醒脑开窍针法联合纳美芬治疗颅脑损伤昏迷患者效果观察

Effect of “Xingnao Kaiqiao” acupuncture combined with nalmefene hydrochloride on patients with cerebral injury and coma

目的探讨醒脑开窍针法联合盐酸纳美芬在颅脑损伤昏迷患者促醒中的应用效果。方法选择2017年5月至2018年11月上海市第三康复医院接诊的94例颅脑损伤昏迷患者作为研究对象,采用随机数表法分为对照组和观察组各47例。对照组给予醒脑开窍针法治疗,观察组在对照组治疗的基础上联合盐酸纳美芬治疗,一个疗程后对患者效果进行评估,一个疗程后比较两组患者的脑血流水平、格拉斯哥昏迷量表(GCS)评分、神经功能障碍(DRS)评分及预后。结果观察组治疗一个疗程后的血流流动速度(VS)、平均血流速度(VM)分别为(92.13±4.32)cm/s、(57.56±4.61)cm/s,明显高于对照组的(87.54±4.15)cm/s、(50.33±4.12)cm/s,差异均有统计学意义(P<0.05);观察组治疗一个疗程后的脑血流波动指数(PI)为0.51±0.01,明显低于对照组的0.56±0.02,GCS评分为(12.31±0.87)分,明显高于对照组的(8.53±0.68)分,DRS评分为(4.21±0.49)分,明显低于对照组的(10.49±0.98)分,差异均有统计学意义(P<0.05);观察组治疗后的良好、中残率分别为72.34%和10.64%,明显高于对照组的44.68%和6.38%,差异均有统计学意义(P<0.05)。结论醒脑开窍针法联合盐酸纳美芬治疗颅脑损伤能改善患者的脑血流水平,降低神经功能障碍,获得良好的治疗效果。

Objective To investigate the effect of“Xingnao Kaiqiao”acupuncture combined with nalmefene hydrochloride on the wakefulness of patients with craniocerebral injury and coma. Methods A total of 94 patients with craniocerebral injury and coma who were admitted to the Third Rehabilitation Hospital of Shanghai City from May 2017 to November 2018 were selected as the study subjects, who were divided into the control group and the observation group by random number table method, with 47 patients in each group. Patients in the control group were treated with “Xingnao Kaiqiao”Acupuncture, while those in the observation group were treated with nalmefene hydrochloride on the basis of the treatment of the control group. The effect of the patients was evaluated after one course of treatment. After one course of treatment, the cerebral blood flow levels of the two groups were compared, as well as the Glasgow Coma Scale (GCS) score, neurological dysfunction (DRS) score, and prognosis. Results The flow velocity (VS) and mean blood flow velocity (VM) of the observation group were (92.13±4.32) cm/s and (57.56±4.61) cm/s, respectively, significantly higher than (87.54±4.15) cm/s and (50.33±4.12) cm/s in the control group (P<0.05). The cerebral blood flow fluctuation index (PI) of the observation group after one course of treatment was 0.51±0.01, significantly lower than 0.56±0.02 in the control group;GCS score was (12.31±0.87) points, significantly higher than (8.53±0.68) points in the control group;DRS score was (4.21±0.49) points, significantly lower than (10.49±0.98) points in the control group (P<0.05). The good rate and moderate disability rate of the observation group were 72.34% and 10.64%, respectively, which were significantly higher than 44.68% and 6.38% of the control group;the differences were statistically significant (P<0.05). Conclusion “Xingnao Kaiqiao”acupuncture combined with nalmefene hydrochloride in the treatment of craniocerebral injury can improve the cerebral blood flow level, reduce neurological dysfunction, and obtain good therapeutic effect.