针康法对缺血性卒中患者肠道菌群及血清TNF-α、IL-18的影响

Effects of acupuncture-rehabilitation therapy on intestinal flora and serum TNF-α and IL-18 in the patients with ischemic stroke

目的观察头穴丛刺长留针配合康复训练对缺血性卒中患者治疗前后肠道菌群及血清中肿瘤坏死因子-α(TNF-α)及白细胞介素-18(IL-18)水平的影响。方法将符合纳入标准的82例患者随机分为A组(头穴丛刺组)、B组(康复训练组)和C组(针康法治疗组),观察3组患者治疗前与治疗后14 d肠道菌群及血清炎性因子水平的变化。结果治疗14 d后患者肠道内有益菌(乳酸杆菌、双歧杆菌)数量均高于本组治疗前,而肠道内致病菌(肠球菌、小梭菌)数量均低于本组治疗前,且C组肠道菌群改善较其他两组更为显著(P <0. 05)。治疗14 d后各组血清中TNF-α、IL-18含量均观察到明显下降,其中C组炎性因子水平明显低于A、B组(P <0. 05)。结论头穴丛刺长留针配合康复训练对缺血性脑卒中患者有着调节肠道菌群和抑制炎性因子释放的作用,其临床疗效优于单纯的头穴丛刺或康复训练。

Objective To observe the effects on intestinal flora and serum TNF-α and IL-18 treated with clustering needling at scalp points and rehabilitation training in the patients with ischemic stroke.Methods A total of 80 eligible patients were randomized into A group(clustering needling at scalp points),B group(rehabilitation training)and C group(acupuncture-rehabilitation therapy).Before and 14 days after treatment,intestinal microflora and serum inflammatory factor levels were observed in the three groups.Results At 14 days of treatment,the intestinal probiotic counts(Lactobacillus and Bifidobacterium)were higher than the counts before treatment and the pathogenic bacteria counts(Enterococcus and Clostridium lactis)lower than the counts before treatment.In the C group,the improvements of the intestinal flora was more significant than the other two groups( P <0.05).At 14 days of treatment,the levels of TNF-α and IL-18 were all reduced obviously in each group,of which,the levels of inflammatory factors in the C group were reduced more obviously than the A and B groups( P <0.05).Conclusion The clustering needling at scalp points combined with rehabilitation training plays the positive roles for regulating intestinal flora and inhibiting the release of inflammatory factors in the patients with ischemic stroke.The clinical therapeutic effects are better than the simple clustering needling at scalp points or rehabilitation training.