针刺治疗对脑卒中偏瘫的疗效和对神经因子的影响

Effects of acupuncture on stroke hemiplegia and nerve factors

目的研究急性缺血性脑卒中偏瘫采用针刺治疗的疗效及其对血清脑源性神经营养因子(BDNF)和神经生长因子(NGF)水平的影响。方法2020年1月至12月在青岛中西医结合医院住院的急性缺血性脑卒中偏瘫患者79例,按随机数字表法将患者随机分为常规治疗组39例和针刺治疗组40例。常规治疗组采用西医常规治疗,针刺治疗组在常规治疗的基础上加针刺治疗。应用Fugl-Meyer(FMA)量表评估患者的上下肢肌力,美国国立卫生院卒中量表(NIHSS)评估神经功能,酶联免疫吸附法检测血清BDNF和NGF水平。结果治疗前,两组患者的NIHSS、FMA评分差异无统计学意义(P>0.05);治疗后两组患者NIHSS、FMA评分均较治疗前改善,且针刺治疗组优于常规治疗组,差异有统计学意义(P<0.01)。治疗前,两组患者的BDNF和NGF水平比较差异无统计学意义(P>0.05);治疗后两组患者BDNF和NGF水平均较治疗前升高,且针刺治疗组高于常规治疗组,差异有统计学意义(P<0.05,P<0.01)。结论针刺可改善急性缺血性脑卒中偏瘫肢体功能及神经功能,可能与提高BDNF和NGF水平有关。

Objective To study the effects of acupuncture on hemiplegia following acute ischemic stroke and on the levels of serum brain-derived neurotrophic factor(BDNF)and nerve growth factors(NGF).Methods A total of seventy-nine inpatients with hemiplegia after acute ischemic stroke in Qingdao Integrated Chinese and Western Medicine Hospital from January to December 2020 were enrolled and randomly divided into routine treatment group(n=39)and acupuncture treatment group(n=40).The conventional western medicine was performed in routine group,and the acupuncture treatment was conducted on the basis of conventional treatment in acupuncture group.Fugl-Meyer Assessment(FMA)was used to assess the muscle strength of upper and lower limbs,National Institutes of Health Stroke Scale(NIHSS)was used to evaluate the nerve function,and enzyme-linked immunosorbent assay(ELISA)was used to detect serum BDNF and NGF levels.Results Before treatment,there were no significant differences in NIHSS and FMA scores and the levels of BDNF and NGF between two groups(P>0.05).After treatment,NIHSS and FMA scores were significantly improved compared to those before treatment in both groups and were better in acupuncture group than those in routine group(P<0.01).BDNF and NGF levels significantly increased compared with those before treatment in two groups and were statistically higher in acupuncture group than those in routine group(P<0.05,P<0.01).Conclusion Acupuncture can improve limb function and nerve function in hemiplegic patients due to acute ischemic stroke,which may be related to increasing the levels of BDNF and NGF.