醒脑开窍针刺与巴曲酶治疗脑梗死疗效及炎症细胞因子检测

Efficacies of Brain-activating and Orifice-opening Acupuncture Versus Batroxobin in Treating Cerebral Infarction and Determination of Inflammatory Cytokine

目的观察醒脑开窍针刺与巴曲酶治疗急性脑梗死的临床效果及炎症细胞因子检测结果。方法 80例脑梗死患者随机分成药物组(巴曲酶)40例,针药组(醒脑开窍联合巴曲酶)40例,另以同期体检正常、年龄相配30例为对照组。比较药物组和针药组患者0 d、15 d、30 d美国国立卫生研究院卒中量表(NIHSS)、改良的Rankin量表(MRS)评分及肿瘤坏死因子-(TNF-)和C-反应蛋白(CRP)、白介素-6(IL-6)变化,并观察治疗前后MRI变化。结果治疗前药物组和针药组TNF-和CRP水平、IL-6均显著高于对照组(P<0.01);与药物组比较,针药组NIHSS、MRS明显改善(P<0.01);治疗后两组患者TNF-及CRP水平、IL-6均有所下降,针药组15 d及30 d两种细胞因子水平低于药物组(P<0.05,P<0.01),接近对照组水平;与药物组比较,针药组治疗后平均缺血面积较小(P<0.05)。结论醒脑开窍针刺联合巴曲酶治疗可降低急性脑梗死TNF-及CRP和IL-6水平,有效控制缺血面积的扩大,改善急性脑梗死神经功能缺损。

Objective To investigate the clinical efficacies of brain-activating and orifice-opening acupuncture versus batroxobin in treating cerebral infarction and the results of inflammatory cytokine determination. Method Eighty patients with cerebral infarction were randomly allocated to a medication （batroxobin） group of 40 cases and an acupuncture plus medication （brain-activating and orifice-opening acupuncture plus batroxobin） group of 40 cases. At the same time, 30 age-matched persons with normal physical examination findings were enrolled as a control group. The National Institute of Health Stroke Scale （NIHSS） scores, the Modified Rankin Scale （MRS） scores, tumor necrosis factor-α （TNF-α）, C-reaction protein （CRP） and interleukin-6 （IL-6） levels were compared between the medication and acupuncture plus medication groups of patients before treatment and at 15 and 30 days after. Post-treatment changes in MRI were observed. Result Before treatment, TNF-ct, CRP and IL-6 levels were significantly higher in the medication and acupuncture plus medication groups than in the control group （P〈0.01）. The NIHSS and MRS scores decreased significantly in the acupuncture plus medication group after treatment compared with the medication group （P〈 0.05）. TNF-α, CRP and IL-6 levels decreased somewhat in the two groups of patients after treatment. The levels of two kinds of cytokines were lower in the acupuncture plus medication group than in the medication group （P〈0.05,P〈0.01） and close to those in the control group at 15 and 30 days after treatment. Compared with the medication group, the number of patients with the enlargement of ischemia area was small in the acupuncture plus medication group （P〈0.05） and the average ischemia area was also small in the acupuncture plus medication group （P〈0.05） after treatment. Conclusion Brain-activating and orifice-opening acupuncture plus batroxobin can reduce TNF-α, CRP and IL-6 levels, effectively prevent the enlargement of ischemia area and improve neurological deficits in acute cerebral infarction.