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王 祎1 罗建昌2 李 璟3▲.中医互动式针刺对急性脑梗死稳定期患者的疗效及炎症因子水平和脑血流动力学的影响[J].中国现代医生,2021,59(27):17-20
中医互动式针刺对急性脑梗死稳定期患者的疗效及炎症因子水平和脑血流动力学的影响
Effect of TCM interactive acupuncture on the efficacy,inflammatory factor levels,and cerebral hemodynamics in patients with stable acute cerebral infarct
  
DOI:
中文关键词:  中医  互动式针刺  理疗  急性脑梗死  康复
英文关键词:TCM  Interactive acupuncture  Physiotherapy  Acute cerebral infarction  Rehabilitation
基金项目:国家自然科学基金面上项目(8167151276)
作者单位
王 祎1 罗建昌2 李 璟3▲ 1.浙江省台州市中心医院(台州学院附属医院)康复科浙江台州 3180002.浙江省台州市立医院针灸推拿康复科浙江台州 3180003.上海中医药大学附属岳阳中西医结合医院针灸科上海 200437 
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中文摘要:
      目的 研究中医互动式针刺对急性脑梗死(Acute cerebral infarct,ACI)稳定期患者的疗效及炎症因子水平和脑血流动力学的影响。方法 选取2018 年1 月至2019 年4 月我院收治的150例ACI 稳定期患者,采用随机数字表法分为针灸组和常规组各75例,两组患者均予以基础康复治疗,针灸组在康复治疗基础上给予中医互动式针刺治疗。比较两组患者干预前后的运动功能、巴氏指数(Barthel index,BI)、局部脑血流量、大脑中动脉(Middle cerebral artery,MCA)平均血流速度(Mean blood flow velocity,Vm)、血清超敏C 反应蛋白(Serum high sensitivity C-reactive protein,hs-CRP)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、白细胞介素-8(Interleukin-8,IL-8)、特异性神经元烯醇化酶(Specific neuron enolase,NSE)、脑源性神经营养因子(Brain derived neurotrophic factor,BDNF)水平。结果 干预前,针灸组和常规组患者血清hs-CRP、TNF-α、IL-8、NSE、BDNF水平差异均无统计学意义(P>0.05);干预后,针灸组患者的血清hs-CRP、TNF-α、IL-8、NSE水平均低于常规组(P<0.05),BDNF水平显著高于常规组(P<0.05);干预前,针灸组和常规组患者局部脑血流量、MCA的Vm 相比,差异均无统计学意义(P>0.05);干预后,针灸组患者的局部脑血流量、MCA的Vm水平显著高于常规组(P<0.05);干预前,针灸组和常规组患者FIM 评分、BI 评分差异均无统计学意义(P>0.05);干预后,针灸组患者的BI 评分显著高于常规组(P<0.05),FIM 评分显著高于常规组(P<0.05)。结论 中医互动式针刺结合常规理疗应用于ACI 患者康复治疗中能显著降低炎性因子水平,改善患者的脑血流动力学指标、肢体运动、日常生活活动能力,值得推广应用。
英文摘要:
      Objective To study the effect of TCM interactive acupuncture on the efficacy,inflammatory factor levels,and cerebral hemodynamics in patients with stable acute cerebral infarct(ACI).Methods One hundred and fifty patients with stable ACI admitted to our hospital from January 2018 to April 2019 were randomly divided into the acupuncture group (n=75) and the conventional group (n=75).The two groups were treated with basic rehabilitation therapy.The acupuncture group was also given interactive acupuncture treatment of traditional Chinese medicine.The motor function,Barthel index (BI),regional cerebral blood flow,mean blood flow velocity (Vm) of the middle cerebral artery(MCA),serum high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),interleukin-8(IL-8),specific neuronal enolase (NSE),and brain-derived neurotrophic factor (BDNF) levels were compared between the two groups before and after the intervention.Results Before the intervention,there was no significant difference in serum hs-CRP,TNFα,IL-8,NSE,and BDNF levels between the acupuncture group and the conventional group(P>0.05).After the intervention,the serum hs-CRP,TNF-α,IL-8,and NSE levels in the acupuncture group were lower than those in the conventional group (P<0.05).The BDNF level in the acupuncture group was significantly higher than that in the conventional group (P<0.05).Before the intervention,there was no significant difference in regional cerebral blood flow and Vm of MCA between the acupuncture group and the conventional group (P>0.05).After the intervention,the regional cerebral blood flow and Vm level of MCA in the acupuncture group were significantly higher than those in the conventional group (P<0.05).Before the intervention,there was no significant difference in FIM score and BI score between the acupuncture group and the conventional group (P>0.05).After the intervention,the BI score in the acupuncture group was significantly higher than that in the conventional group (P<0.05),and the FIM score was significantly higher than that in the conventional group (P<0.05).Conclusion Interactive acupuncture combined with conventional physiotherapy in the rehabilitation therapy of patients with ACI can significantly reduce inflammatory factors,improve the cerebral hemodynamic parameters,limb movement,and activities of daily living,which is worthy of promotion and application.
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