电针刺激联合高压氧治疗对高血压脑出血患者神经功能及认知能力的影响

Effects of electroacupuncture combined with hyperbaric oxygen therapy on neural function and cognitive ability in patients with hypertensive cerebral hemorrhage

目的探讨电针刺激联合高压氧(HBO)治疗对高血压脑出血患者神经功能及认知能力的影响。方法选取2016年1月至2019年6月国药葛洲坝中心医院神经内科收治的180例高血压脑出血患者作为研究对象,按照随机数字表法分为HBO组(n=60)、电针组(n=60)及HBO联合电针组(联用组,n=60)。比较治疗前后3组患者临床疗效、脑水肿、神经功能及认知能力的改善情况。结果治疗2、4个疗程后,3组患者绝对脑水肿体积及相对脑水肿体积逐渐降低,且联用组患者绝对脑水肿体积及相对脑水肿体积较HBO组及电针组显著减小,差异均有统计学意义(P<0.05)。治疗4个疗程后,联用组治疗总有效率(91.67%)显著高于HBO组(81.67%)和电针组(76.67%),差异均有统计学意义(P<0.05)。3组患者血清神经元特异性烯醇化酶(NSE)及S100β蛋白水平较治疗前明显降低,且联用组患者血清NSE及S100β蛋白水平低于HBO组和电针组,差异均有统计学意义(P<0.05)。3组患者简易精神状态检查量表(MMSE)评分及Barthel指数评分较对照组显著上升,且联用组患者MMSE评分改善明显优于HBO组及电针组,差异有统计学意义(P<0.05)。结论电针联合HBO治疗通过电刺激及改善缺血缺氧能有效减轻患者的脑水肿,修复脑神经损伤,从而改善患者的认知功能。

Objective To explore the effects of electroacupuncture combined with hyperbaric oxygen(HBO)therapy for the improvement of the neural function and cognitive ability in patients with hypertensive cerebral hemorrhage.Methods A total of 180 patients with hypertensive cerebral hemorrhage admitted in Department of Neurology of the Sinopharm-Gezhouba Central Hospital of China Three Gorges University from the January of 2016 to the June of 2019 were selected and randomly divided into hyperbaric oxygen group(HBO group)(n=60),electric acupuncture group(EA group)(n=60),and EA combined HBO treatment group(EA+HBO group)(n=60)by random number table method.The clinical curative effect and the improvements of cerebral edema,neural function,and cognitive ability were compared in the three groups before and after treatment.Results After 2 and 4 courses of the treatment,the absolute cerebral edema volume and relative cerebral edema volume of the patients were gradually decreased,and the absolute volumes in the EA+HBO group were significantly decreased compared with those in the HBO group and the EA group with statistically significant differences(P<0.05).After 4 courses of the treatment,the total effective rate of the EA+HBO group was 91.67%,which was significantly higher than those of the HBO group(81.67%)and the EA group(76.67%)with statistically significant differences(P<0.05).The serum neuron-specific enolase(NSE)and S100βlevels of the three groups were significantly lower than those before the treatments,and the levels in the EA+HBO group were lower than those in other two groups.The differences were statistically significant(P<0.05).After treatment,the mini-mental state examination(MMSE)score and Barthel index score of the patients were significantly increased(P<0.05),and the improvement of MMSE score in the EA+HBO group was significantly better than those in the HBO group and the EA group with statistically significant differences(P<0.05).Conclusion Electroacupuncture combined with HBO can effectively reduce cerebral edema,repair cerebral nerve damage,and improve patients′cognitive function through electrical stimulation and abatement of ischemia and hypoxia.