通督调神针刺法治疗风痰瘀阻型急性脑梗死临床观察

Clinical Effect of Tongdu Tiaoshen Acupuncture in Treatment of Acute Cerebral Infarction with Wind-phlegm Stasis Syndrome

目的从炎性因子水平探究通督调神针刺法治疗急性脑梗死的作用机制。方法将40例风痰瘀阻型急性脑梗死患者随机分为治疗组和对照组,每组20例。对照组患者接受改善脑循环、抗血小板聚集、保护神经等治疗措施,治疗组患者加用通督调神针刺疗法。采用改良Rankin量表(modified Rankin scale,mRS)和美国国立卫生研究院卒中量表(NIH Stroke Scale,NIHSS)评价脑梗死后神经功能缺损,治疗前后分别检测血浆白细胞介素-6(interleukin-6,IL-6)和超敏C反应蛋白(high sensitive C-reactive protein,hsCRP)水平。结果治疗组临床疗效明显优于对照组,差异具有统计学意义(P<0.05)。治疗1周后,两组IL-6水平显著降低(P<0.05),hs-CRP水平显著升高(P<0.05),且治疗组IL-6和hs-CRP水平显著低于对照组(P<0.05)。治疗4周后,两组IL-6和hs-CRP水平较治疗1周后明显下降(P<0.05);两组IL-6和hs-CRP水平比较,差异无统计学意义(P>0.05)。治疗4周后,两组NIHSS和mRS评分均较治疗前明显下降(P<0.05),且治疗组NIHSS和mRS评分降低程度显著大于对照组(P<0.05)。结论通督调神针刺法改善风痰瘀阻型急性脑梗死患者神经功能缺损的机制与降低血浆IL-6、hs-CRP水平有关。

Objective To investigate the mechanism of action of Tongdu Tiaoshen Acupuncture in the treatment of acute cerebral infarction based on the levels of inflammatory factors.Methods A total of 40 patients with acute cerebral infarction with wind-phlegm stasis syndrome were randomly divided into treatment group and control group, with 20 patients in each group.The patients in the control group were given treatment to improve cerebral circulation, inhibit platelet aggregation, and protect the nerves, and those in the treatment group were given Tongdu Tiaoshen Acupuncture in addition to the treatment in the control group.The modified Rankin scale （mRS） and National Institutes of Health Stroke Scale （NIHSS） were used to evaluate neurological defects after cerebral infarction, and the plasma levels of interleukin-6 （IL-6） and high-sensitivity C-reactive protein （hs-CRP） were measured before and after treatment.Results The treatment group had a significantly better clinical outcome than the control group （P〈0.05）.After 1 week of treatment, both groups had a significant reduction in IL-6 level （P〈0.05） and a significant increase in hs-CRP level （P〈0.05）, and the treatment group had significantly lower levels of IL-6 and hs-CRP than the control group （P〈0.05）.After 4 weeks of treatment, both groups had significant reductions in the levels of IL-6 and hs-CRP （P〈0.05）, and there were no significant differences in the levels of IL-6 and hs-CRP between the two groups （P〉0.05）.After 4 weeks of treatment, both groups had significant reductions in NIHSS and mRS scores （P〈0.05）, and the treatment group had significantly greater reductions compared with the control group （P〈0.05）.Conclusion Tongdu Tiaoshen Acupuncture can improve neurological defects in patients with acute cerebral infarction with wind-phlegm stasis syndrome, possibly by reducing the plasma levels of IL-6 and hs-CRP.