针刺配合早期康复训练治疗急性脑梗死临床研究

Clinical Study on Acupuncture plus Early-stage Rehabilitation Training for Acute Cerebral Infarction

目的观察针刺配合早期康复训练对急性脑梗死患者神经功能及血清缺血修饰清蛋白(IMA)和神经元特异性烯醇化酶(NSE)水平的影响。方法将68例急性脑梗死患者随机分为治疗组和对照组,每组34例。对照组给予常规药物治疗,治疗组在对照组基础上采用针刺配合早期康复训练治疗。两组均每日治疗1次,10 d为1个疗程。治疗3个疗程后,观察两组治疗前后血清IMA及NSE水平的变化情况,比较两组治疗前后临床神经功能缺损程度评分(MESSS)、日常生活能力评分(BI)及Fugl-Meyer运动功能量表评分(FMA)。结果两组治疗后MESSS、BI及FMA评分与同组治疗前比较,差异均具有统计学意义(P<0.01)。治疗组治疗后MESSS、BI及FMA评分与对照组比较,差异具有统计学意义(P<0.05)。两组治疗后血清IMA、NSE水平与同组治疗前比较,差异均具有统计学意义(P<0.01)。且治疗组治疗后血清IMA、NSE水平均明显低于对照组(P<0.01)。结论针药并用配合早期康复训练能促进急性脑梗死患者神经功能恢复,这与有效降低血清NSE、IMA水平有关。

Objective To observe the effect of acupuncture plus early-stage rehabilitation training on the neurological function and levels of serum ischemia-modified albumin （IMA） and neuron-specific enolase （NSE） in patients with acute cerebral infarction.Method Sixty-eight patients with acute cerebral infarction were randomized into a treatment group and a control group, 34 cases each. The control group was intervened by conventional medications, while the treatment group was intervened by acupuncture plus early-stage rehabilitation training in addition to the medications given to the control group. The two groups were both treated once a day, 10 d as a treatment course. Three treatment courses later, the changes of serum IMA and NSE levels were observed; the Modified Edinburgh-Scandinavian Stroke Scale （MESSS）, Barthel Index （BI） and Fugl-Meyer Assessment （FMA） scores were compared before and after the treatment.Result The MESSS, BI and FMA scores were significantly changed in both groups after the intervention （P〈0.01）. After the intervention, the MESSS, BI and FMA scores in the treatment group were significantly different from those in the control group （P〈0.05）. The serum IMA and NSE levels were significantly changed in both groups after the intervention （P〈0.01）. After the treatment, the serum IMA and NSE levels in the treatment group were markedly lower than those in the control group （P〈0.01）.Conclusion Acupuncture medication combined plus early-stage rehabilitation training can promote the recovery of neurological function of acute cerebral infarction patients, which is related to the down-regulation of serum NSE and IMA levels.