针灸联合替罗非班对急性进展性脑梗死的疗效研究  

Effect of acupuncture and moxibustion combined with tirofiban on patients with acute progressive cerebral infarction

作　　者：刘勇[1,3] 张美云[2] 胡冠群[2] 刘玲凤 LIU Yong;ZHANG Mei yun;HU Guanqun;LIU Lingfeng(People′s Hospital Clinical School,Tianjin Medical University,Tianjin 300070,China;Department of Neurology,Tianjin Union Medical Center,Tianjin 300121,China;Department of Neurology,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Hebei Medical University,Cangzhou 061000,China)

机构地区：[1]天津医科大学人民医院临床学院,天津300070 [2]天津市人民医院神经内科,天津300121 [3]河北医科大学附属沧州中西医结合医院神经内科,沧州061000

出　　处：《天津医科大学学报》2024年第3期245-249,共5页Journal of Tianjin Medical University

基　　金：河北省卫生健康委员会资助项目(20220675)。

摘　　要：目的:分析针灸联合替罗非班对急性进展性脑梗死的疗效。方法:收集2022年8月至2023年7月来天津市人民医院神经内科就诊的114例急性进展性脑梗死患者为研究对象,采用随机对照研究,按随机数字表法分为联合组和对照组,每组57例;对照组给予阿司匹林联合氯吡格雷“双抗”治疗,联合组给予阿司匹林联合氯吡格雷“双抗”治疗+替罗非班联合针灸治疗;记录并比较两组患者临床疗效、美国国立卫生研究院卒中量表(NIHSS)评分、简易智能精神状态检查量表(MMSE)评分、血液流变学指标水平及不良反应。结果:联合组临床总有效率为85.96%(49/57),对照组临床总有效率为68.42%(39/57),联合组显著高于对照组(P<0.05);第7天,联合组NIHSS评分显著低于对照组(P<0.05),MMSE评分与对照组相比无差异(P>0.05);第14天,联合组NIHSS评分显著低于对照组,MMSE评分显著高于对照组(P<0.05);与治疗前相比,第7天和第14天两组NIHSS评分依次显著降低,MMSE评分依次显著升高(均P<0.05)。第7天和第14天,联合组全血高切黏度、全血低切黏度、血浆黏度、红细胞电泳时间均显著低于对照组(均P<0.05)。与治疗前相比,第7天和第14天两组全血高切黏度、全血低切黏度、血浆黏度、红细胞电泳时间均依次显著降低(均P<0.05)。联合组不良反应总发生率为8.77%,对照组为12.28%,两组之间比较差异无统计学意义(P>0.05)。结论:针灸联合替罗非班治疗急性进展性脑梗死患者的疗效显著,有效降低了NIHSS评分,提高了MMSE评分,并改善患者血液流变学指标,用药安全性高。Objective:To analyze the impacts of acupuncture and moxibustion combined with tirofiban on patients with acute progressive cerebral infarction.Methods:A total of 114 patients with acute progressive cerebral infarction who visited the Department of Neurology,Tianjin Union Medical Center from August 2022 to July 2023 were enrolled in this study.A randomized single blind controlled study was conducted.They were divided into a combination group and a control group using a random number table method,with 57 cases in each group.The control group was given aspirin combined with clopidogrel"dual antiplatelet therapy(DAPT)"treatment,and the combined group was given aspirin combined with clopidogrel"dual antiplatelet therapy(DAPT)"treatment+tirofiban combined with acupuncture and moxibustion treatment.The clinical efficacy,National Institutes of Health Stroke Scale(NIHSS)scores,Mini Mental State Examination(MMSE)scores,levels of hemorheological indicators,and adverse reactions between two groups were recorded and compared.Results:The total clinical effective rate of the combination group was 85.96%(49/57),while that of the control group was 68.42%(39/57),the combination group were obviously higher than the control group(P<0.05);on the 7th day,the NIHSS score of the combined group was significantly lower than that of the control group(P<0.05),while the MMSE score showed no difference compared with the control group(P>0.05);on the 14th day,the NIHSS score of the combined group was significantly lower than that of the control group,while the MMSE score was significantly higher than that of the control group(P<0.05).Compared with before treatment,the NIHSS scores in both groups on the 7th and 14th day decreased significantly,while the MMSE scores increased significantly(all P<0.05).On the 7th and 14th day,the whole blood high shear viscosity,whole blood low shear viscosity,plasma viscosity,and red blood cell electrophoresis time in the combination group were significantly lower than those in the control group(all P<0.05).Compa

关 键 词：针灸 替罗非班 急性进展性脑梗死 神经功能 血液流变学 

分 类 号：R277.7[医药卫生—中医学]