神经节苷脂穴位注射、针刺联合亚低温对缺血缺氧性脑病新生儿疗效观察

Observation on Effect of Acupoint Injection of Ganglioside and Acupuncture Combined with Mild Hypothermia on Neonates with Hypoxic Ischemic Encephalopathy

目的探讨神经节苷脂穴位注射、针刺联合亚低温对缺血缺氧性脑病(hypoxic-ischemic encephalopathy,HIE)新生儿的疗效。方法选取2017年1月—2019年6月该院收治的HIE患儿86例,按随机数字表法分为观察组(n=43)与对照组(n=43)。对照组在常规治疗的基础上给予亚低温治疗,持续72 h;观察组在对照组的基础上给予神经节苷脂穴位注射、针刺治疗,连续治疗28 d。统计并比较治疗后两组的临床疗效;比较两组患儿治疗前后新生儿行为神经功能(NBNA)评分、肌酸激酶脑型同工酶(CK-BB)水平以及血清神经功能及肌酸激酶同工酶(CK-MB)、肌红蛋白(MYO)、脑钠肽(BNP)水平;比较两组不良反应发生情况;比较两组后遗症发生情况。结果与对照组比较,治疗后观察组总有效率显著升高(P<0.05);与治疗前比较,治疗后两组患儿NBNA评分均升高,且观察组高于对照组(P<0.05);与治疗前比较,治疗后两组患儿血清CK-BB水平及CK-MB、MYO、BNP水平均降低,且观察组低于对照组(P<0.05);治疗期间,对照组不良反应发生率为9.30%(4/43),观察组不良反应发生率为6.98%(3/43),两组比较差异无统计学意义(P>0.05);观察组脑瘫后遗症发生率(2.33%,1/43)低于对照组(18.60%,8/43)(P<0.05)。结论神经节苷脂穴位注射、针刺联合亚低温治疗HIE可显著提高临床疗效,降低患儿血清CK-BB、CK-MB、MYO及BNP水平,促进神经功能恢复,缓解病情,且后遗症发生率较低,安全性较高。

Objective To investigate the effect of acupoint injection of ganglioside and acupuncture combined with mild hypothermia in neonates with ischemic hypoxic encephalopathy(HIE).Methods Eighty-six children with HIE treated in our hospital from January 2017 to June 2019 were selected and divided into observation group(n=43)and control group(n=43)according to the random number table method.The control group was given mild hypothermia on the basis of conventional treatment for 72 h.The observation group was given ganglioside acupoint injection and acupuncture on the basis of the control group continuously for 28 days.We counted and compared the clinical effects of the two groups after treatment.The neonatal behavioral nerve function(NBNA)score,creatine kinase brain isoenzyme(CK-BB)level and serum creatine kinase isoenzyme(CK-MB),myoglobin(MYO)and brain natriuretic peptide(BNP)levels were compared between the two groups before and after treatment.We compared the incidence of adverse reactions and the incidence of sequelae between the two groups.Results Compared with that of the control group,the total effective rate in the observation group was increased significantly after treatment(P<0.05).Compared with those before treatment,the NBNA scores in both groups were increased after treatment,and the observation group’s score was higher than that of the control group(P<0.05).Compared with those of before treatment,the serum levels of CK-BB,CK-MB,MYO and BNP in both groups were decreased after treatment,and the observation group’s levels were lower than those of the control group(P<0.05).During treatment,the incidence of adverse reactions in the control group was 9.30%(4/43),and that in the observation group was 6.98%(3/43),and there was no significant difference between the two groups(P>0.05).The incidence of sequelae of cerebral palsy in the observation group(2.33%,1/43)was lower than that in the control group(18.60%,8/43)(P<0.05).Conclusion Acupoint injection of gangliosides and acupuncture combined with mild hypothermia in the treatment of HIE can significantly improve the clinical efficacy,reduce the serum levels of CK-BB,CK-MB,MYO and BNP in children,promote neurological recovery and alleviate the condition,and the incidence of sequelae is low with higher security.