通督调神针刺法对缺血性卒中后轻度认知功能障碍患者血管内皮功能及炎症因子水平的影响  

Effects of Tongdu Tiaoshen acupuncture on vascular endothelial function and inflammatory factors in patients with mild cognitive impairment after ischemic stroke

作　　者：刘辉[1] 李佩芳[1] 孙培养[1] 吴杰[1] 李难[1] 刘诗洋 张芳 王宇[1] Liu Hui;Li Peifang;Sun Peiyang;Wu Jie;Li Nan;Liu Shiyang;Zhang Fang;Wang Yu(Department of Encephalopathy,the Second Affiliated Hospital of Anhui University of Chinese Medicine,Hefei 230061,China)

机构地区：[1]安徽中医药大学第二附属医院脑病科,合肥230061

出　　处：《国际中医中药杂志》2024年第2期175-180,共6页International Journal of Traditional Chinese Medicine

基　　金：安徽省高校自然科学基金重点项目(KJ2020A0428);安徽省教育厅重点项目(2022AH050501);安徽中医药大学第二附属医院杏林计划项目(0500-48-31)。

摘　　要：目的探讨通督调神针刺法对缺血性卒中(IS)后轻度认知功能障碍(MCI)患者血管内皮功能及炎症因子水平的影响。方法回顾性分析2020年1月-2022年9月本院71例IS后MCI患者的临床资料, 按治疗方法分为通督调神针刺组31例与常规体针组40例。2组均口服尼莫地平片, 在此基础上常规体针组给予常规体针治疗, 通督调神针刺组给予通督调神针刺法治疗。2组均14 d为1个疗程, 共治疗2个疗程。分别于治疗前后采用放射免疫法检测血清NO、内皮素-1(ET-1)水平, ELISA法检测血清碱性成纤维细胞生长因子(bFGF)、VEGF水平及血浆同型半胱氨酸(Hcy)、IL-6水平;采用蒙特利尔认知评估量表(MoCA量表)、简易智力状态检查量表(MMSE)评估患者认知功能及智力水平, 评价临床疗效。结果通督调神针刺组总有效率为90.32%(28/31)、常规体针组为70.00%(28/40), 2组比较差异有统计学意义(χ^(2)=4.33, P=0.037)。通督调神针刺组治疗后血浆Hcy、IL-6水平低于常规体针组(t值分别为2.57、9.36, P<0.05或P<0.01);血清bFGF、VEGF、NO水平高于常规体针组(t值分别为10.03、9.29、8.17, P<0.01), ET-1水平低于常规体针组(t=2.41, P=0.019);通督调神针刺组治疗后MoCA量表评分[(28.24±4.45)分比(25.32±4.34)分, t=2.78]、MMSE量表评分[(28.73±1.44)分比(28.02±1.22)分, t=2.25]高于常规体针组(P<0.01)。结论通督调神针刺法有利于改善IS后MCI患者的血管内皮功能, 降低炎症因子水平, 促进认知功能及智力水平的恢复, 提高临床疗效。Objective To explore the effects of Tongdu Tiaoshen acupuncture on vascular endothelial function and inflammatory factors in patients with mild cognitive impairment(MCI)after ischemic stroke(IS).Methods A retrospective analysis was performed on the clinical data of 71 patients with MCI after IS in the hospital between January 2020 and September 2022.According to different treatment methods,they were divided into Tongdu Tiaoshen acupuncture group(n=31,Tongdu Tiaoshen acupuncture+oral nimodipine tables)and routine body-acupuncture group(n=40,routine body-acupuncture group+oral nimodipine tables).Both groups were treated for 2 courses(14 d/course).Before and after treatment,levels of serum NO and endothelin-1(ET-1)were detected by radioimmunoassay,and levels of serum basic fibroblast growth factor(bFGF)and vascular endothelial growth factor(VEGF),plasma homocysteine(Hcy)and IL-6 were detected by ELISA.The cognitive function of patients was evaluated and intelligence level by Montreal Cognitive Assessment Scale(MoCA),Mini-Mental State Examination(MMSE)and the clinical curative effect was also evaluated.Results The total response rates in Tongdu Tiaoshen acupuncture group and routine body-acupuncture group were 90.32%(28/31)and 70.00%(28/40),and the difference between the two groups was statistically significant(χ^(2)=4.33,P=0.037).After treatment,levels of plasma Hcy and IL-6 in Tongdu Tiaoshen acupuncture group were lower than those in the routine body-acupuncture group(t=2.57,9.36,P<0.05 or P<0.01).After treatment,levels of serum bFGF,VEGF and NO in Tongdu Tiaoshen acupuncture group were significantly higher than those in the routine body-acupuncture group(t=10.03,9.29,8.17,P<0.01),while ET-1 level was significantly lower than that of the routine body-acupuncture group(t=2.41,P=0.019).After treatment,MoCA score[(28.24±4.45)vs.(25.32±4.34),t=2.78],MMSE score[(28.73±1.44)vs.(28.02±1.22),t=2.25]in Tongdu Tiaoshen acupuncture group were higher than those in the routine body-acupuncture group(P<0.01).Conclusion Ton

关 键 词：缺血性卒中 认知功能障碍 碱性成纤维细胞生长因子 血管内皮生长因子 炎症因子 

分 类 号：R246.6[医药卫生—针灸推拿学]