不同刺法对急性脑梗塞患者CRP水平影响的临床研究

Study on effects of different acupuncture therapies on serum Creactive protein level in patients with acute cerebral infarction

目的:探讨醒脑开窍针法、头体针法、头针法及体针法4种不同刺法在不同时间段对急性脑梗塞(ACI)患者血清C反应蛋白(CRP)水平的影响,并观察4种针法对ACI神经功能恢复的影响。方法:选择2005年6月～2006年6月深圳市中医院针灸科、急诊科急诊住院ACI患者126例,随机分为4组,包括醒脑开窍针刺法组(32例),头体针结合组(31例),头针组(31例)和体针组(32例),4组患者在常规对症治疗的基础上,分别加用醒脑开窍针法、头体针、单纯头针和单纯体针4种针法,分别在第1天治疗前、第3、7、15天观察各组患者血清CRP水平的变化,并对各组患者进行临床疗效评定。结果:在第1天治疗前,醒脑开窍针刺法组(1组)、头体针组(2组)、单纯头针组(3组)和单纯体针组(4组)4组患者血清CRP水平无明显差异(P>0.05);第3、7、15天时,1组、2组的血清CRP水平明显低于3组和4组,差异有统计学意义(P<0.01),而1组与2组相比,CRP水平无显著差异(P>0.05)。第15天时,4组临床疗效评定比较,1组的有效率为96.9%,与2、3、4组相比,差异有统计学意义(P<0.01);第30天时,4组有效率分别为96.9%、93.5%、71.0%和68.75%,1组与3、4组相比,差异有统计学意义(chi^2=6.09,9.27,P<0.05,P<0.01),2组与3、4组相比,差异有统计学意义(chi^2=5.42,6.28,P<0.05),1、2组相比,临床疗效差别无统计学意义(chi^2=0.00,P>0.05)。结论:醒脑开窍针刺法及头体针结合法较单纯头针或单纯体针法能显著减少急性脑梗塞的炎症反应,而醒脑开窍针刺法对急性脑梗塞早期的神经功能恢复有明显优势。

Object:To explore the effcets of the Xingnao Kaiqiao thera- py,scalp-acupuncture combined with body-acupuncture,scalp- acupuncture and body-acupuncture on the serum C-reactive protein level of patients with acute cerebral infarction in different periods.Methods:One hundred and twenty-six patients were randomly divided into 4 groups:the 1st group with Xingnao Kaiqiao therapy(n =32),the 2nd group with scalp-acupuncture combined with body- acupuncture(n=31),the 3rd group with scalp-acupuncture(n= 31)and the 4th group with body-acupuncture(n=32).The pa- tients in these 4 groups were given relevant methods on the basis of symptomatic treatment of western medicine.We observed the changes of serum C-reactive protein level at the 1st,3rd,7th and 15th day.Meanwhile,we evaluated the clinical effects of patients in each group.Results:The serum C-reactive protein levels in the 4 groups had no difference at the 1st day(P>0.05).On the 3rd,7th and 15th day,the serum C-reactive protein levels in the 1st and 2nd group were obviously lower than in the 3rd and 4th day,with significant difference(P<0.01),but there was no difference between the 1st and 2nd group(P>0.05).At the 15th day,the clinical effective rate was 96.9% in the 1st group,with significant differences as the 1st group compared with other groups(P<0.01).At the 30th day,the clinical effective rates were respectively 96.9%,93.5%,71.0% and 68.75%,with significant differences as the first group compared with the 3rd and 4th group.(chi^2=6.09,9.27,P<0.05,P<0.01)and as the 2nd group comapared with the 3rd and 4th group(chi^2 =5.42,6.28,P<0.05),but there was no difference between the 1st and 2nd group(chi^2=0.00,P>0.05).Conclusion:The Xing- nao Kaiqiao therapy and scalp-acupuncture combined with body- acupuncture are easier to obviously relieve the inflammatory response in the patients with acute cerebral infarction than only scalp-acupuncture or body-acupuncture.However,the Xingnao Kaiqiao therapy has ob- vious effects on the rehabilitation of the neurological functions in the early acute cerebral infarction.