电针对脑卒中患者的疗效及其对肠道菌群的影响  

Effect of Electroacupuncture on intestinal microflora abundance in stroke patients and its therapeutic evaluation

作　　者：尹韬 袁伟渠 缑燕华[1] 于海波[1] 彭少林[2] 毕钰桢[2] YIN Tao;YUAN Weiqu;GOU Yanhua;YU Haibo;PENG Shaolin;BI Yuzhen(Acupuncture and Moxibustion Department of Shenzhen Traditional Chinese Medicine Hospital,Shenzhen,Guangdong 518033,China;不详)

机构地区：[1]深圳市中医院针灸科,广东518033 [2]深圳市中医院老年医学科,广东518033

出　　处：《中国微生态学杂志》2023年第11期1323-1328,共6页Chinese Journal of Microecology

基　　金：广东省中医药管理局科研项目(20201306)。

摘　　要：目的 探讨电针对脑卒中患者的疗效及对患者肠道菌群丰度的影响,为该类患者的治疗提供参考。方法 选取我院40例脑卒中患者在中风常规针刺基础上,予以电针治疗(双侧天枢穴、双侧足三里穴、双侧曲池穴),最后纳入30例患者为观察组,同时另选取30例健康者作为对照组。观察治疗前后患者的神经功能恢复状态(m RS评分),同时收集患者新鲜粪便标本,用16S rDNA高通量测序技术检测肠道菌群结构。结果 经电针治疗,30例患者m RS评分显著改善,其中显效26例,治愈2例,无效2例,临床总有效率为93.3%。与对照组比较,脑卒中患者治疗前粪便中拟杆菌门丰度减少,厚壁菌门丰度增加,拟杆菌门/厚壁菌门(B/F)比例显著减少(均P<0.05);且梭菌纲作为厚壁菌门下的主要细菌纲其丰度显著增加(P<0.05)。治疗后观察组患者粪便中拟杆菌门丰度较对照组和同组治疗前均显著增加(均P<0.05),厚壁菌门丰度较对照组显著增加,但较治疗前显著减少(均P<0.05);B/F比例较对照组减少,而较治疗前显著增加(均P<0.05)。结论 电针可有效治疗脑卒中,同时可通过调节肠道B/F比例,增加有益菌,减少炎症相关致病菌,改善肠道菌群结构。Objective To explore the therapeutic effect of electroacupuncture on stroke and its influence on the abundance of intestinal flora in patients with stroke. Methods Based on routine acupuncture for stroke, 40 patients with stroke were selected to receive electroacupuncture treatment (bilateral Tianshu points, bilateral Zusanli points, and bilateral Quchi points). Finally, 30 patients were included in observation group, while another 30 healthy individuals were enrolled as control group. After a series of interventions, the neurological recovery status (mRS score) of patients before and after treatment was observed, and fresh stool samples were collected. The structure of intestinal flora was detected using 16S rDNA high throughput sequencing technology. Results After electroacupuncture treatment, the mRS scores of observation group patients were significantly improved, with 26 cases showing significant effect, 2 cases cured, and 2 cases ineffective. The total clinical efficiency rate was 93.3%. Before treatment, compared with the control group, the abundance of Bacteroides in the feces of observation group patients decreased, while that of Bacteroides increased, and the proportion of Bacteroides/Firmicutes (B/F) significantly decreased (all P<0.05). The abundance of Clostridia as the main class of bacteria under the Firmicutes increased significantly (P<0.05). After treatment, the abundance of Bacteroides in the feces of patients increased significantly compared to the control group and before treatment (all P<0.05). Compared with the control group, the abundance of Firmicutes in observation group increased, but lower than before treatment. The B/F ratio in observation group was lower than control group but higher than before treatment (P<0.05). Conclusion Electroacupuncture can treat stroke with significant efficacy. By adjusting the ratio of B/F, Electroacupuncture can increase metabolic beneficial bacteria, reduce inflammation related pathogenic bacteria, and improve intestinal flora structure.

关 键 词：电针 脑卒中 肠道菌群 

分 类 号：R246.9[医药卫生—针灸推拿学]