不同时机介入醒脑开窍针刺法对急性脑梗死的效果及炎症因子和VEGF的影响  

The effect of xinnao kaiqiao acupuncture at different interventions on acute cerebral infarction and its impact on inflammatory factors and VEGF

作　　者：刘姗 白雪 陆亮亮[1] 易兴阳[3] 谢娟 卿婷 蹇睿 LIU Shan;BAI Xue;LU Liangliang(Department of Neurology,Jingyang District Hospital of Traditional Chinese Medicine,Deyang 61800,China;Department of Neurology,Affiliated Hospital of Traditional Chinese Medicine,Southwest Medical University,Luzhou 646000,China)

机构地区：[1]德阳市旌阳区中医院神经内科,四川德阳618000 [2]西南医科大学附属中医医院神经内科,四川泸州646000 [3]德阳市人民医院神经内科,四川德阳618000 [4]成都中医药大学附属医院德阳医院神经内科,四川德阳618000 [5]德阳市第二人民医院神经内科,四川德阳618000

出　　处：《四川中医》2025年第2期192-197,共6页Journal of Sichuan of Traditional Chinese Medicine

基　　金：四川省中医药管理局科技项目(编号:2021MS180)。

摘　　要：目的:观察不同时机介入醒脑开窍针刺法对急性脑梗死(Acute Cerebral Infarction,ACI)患者的临床影响。方法:选择2021年3月~2022年12月就诊于本院和协作单位发病24小时内的ACI住院患者,数字化随机1∶1分为对照组和观察组。两组均接受相同的基础治疗,观察组于发病24小时内介入醒脑开窍针刺治疗,对照组于发病72小时后介入,采用美国国立卫生院卒中量表(National Institutes of Health Stroke Scale,NIHSS)、BI指数(Barthel Index)、改良Rankin量表(Modified Rankin Scale,mRS)和血清肿瘤坏死因子-α(Tumor Necrosis Factor-α,TNF-α)、白介素-6(Interleukin-6,IL-6)、血管内皮生长因子(Vascular Endothelial Growth Factor,VEGF)指标评估临床疗效。结果:观察组总有效率显著高于对照组(P<0.05)。两组患者治疗后的NIHSS评分、mRS评分和BI指数较入院时均改善,且观察组优于对照组(P<0.05);观察组治疗14天时血清TNF-α和IL-6水平较对照组低(P<0.05);治疗后观察组的VEGF水平显著高于对照组(P<0.05);3个月随访观察组mRS评分0~1分的比例高于对照组(P<0.05)。结论:24小时内介入醒脑开窍针刺法治疗ACI患者能有效改善临床症状,减少神经功能缺损,提高患者日常生活自理能力,减少3月残疾率。Objective:To observe the clinical effects of different timing interventions of Xinnao Kaiqiao acupuncture on patients with Acute Cerebral Infarction(ACI).Methods:ACI inpatients who attended our hospital and collaborating units within 24 hours of the onset of the disease from March 2021 to December 2022 were selected and digitally randomized 1∶1 into a control group and an observation group.Both groups received the same basic treatment,and the observation group was intervened within 24 hours of the onset of ACI,while the control group was intervened after 72 hours of the onset of ACI,using the National Institutes of Health Stroke Scale(NIHSS),the Barthel Index(BI),the Modified Rankin Scale(Modified).The National Institutes of Health Stroke Scale(NIHSS),BI Index(Barthel Index),Modified Rankin Scale(mRS),and serum tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),vascular endothelial growth factor(VEGF),and other factors were used.Vascular Endothelial Growth Factor(VEGF)indicators to assess the clinical efficacy.Results:The total effective rate of the observation group was significantly higher than that of the control group(P<0.05).The NIHSS,mRS and BI of patients in both groups improved after treatment compared with those at admission,and the observation group was better than the control group(P<0.05);the serum TNF-αand IL-6 levels in the observation group were lower than those in the control group at 14 days of treatment(P<0.05);the VEGF level in the observation group was significantly higher than that in the control group after treatment(P<0.05);the proportion of mRS scores 0~1 was higher in the observation group than in the control group at 3-month follow-up.Conclusion:The 24-hour intervention of Xinnao Kaiqiao acupuncture method for treating ACI patients can effectively improve clinical symptoms,reduce neurological deficits,improve the patientsability to take care of themselves in daily life,and reduce the 3-month disability rate.

关 键 词：醒脑开窍针刺法 急性脑梗死 炎症因子 VEGF 

分 类 号：R245[医药卫生—针灸推拿学]