针灸联合高压氧治疗对重症病毒性脑炎患儿神经功能及脑血流的影响

Effects of acupuncture combined with hyperbaric oxygen on neurological function and cerebral blood flow of children with severe viral encephalitis

目的探讨针灸联合高压氧治疗对重症病毒性脑炎患儿神经功能及脑血流的影响。方法选取2016年8月至2018年12月郑州大学第二附属医院儿科收治的重症病毒性脑炎患儿100例,按随机数字表法分为对照组和观察组,各50例。对照组在常规药物治疗的基础上增加高压氧治疗,观察组在对照组基础上增加针灸治疗,疗程3周。比较2组临床症状及体征恢复时间、美国国立卫生研究院卒中量表(National Institutes of Health stroke scale,NIHSS)评分、格拉斯哥昏迷指数(Glasgow coma scale,GCS)评分、脑血流指标。结果观察组退热时间、头痛呕吐消退时间、意识清醒时间、脑电图好转时间均短于对照组,差异有统计学意义(P<0.05);观察组治疗后NIHSS评分低于对照组,GCS评分高于对照组,差异有统计学意义(P<0.05);治疗后,2组收缩期血流速度、平均血流速度、搏动指数水平低于治疗前,且观察组低于对照组,差异均有统计学意义(P<0.05)。结论针灸联合高压氧治疗重症病毒性脑炎患儿,能有效改善其临床症状及体征,降低神经功能缺损程度,加快意识恢复状态,改善脑血流指标,从而使康复进程得到有效提高.

Objective To investigate the effects of acupuncture combined with hyperbaric oxygen on neurological function and cerebral blood flow of pediatric patients with severe viral encephalitis.Methods A total of 100 pediatric patients with severe viral encephalitis admitted to the Department of Pediatrics of the Second Affiliated Hospital of Zhengzhou University from August 2016 to December 2018 were selected as research objects and randomly divided into the observation group(n=50)and the control group(n=50)by the random number table method.Patients in both groups received conventional medical treatment.The patients in the control group were supplemented with hyperbaric oxygen,while the patients in the observation group were treated with acupuncture on the basis of the treatment in the control group.The clinical symptoms,the recovery time of body signs,the score of National Institute of Health stroke scale(NIHSS),the score of Glasgow coma scale(GCS),and the cerebral blood flow indexes were compared between the two groups.Results The defervescence period,the time required for headache and vomiting to subside,the recovery time of consciousness,and the improvement time of electroencephalogram in the observation group were all shorter than those in the control group,the differences were statistically significant(P<0.05).After treatment,the NIHSS score of the observation group was lower than that of the control group,but the GCS score of the observation group was higher than that of the control group(P<0.05).After treatment,the systolic blood flow velocity(Vs),mean flow velocity(Vm),and pulsatility index(PI)in the two groups were lower than those before treatment,and the above-mentioned indexes of the observation group were lower than those of the control group,the differences were statistically significant(P<0.05).Conclusion In the treatment of severe viral encephalitis in children,acupuncture combined with hyperbaric oxygen can improve the clinical symptoms and signs,alleviate the severity of neurologic impairment,promote the recovery of consciousness,decrease the cerebral blood flow indexes,and speed up rehabilitation.