醒脑调神开窍针法联合高压氧治疗一氧化碳中毒迟发性脑病临床疗效及对血清免疫细胞因子和脑脊液神经递质的影响

Efficacy of Xing Nao Kai Qiao Needling Method combined with hyperbaric oxygen in the treatment of delayed encephalopathy after carbon monoxide poisoning and its effect on serum cytokines and brain neurotransmitters

目的观察醒脑调神开窍针法联合高压氧治疗一氧化碳中毒迟发性脑病(DEACMP)的临床疗效及对血清免疫细胞因子和脑脊液神经递质的影响。方法将93例DEACMP患者按照随机数字表法分为2组,均予常规对症治疗,对照组46例加高压氧治疗,治疗组47例在对照组治疗基础上加醒脑调神开窍针法治疗,2组均治疗8周。比较2组临床疗效;比较2组治疗前后血清免疫细胞因子干扰素γ(IFN-γ)、白细胞介素4(IL-4)、转化生长因子-β1(TGF-β1),脑脊液脑神经递质多巴胺(DA)、5-羟色胺(5-HT)、乙酰胆碱(Ach)水平变化。结果治疗组总有效率91.49%(43/47),对照组总有效率76.09%(35/46),治疗组总有效率高于对照组(P<0.05)。治疗后,2组血清IL-4、TGF-β1水平均较本组治疗前升高(P<0.05),IFN-γ水平降低(P<0.05),且治疗组IL-4、TGF-β1水平均高于对照组(P<0.05),IFN-γ水平低于对照组(P<0.05)。治疗后,2组脑脊液DA、5-HT水平均较本组治疗前升高(P<0.05),Ach水平降低(P<0.05),且治疗组DA、5-HT水平均高于对照组(P<0.05),Ach水平低于对照组(P<0.05)。结论醒脑调神开窍针法联合高压氧治疗可提高DEACMP的临床疗效,可能与改善患者免疫功能、调节脑神经递质有关。

Objective To observe the clinical efficacy of Xing Nao Kai Qiao Needling Method combined with hyperbaric oxygen in the treatment of DEACMP and its effect on serum cytokines and brain neurotransmitters. Methods A total of 93 patients with DEACMP were divided into two groups according to the random number table method,the control group were treated with hyperbaric oxygen( n = 46),the treatment group( n = 47) were treated with Xingnao Tiaoshen Kaiqiao acupuncture combined with hyperbaric oxygen on the basis of the control group. Both groups were treated for 8 weeks. 8 weeks after therapy,The clinical efficacy of the two groups was compared;The levels of serum interferon-γ( IFN-γ),interleukin-4( IL-4),transforming growth factor-β1( TGF-β1),dopamine( DA),5-hydroxytryptamine( 5-HT) and acetylcholine( Ach) in cerebrospinal fluid were compared between the two groups before and after treatment. Result The total effective rate of the treatment group was 91. 49%( 43/47),and that of the control group was 76. 09%( 35/46). The total effective rate of the treatment group was higher than that of the control group( P < 0. 05). After treatment,the levels of serum IL-4 and TGF-β1 in the two groups were higher than those before treatment( P < 0. 05),and the level of IFN-γ was lower( P < 0. 05). The levels of IL-4 and TGF-β1 in the treatment group were higher than those in the control group( P < 0. 05),and the level of IFN-γ was lower than that in the control group( P < 0. 05). The levels of DA and 5-HT in cerebrospinal fluid of the two groups were higher than those before treatment( P < 0. 05),and the level of Ach was lower( P <0. 05). The levels of DA and 5-HT in the treatment group were higher than those in the control group( P < 0. 05),and the level of IFN-γ was lower than that in the control group( P < 0. 05). Conclusion Xing Nao Kai Qiao Needling Method combined with hyperbaric oxygen can improve the clinical efficacy of patients with DEACMP,which may be related to the improve of cellular immune function,regulation neurotransmitters.