不同针灸介入时机对大脑中动脉供血区急性脑梗死神经功能预后的影响  

Effect of Different Acupuncture Intervention Timing on Prognosis of Neurological Function in Acute Cerebral Infarction with Middle Cerebral Artery

作　　者：杨利[1] 何晓宏[1] 王小慧 李梦雪[1] 姚生荣 YANG Li;HE Xiaohong;WANG Xiaohui;LI Mengxue;YAO Shenrong(Affiliated Hospital of Qinghai University,Xining 810000,Qinghai,China)

机构地区：[1]青海大学附属医院,青海西宁810000

出　　处：《中华中医药学刊》2024年第5期196-200,共5页Chinese Archives of Traditional Chinese Medicine

基　　金：青海省医药卫生科技项目(2021-wjzdx-44)。

摘　　要：目的观察不同针灸介入时机对大脑中动脉供血区急性脑梗死神经功能预后的影响。方法回顾性选取2020年1月—2022年8月收治的116例大脑中动脉供血区急性脑梗死患者的临床资料进行分析,根据针灸介入时机分为两组。两组均进行静脉溶栓及常规药物治疗,观察组61例患者于发病72 h内给予针灸治疗,对照组55例患者于发病2周时给予针灸治疗。检测两组不同时间点侧支循环代偿情况、脑损伤标志物的水平,评估两组不同时间点简易精神状态检查(Mini-mental state examination,MMSE)评分、神经功能评分、Barthel指数(Barthel index,BI)评分、肢体运动功能评分、中医症状评分的差异,统计两组疗效。结果治疗前,两组侧支循环代偿情况比较,差异无统计学意义(P>0.05)。治疗4周和随访时,两组患侧大脑前动脉平均血流速度与对侧大脑中动脉平均血流速度的比值(Ratio of the average flow ve⁃locity of the affected anterior cerebral artery to the average flow velocity of the contralateral middle cerebral artery,iVACA/cVM⁃CA)较治疗前升高,观察组同时间点较对照组更高(P<0.05);两组患侧大脑后动脉平均血流速度与对侧大脑中动脉平均血流速度的比值(Ratio of the average flow velocity of the affected posterior cerebral artery to the average flow velocity of the contralateral middle cerebral artery,iVPCA/cVMCA)与治疗前比较,差异无统计学意义(P>0.05)。治疗前,两组脑损伤标志物比较,差异无统计学意义(P>0.05)。治疗4周和随访时,两组脑源性神经营养因子(Brain-derived neurotrophic factor,BDNF)较治疗前升高,观察组同时间点较对照组更高(P<0.05);两组钙结合蛋白β(Calcium binding proteinβ,S100β)、神经胶质纤维酸性蛋白(Glial fibrillary acid protein,GFAP)较治疗前下降,观察组同时间点较对照组更低(P<0.05)。治疗前,两组Fugl-Meyer评分、中医症状评分等相关评分比较,差异无统计学意义(P>Objective To observe the effect of different acupuncture intervention timing on the prognosis of neurological func⁃tion in acute cerebral infarction with middle cerebral artery.Methods The clinical data of 116 patients with acute cerebral infarc⁃tion in the middle cerebral artery blood supply area admitted to the hospital from January 2020 to August 2022 were retrospective⁃ly analyzed,and divided into two groups according to the timing of acupuncture intervention.Both groups received intravenous thrombolysis and conventional drug therapy.Sixty-one patients in the observation group received acupuncture treatment within 72 hours of onset,and fifty-five patients in the control group received acupuncture treatment within 2 weeks of onset.Collateral circulation compensation and brain injury markers of the two groups were detected at different time points.Mini-Mental State Examination(MMSE)score,neurological function score and Barthel index(BI)score,limb motor function score,traditional Chi⁃nese medicine symptom score were evaluated at different time points in the two groups.Results Before treatment,there was no significant difference in collateral circulation compensation between the two groups(P>0.05).At 4 weeks of treatment and follow-up,the ratio of the average flow velocity of the affected anterior cerebral artery to the affected anterior cerebral artery.Ratio of the average flow velocity of the affected anterior cerebral artery to the affected anterior cerebral artery average flow velocity of the contralateral middle cerebral artery(iVACA/cVMCA)was higher than that before treatment,and the ration of the observation group was higher than that of the control group at the same time point(P<0.05).The ratio of the average flow velocity of the af⁃fected posterior cerebral artery to the two groups.Ratio of the average flow velocity of the affected posterior cerebral artery to the two groups the average flow velocity of the contralateral middle cerebral artery(iVPCA/cVMCA)was not significantly different from th

关 键 词：针灸 大脑中动脉供血区 急性脑梗死 脑损伤标志物 脑血流 神经功能 

分 类 号：R246.1[医药卫生—针灸推拿学]