醒脑开窍针法联合改良强制性运动疗法对脑梗死患者血清铁代谢的影响  

Effect of Consciousness-Restoring and Orifice-Opening Acupuncture Combined with Modified Constraint Induced Movement Therapy on Serum Iron Metabolism in Patients with Cerebral Infarction

作　　者：王开欣 胡采红 罗涛[2] 魏从兵 WANG Kaixin;HU Caihong;LUO Tao;WEI Congbing(The Affiliated Hospital of China University of Geocsciences,Wuhan 430074,Hubei,China;Wuhan Central Hospital,Wuhan 430074,Hubei,China)

机构地区：[1]中国地质大学(武汉)医院,湖北武汉430074 [2]华中科技大学同济医学院附属武汉市中心医院,湖北武汉430074

出　　处：《辽宁中医杂志》2024年第12期158-162,共5页Liaoning Journal of Traditional Chinese Medicine

基　　金：武汉市卫生健康委员会科研立项项目(XG202005070060)。

摘　　要：目的观察醒脑开窍针法联合改良强制性运动疗法(modified constraint induced movement therapy,mCIMT)治疗脑梗死的临床疗效以及对血清铁代谢的影响。方法选取2020年7月—2022年10月68例脑梗死患者随机分为综合治疗组(34例)和mCIMT组(34例)。mCIMT组予强化训练患侧上肢和限制健侧上肢康复技术治疗;综合治疗组在mCIMT组基础上予醒脑开窍针法治疗。比较两组脑梗死患者临床疗效、美国国立卫生研究院卒中量表(National Institutes of Health stroke scale,NIHSS)评分、简化Fugl-Meyer评定法(Fugl-Meyer Assessment,FMA)评分、改良Barthel指数(modified Barthel index,MBI)评分、血清铁蛋白(ferritin,FE)、血清转铁蛋白(transferrin,TRF)、血清总铁结合力(total iron-binding capacity,TIBC)水平。结果治疗后,两组脑梗死患者NIHSS评分、血清FE水平均低于治疗前(P<0.01),FMA评分、MBI评分、血清TRF水平、血清TIBC水平均高于治疗前(P<0.01);综合治疗组NIHSS评分、血清FE水平均低于mCIMT组,FMA评分、MBI评分、血清TRF水平、血清TIBC水平均高于mCIMT组(P<0.01)。综合治疗组临床有效率高于mCIMT组[91.18%(31/34)vs 70.59%(24/34)](P<0.05)。结论醒脑开窍针法联合mCIMT治疗脑梗死患者疗效确切,能够改善神经缺损程度、运动功能、日常生活能力和血清铁代谢水平,值得临床进一步推广应用。Objective To observe the clinical efficacy and the influence on serum iron metabolism of consciousness-restoring and orifice-opening acupuncture combined with modified constraint induced movement therapy(mCIMT)in the treatment of cerebral infarction.Methods Sixty-eight patients with cerebral infarction from July 2020 to October 2022 were randomly divided into multimodality therapy group(34 cases)and mCIMT group(34 cases).The mCIMT group was treated with enhanced training of the affected upper limb and limited rehabilitation techniques for the healthy upper limb.The multimodality therapy group was treated with consciousness-restoring and orifice-opening acupuncture on the basis of the mCIMT group.The clinical efficacy,National Institutes of Health stroke scale(NIHSS)score,Fugl-Meyer Assessment(FMA)score,modified Barthel index(MBI)score,serum ferritin(FE),serum transferrin(TRF)and serum total iron-binding capacity(TIBC)were compared between the two groups.Results After treatment,NIHSS score and serum FE level were lower while the scores of FMA and MBI and the serum levels of TRF and TIBC were higher than those before treatment in both groups(P<0.01).NIHSS score and serum FE level in the multimodality therapy group were lower while the scores of FMA and MBI and the serum levels of TRF and TIBC were higher than those in the mCIMT group(P<0.01).The clinical effective rate of the multimodality therapy group was higher than that of the mCIMT group[91.18%(31/34)vs 70.59%(24/34)](P<0.05).Conclusion Consciousness-restoring and orifice-opening acupuncture combined with mCIMT has a remarkable efficacy on patients with cerebral infarction,which can improve neurologic deficits,motor function,activity of daily living and serum iron metabolism level.It is worthy of further promoting and applying in clinical practice.

关 键 词：脑梗死 醒脑开窍针法 改良强制性运动疗法 铁蛋白 转铁蛋白 总铁结合力 

分 类 号：R25[医药卫生—中医内科学]