针刺联合穴位注射治疗新生儿缺氧缺血性脑病:随机对照研究

Neonatal hypoxic ischemic encephalopathy treated with acupuncture combined with acupoint injection:a randomized controlled trial

目的:观察针刺联合穴位注射神经生长因子与胞磷胆碱钠静脉点滴及肌肉注射神经生长因子治疗新生儿缺氧缺血性脑病的临床疗效差异。方法:61例新生儿缺氧缺血性脑病患儿随机分为观察组(32例)和对照组(29例)。观察组采用针刺联合穴位注射神经生长因子,选穴百会、大椎、风府,每穴0.5mL,每天1次;对照组采用胞磷胆碱钠静脉点滴及肌肉注射神经生长因子,两组均7天为一疗程,共治疗3个疗程。分别于治疗7天、14天、21天后观察两组临床疗效、行为神经测定积分和不良反应。结果:治疗7天、14天、21天后观察组总有效率分别为50.0%(16/32)、68.8%(22/32)、78.1%(25/32),对照组分别为69.0%(20/29)、72.4%(21/29)、82.8%(24/29),在7天时间点对照组优于观察组(P<0.05);两组治疗7天、14天、21天行为神经测定积分均较治疗前明显提高(P<0.05,P<0.01),在7天时间点,对照组优于观察组(P<0.05),在14天、21天时组间差异无统计学意义(均P>0.05);观察组不良反应发生率低于对照组[14.3%(5/35)vs 31.4%(11/35),P<0.05],且程度较轻。结论:针刺联合穴位注射治疗新生儿缺氧缺血性脑病,1周时总体疗效不如胞磷胆碱钠静脉点滴及肌肉注射神经生长因子,但随着疗程的延长,疗效逐步提高,且不良反应少。

Objective To observe the clinical efficacy difference in the treatment of neonatal hypoxie ischemic encephalopathy （NHIE） between the combined therapy of acupuncture and acupo^nt injection of nerve growth factor （NGF） and the combined therapy of the intravenous drop of citicoline sodium and intramuscular injection of NGF. Methods Sixty-one cases of NHIE were randomized into an observation group （32 cases） and a control group （29 cases）. In the observation group, acupuncture combined with acupint injection of NGF was adopted. The aeupoints were Baihui （GV 20）, Dazhui （GV 14） and Fengfu （GV 16）, 0.5 mL each acupoint, once a day. In the control group, the intravenous drop of citieoline sodium and intramuscular injection of NGF were used. The treatment of 7 days made one session and 3 sessions were required. Separately, in 7, 14 and 21 days of treatment, the clinical efficacy, behavior nerve determination score and adverse reaction were observed in the two groups. Results In 7, 14 and 21 days of treatment, the total effective rates were 50.0% （16/32）, 68.8% （22/32） and 78.1% （25/32） in the observation group and were 69.0% （20/29）, 72.4% （21/29） and 82.8% （24/29） in the control group. The result in the control group was better than that in the observation group in the 7 days （P〈 0.05）. The behavior determination scores in 7, 14 and 21 days were all improved obviously as compared with those before treatment in the two groups （P〈0.05, P〈0.01）. The score in the control group was better than that in the observation group in the 7 days （P%0. 05）. The differences were not significant in the scores between the two groups in 14 and 21 days （both P〉0.05）. The incidence of adverse reaction in the observation group was lower than that in the control group [14.3% （5/35） vs 31.4% （11/35）, P〈0.05] and the severity was mild. Conclusion In the lreatment of NHIE with the combined therapy of acupuncture and acupint injection, the overall efficacy in 1 week is inferior to thai of the combined therapy of the intravenous drop of citicoline sodium and intramuscular injection of NGF. But the efficacy is improved gradually along with the treatment progression and the adverse reaction is less.