温针灸对高血压脑出血恢复期气虚血瘀患者S100B、MMP-9、Hcy及炎性因子水平的影响

Effects of Warm Needling on the Levels of S100B,MMP-9,Hcy and Inflammatory Factors in Patients with Remission-stage Hypertensive Cerebral Hemorrhage Due to Qi Deficiency and Blood Stasis

目的观察温针灸治疗高血压脑出血恢复期气虚血瘀患者的临床疗效及对血清S100B蛋白(S100B)、基质金属蛋白酶-9(MMP-9)、同型半胱氨酸(Hcy)、脑源性神经营养因子(BDNF)和炎性因子水平的影响。方法高血压脑出血恢复期气虚血瘀患者共98例,将其随机分为对照组(49例)和观察组(49组)。对照组采用西医常规治疗,观察组在对照组治疗基础上联合温针灸治疗,两组均治疗4周。比较两组临床疗效,比较两组治疗前后神经功能缺损评估(NIHSS)评分和血清S100蛋白(S100B)、基质金属蛋白酶-9(MMP-9)、同型半胱氨酸(Hcy)、脑源性神经营养因子(BDNF)及炎性因子水平。结果观察组总有效率为91.8%,高于对照组的69.4%,两组差异具有统计学意义(P<0.05)。观察组治疗2周后、治疗后的NIHSS评分均低于对照组(P<0.05)。治疗后,观察组血清S100B、MMP-9、Hcy、白介素(IL)-18、IL-6水平均低于对照组(P<0.05),而观察组血清BDNF水平高于对照组(P<0.05)。结论温针灸联合药物治疗可提高高血压脑出血恢复期气虚血瘀患者的临床疗效,有助于减轻脑出血恢复期患者炎症反应,促进神经功能修复。

Objective To observe the clinical efficacy of warm needling in treating patients with hypertensive cerebral hemorrhage in remission stage due to qi deficiency and blood stasis and its effects on the levels of serum S100B protein(S100B),matrix metalloproteinase(MMP)-9,homocysteine(Hcy),brain-derived neurotrophic factor(BDNF)and inflammatory factors.Method A total of 98 patients with remission-stage hypertensive cerebral hemorrhage differentiated as qi deficiency and blood stasis were randomized into a control group of 49 cases and an observation group of 49 cases.The control group was intervened by conventional Western medicine treatment,while the observation group was given additional warm needling treatment,lasting for 4 weeks in both groups.Clinical efficacy was compared between the two groups,as well as the score of National Institute of Health stroke scale(NIHSS)and the levels of serum S100B,MMP-9,Hcy,BDNF and inflammatory factors before and after treatment.Result The total effective rate was 91.8%in the observation group,higher than 69.4%in the control group,and the difference was statistically significant(P<0.05).The NIHSS score was lower in the observation group than in the control group at 2-week treatment and at the end of treatment(P<0.05).After treatment,the levels of serum S100B,MMP-9,Hcy,interleukin(IL)-18 and IL-6 were all lower in the observation group than in the control group(P<0.05),and the serum BDNF level was higher in the observation group than in the control group(P<0.05).Conclusion Warm needling plus medication can enhance the clinical efficacy in treating patients with remission-stage hypertensive cerebral hemorrhage differentiated as qi deficiency and blood stasis;it is beneficial to the reduction of inflammatory reactions and the repair of neurological function in remission-stage cerebral hemorrhage.