针药结合治疗热瘀型脓毒症脑功能障碍临床观察  

Clinical Observation on Acupuncture Combined with Medicine in Treatment of Sepsis-Induced Brain Dysfunction of Heat Toxin and Blood Stasis Type

作　　者：孙芳园[1] 叶亮 耿欢 吴孝雄 SUN Fangyuan;YE Liang;GENG Huan;WU Xiaoxiong(Shanghai Seventh People′s Hospital of Shanghai University of Traditional Chinese Medicine,Shanghai 200137,China)

机构地区：[1]上海中医药大学附属第七人民医院,上海200137

出　　处：《辽宁中医杂志》2024年第3期180-182,I0007,共4页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(82174189);上海市卫生健康委员会卫生行业临床研究专项(20214Y0281);上海市卫生健康委员会华东片区及市级中医专科专病联盟建设[ZY(2021-2023)-0302];浦东新区卫生系统浦东名中医继承人培养计划(PWRzj2020-02);浦东新区卫生健康委员会学科建设项目重点亚专科(PWZy2020-07);第七人民医院名中医继承人培养计划项目(JCR2022-01)。

摘　　要：目的脓毒症所致脑功能障碍(sepsis-induced brain dysfunction,SIBD)是指非中枢神经系统感染的脓毒症所致的弥漫性脑功能障碍。观察针药结合治疗热瘀型SIBD作用。方法临床试验共有30例患者,分为对照组和治疗组各15例。对照组给予西医标准治疗,治疗组在此基础加用电针和中药治疗。观察基础疾病、病原菌、呼吸机等基线情况;观察治疗前及治疗后7 d的有效率、30 d病死率、格拉斯哥昏迷评分法(Glasgow Coma Scale,GCS)、蒙特利尔认知评估量表(Montreal Cognitive Assessment,MoCA)、神经元特异性烯醇化酶(neuron specific enolase,NSE)、白细胞(white blood cells,WBC)、C反应蛋白(C-reaction protein,CRP)、白细胞介素6(interleukin-6,IL-6)、白细胞介素8(interleukin-8,IL-8)及肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)指标。结果治疗后,治疗组临床疗效优于对照组(P<0.05);治疗组GCS评分、MoCA量表均高于对照组(P<0.05);NSE、WBC、CRP、IL-6低于对照组(P<0.05),两组TNF-α水平差异无统计学意义。结论针药结合治疗热瘀型SIBD可以改善神经系统功能。Objective To observe the effect of acupuncture combined with medicine on sepsis-induced brain dysfunction(SIBD)of heat toxin and blood stasis type.Methods Thirty patients were randomly divided into the observation group and the control group,with 15 cases in each group.The control group was treated with basal treatment for 7 days.On the basis of the control group,the observation group was additionally treated with acupuncture combined with decoction for 7 days.The clinical efficacy and Glasgow Coma Scale(GCS)scores,Montreal Cognitive Assessment(MoCA)scores,neuron specific enolase(NSE),white blood cells(WBC),C-reaction protein(CRP),interleukin-6(IL-6),interleukin-8(IL-8)and tumor necrosis factor-α(TNF-α)of the two groups were observed and compared.Results After treatment,the clinical efficacy of the observation group was higher than that of the control group(P<0.05).GCS scores and MoCA scores of the observation group were higher than those of the control group(P<0.05).The levels of NSE,WBC,CRP,IL-6,IL-8 and TNF-αof the observation group were lower than those of the control group(P<0.05).Conclusion Acupuncture combined with medicine in the treatment of SIBD of heat toxin and blood stasis type can improve the clinical curative effect and nervous system function.

关 键 词：脓毒症脑功能障碍 MOCA NSE 针药结合 

分 类 号：R246[医药卫生—针灸推拿学]