针灸配合康复理疗对脑出血患者神经功能及血清NSE水平的影响

Effect of Acupuncture Combined with Rehabilitation Physiotherapy on Nerve Function and Serum NSE Level in Patients with Cerebral Hemorrhage

目的:观察针灸配合康复理疗对脑出血患者神经功能及血清神经特异性烯醇化酶(NSE)水平的影响。方法:选取116例脑出血患者,按随机数字表法分为对照组和观察组各58例。对照组给予常规干预,观察组在对照组基础上给予针灸配合康复理疗。比较2组临床疗效,分析干预前后血清生化指标,并评价预后生活质量。结果:观察组总有效率为87.93%,高于对照组72.41%,差异有统计学意义(P<0.05)。干预前,2组美国国立卫生研究院卒中量表(NIHSS)评分比较,差异无统计学意义(P>0.05)。干预后1个月、3个月,2组NIHSS评分逐渐降低,且观察组NIHSS评分均低于同一时间点对照组,差异均有统计学意义(P<0.05)。干预前,2组NSE、中枢神经特异蛋白(S100-β)、内皮素-1 (ET-1)、丙二醛(MDA)、肿瘤坏死因子-α(TNF-α)水平比较,差异均无统计学意义(P>0.05)。干预后,2组NSE、S100-β、ET-1、MDA、TNF-α水平较治疗前降低(P<0.05),且观察组NSE、S100-β、ET-1、MDA、TNF-α水平均低于对照组(P<0.05)。随访6个月后,观察组脑卒中影响量表(SIS)各维度评分及总分均高于对照组,差异均有统计学意义(P<0.05)。结论:针灸配合康复理疗可有效降低NSE、氧化应激指标、炎性因子等水平,从而提高临床治疗效果。

Objective:To observe the effect of the therapy of acupuncture and rehabilitation physiotherapy on the nerve function and level of neurospecific enolase(NSE) in serum in patients with cerebral hemorrhage. Methods : A total of116 patients with cerebral hemorrhage were selected and divided into the control group and the observation group according to the random number table method,58 cases in each group. The control group was given routine intervention,and the observation group was additionally given acupuncture and rehabilitation physiotherapy based on the treatment of the control group. The clinical effect was compared between the two groups, and the biochemical indexes in serum were analyzed before and after intervention,and the prognostic quality of life was evaluated. Results:The total effective rate was 87.93%in the observation group,higher than that of 72.41% in the control group,the difference being significant(P<0.05). Before intervention,there was no significant difference in the comparison of scores of the National Institute of Health Stroke Scale(NIHSS) between the two groups(P>0.05). One month after intervention and three months after intervention, the NIHSS scores in both groups were gradually decreased,and those in the observation group were all lower than those in the control group at the same time point,differences being significant(P<0.05). Before intervention,there was no significant difference in the comparison of the levels of NSE,S100-β protein(S100-β),endothelin-1(ET-1),malondialdehyde(MDA),and tumor necrosis factor-α(TNF-α) between the two groups(P>0.05). After intervention,the levels of NSE,S100-β,ET-1,MDA and TNF-α in both groups were decreased when compared with those before treatment, and the above levels in the observation group were lower than those in the control group(P<0.05). After follow-up for six months,the score of each dimension in Stroke Impact Scale(SIS) and the total score of SIS in the observation group were all higher than those in the control group, differences being significant(P<0.05). Conclusion: The therapy of acupuncture and rehabilitation physiotherapy can effectively reduce the levels of NSE, oxidative stress indexes and inflammatory cytokines, so as to improve the clinical therapeutic effect.