电针对急性脑出血患者疗效及血清AQP4含量的影响  

Efficacy of electroacupuncture on acute intracerebral hemorrhage and its effect on serum AQP4 in patients

作　　者：倪思铭 吕鹤群 徐疏影 彭拥军 NI Si-ming;LV He-qun;XU Shu-ying;PENG Yong-jun(Department of Acupuncture-Moxibustion and Rehabilitation,Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,Jiangsu Province,China)

机构地区：[1]南京中医药大学附属医院针灸康复科,江苏南京210029

出　　处：《中国针灸》2023年第10期1099-1103,共5页Chinese Acupuncture & Moxibustion

基　　金：国家自然科学基金面上项目:82174484、81973932;江苏省中医院高峰学术人才项目:k2021rc24;江苏省第六期“333高层次人才培养工程”项目;江苏省普通高校研究生科研创新计划项目:SJCX22_0738。

摘　　要：目的:在常规西医治疗基础上,观察电针对急性脑出血(ICH)患者神经功能、生活能力、精神状态方面及血清水通道蛋白4(AQP4)含量的影响。方法:将72例急性ICH患者随机分为观察组(36例,脱落4例)及对照组(36例,脱落2例)。对照组予常规西医治疗(包括止血、预防再出血、调控血压、减轻神经水肿、降低颅内压等),观察组在对照组治疗基础上联合电针治疗,穴取水沟,患侧内关、三阴交等,同侧三阴交、内关连接电针正负极,予疏密波,频率2 Hz/100 Hz,强度以患者耐受为度,每次30 min,每天1次,每周6次。两组均治疗2周。于治疗前后,观察两组患者美国国立卫生研究院卒中量表(NIHSS)评分、改良Barthel指数(MBI)评分、简易智能精神状态检查量表(MMSE)评分,ELISA法检测血清AQP4含量,并比较两组疗效及安全性。结果:治疗后,两组患者NIHSS评分、血清AQP4含量降低(P<0.05),MBI、MMSE评分升高(P<0.05);观察组NIHSS评分、血清AQP4含量低于对照组(P<0.05),MBI、MMSE评分高于对照组(P<0.05)。观察组总有效率为93.8%(30/32),高于对照组的73.5%(25/34,P<0.05)。两组患者均未出现不良反应及不良事件,均较安全。结论:在常规西医治疗基础上,电针治疗可有效改善急性ICH患者神经功能、生活能力、精神状态,降低血清AQP4含量,初步提示电针能有效治疗ICH可能与其调控血清AQP4含量有关。Objective To observe the effects on neural function,living ability and mental state of the patients with acute intracerebral hemorrhage(ICH),as well as aquaporin 4(AQP4)in the serum after treated with electroacupuncture(EA)on the base of routine therapy of western medicine.Methods Seventy-two acute ICH patients were randomized into an observation group(36 cases,4 cases dropped off)and a control group(36 cases,2 cases dropped off).In the control group,the conventional treatment was delivered such as stopping bleeding,preventing re-hemorrhage,controlling blood pressure,mitigating neural edema and reducing intracranial pressure.In the observation group,on the base of the treatment in the control group,EA was supplemented.Acupoints included Shuigou(GV 26),bilateral Neiguan(PC 6)and Sanyinjiao(SP 6)etc.Electric stimulation was operated at Neiguan(PC 6)and Sanyinjiao(SP 6)on the same side,with disperse-dense wave,and 2 Hz/100 Hz in frequency,tolerable current intensity.Electric stimulation was delivered for 30 min in each treatment,once daily and for 6 times per week.The duration of treatment was 2 weeks in the two groups.Before and after treatment,changes of the scores of National Institutes of Health stroke scale(NIHSS),modified Barthel index(MBI)and mini-mental state examination(MMSE),as well as AQP4 content in the serum were observed in the two groups;the efficacy and safety were compared between the two groups.Results The NIHSS scores and the serum AQP4 content decreased after treatment when compared with those before treatment in the two groups(P<0.05),while,MBI and MMSE scores increased(P<0.05).In the observation group,NIHSS score and serum AQP4 content were lower than those of the control group(P<0.05),and MBI and MMSE scores were higher(P<0.05).The total effective rate of the observation group was 93.8%(30/32),higher than that of the control group(73.5%,25/34,P<0.05).The treatment in the two groups was safe,without adverse reactions and events occurring in the patients.ConclusionElectroacupuncture,on the base

关 键 词：急性脑出血 电针 水通道蛋白4 随机对照试验 

分 类 号：R246.2[医药卫生—针灸推拿学]