AIS溶栓患者神经功能恢复,改善日常生活能力,可能与降低炎性因子水平从而抑制炎性反应、改善脑血管缺血后再灌注损伤有关。Objective To observe the effects of acupuncture on neurologic function and serum inflammatory factors in patients after thrombolysis in acute ischemic stroke(AIS).Methods A total of 102 AIS patients with onset to treatment time(OTT)≤3 h were randomly divided into an observation group and a control group,51 cases each group.In the control group,thrombolysis and conventional medical treatment were applied.On the basis of the treatment as the control group,acupuncture at Shuigou(GV 26),Zhongwan(CV 12),Qihai(CV 6),Neiguan(PC 6),etc.was applied in the observation group,30 min each time,once a day.Both groups were treated for 2 weeks.Before and after treatment,the scores of National Institutes of Health stroke scale(NIHSS),modified Rankin scale(mRS),modified Barthel index(MBI)and serum level of homocysteine(Hcy),hypersensitive C-reactive protein(hs-CRP)were compared,and the clinical efficacy was evaluated in the two groups.Results After treatment,the scores of NIHSS,mRS and serum level of Hcy,hs-CRP were decreased compared with those before treatment(P<0.05),while the MBI scores were increased(P<0.05)in the two groups.The scores of NIHSS,mRS and serum level of Hcy,hs-CRP in the observation group were lower than those in the control group(P<0.05,P<0.01),the MBI score in the observation group was higher than that in the control group(P<0.01).The total effective rate was 88.2%(45/51)in the observation group,which was superior to 70.6%(36/51)in the control group(P<0.05).Conclusion Acupuncture could promote the recovery of neurologic function in patients after thrombolysis in AIS,improve the ability of daily living,which may be related to reducing the level of inflammatory factors,thus inhibiting inflammatory response and improving cerebral ischemia reperfusion injury.

关 键 词：急性缺血性脑卒中 针刺 溶栓 神经功能 炎性因子 随机对照试验 

分 类 号：R246.6[医药卫生—针灸推拿学]