丁苯酞联合针刺对急性缺血性脑卒中患者神经功能的影响

Effect of butylphthalide combined with acupuncture on neurological function in patients with acute ischemic stroke

目的观察丁苯酞注射液联合针刺治疗对急性缺血性脑卒中(AIS)患者神经功能的影响。方法回顾性分析70例AIS患者的临床资料,将于常规治疗基础上予以丁苯酞联合针刺治疗的35例纳入A组,将同期于常规治疗基础上仅予以针刺治疗的35例纳入B组。于治疗前(T1)和治疗14 d后(T2),检测两组血清神经元特异性烯醇化酶(NSE)、S-100β水平及大脑前动脉(ACA)、中动脉(MCA)、后动脉(PCA)血流速度(Vm),评估患者神经功能[神经功能缺损评分量表(NIHSS)]和日常活动能力[改良Barthel指数评定量表(MBI)]。观察不良反应情况。结果 T2时,两组NIHSS评分和血清S-100β、NSE水平均较T1时降低,且A组低于B组(P <0.05);MBI评分和ACA、MCA、PCA的Vm则均较T1时升高,且A组高于B组(P <0.05)。两组不良反应率比较无统计学差异(P> 0.05)。结论丁苯酞注射液联合针刺治疗可显著改善AIS患者神经功能、日常活动能力和颅内血流动力学状态,减轻脑组织损伤,且安全性良好。

Objective To explore the effect of butylphthalide injection combined with acupuncture on neurological functions of patients with acute ischemic stroke (AIS). Methods The clinical data of 70 patients with AIS were divided into group A and group B for retrospective analysis (n=35, respectively). The patients treated with butylphthalide combined with acupuncture on the basis of routine treatment were included in group A, and those treated with acupuncture only on the basis of routine treatment at the same time were included in group B. Before the treatment (T1) and 14 d after the treatment (T2), the serum levels of neuron specific enolase (NSE), S-100β and the blood flow velocity (Vm) of anterior cerebral artery (ACA), middle cerebral artery (MCA), posterior cerebral artery (PCA) were measured, and the neurological function (National Institute of Health stroke scale, NIHSS) and daily activity (Modified Barthel Index, MBI) of the patients were evaluated. The adverse reactions were observed. Results At T2, the NIHSS score and serum S-100β as well as NSE levels of the two groups were lower than those at T1, and those of group A were lower than those of group B (P < 0.05), while MBI scores and the Vm of ACA, MCA and PCA were higher than those at T1, and those of group A was higher than those of group B (P < 0.05). There was no significant difference in the rate of adverse reactions between the two groups (P > 0.05). Conclusion Butylphthalide injection combined with acupuncture can significantly improve the neurological function, daily activity and intracranial hemodynamics in patients with AIS, and reduce brain tissue injury, with good safety.