针灸联合常规西药在危重症脑出血患者术后治疗中的应用价值

Application value of acupuncture combined with conventional Western medicine in postoperative treatment of patients with critical cerebral hemorrhage

目的分析针灸联合常规西药在危重症脑出血患者术后治疗中的应用价值。方法抽取2019年7月至2021年3月漯河市第二人民医院收治的危重症脑出血术后患者92例,按随机数字表法分为针灸组与常规组,每组46例。常规组采用常规西药治疗,针灸组在常规组治疗基础上采用针灸治疗。比较两组疗效和治疗前后美国国立卫生院卒中量表(NIHSS)评分、日常生活能力量表(ADL)评分、Fugl-Meyer运动功能测评法(FMA)评分、急性生理与慢性健康(APACHEⅡ)评分及格拉斯哥昏迷量表(GCS)评分,比较两组治疗前后脑血流动力学及氧化应激指标。结果针灸组总有效率(91.30%,42/46)高于常规组(76.09%,35/46),P<0.05。治疗前,NIHSS、ADL、APACHEⅡ、FMA、GCS评分比较差异未见统计学意义(P>0.05);治疗后,针灸组NIHSS、ADL、APACHEⅡ评分低于常规组,FMA、GCS评分高于常规组(P<0.05)。治疗前,两组缩期峰值流速(Vs)、平均血流速度(Vm)及氧化应激水平比较差异未见统计学意义(P>0.05);治疗后,针灸组Vs、Vm高于常规组(P<0.05),氧化应激水平低于常规组(P<0.05)。结论危重症脑出血患者术后采用针灸早期介入联合常规西药治疗的效果确切,可改善脑血流动力学,调节氧化应激,降低病情严重程度,改善神经功能、运动功能和昏迷状态,提高日常生活能力。

Objective To analyze the application value of acupuncture combined with conventional Western medicine in postoperative treatment of patients with critical cerebral hemorrhage.Methods A total of 92 patients with critical cerebral hemorrhage treated in Luohe Second People’s Hospital from July 2019 to March 2021 were selected and divided into acupuncture group and conventional group by random number table method,with 46 cases in each group.The conventional group was treated with conventional Western medicine,and the acupuncture group was treated by acupuncture based on the treatment of the conventional group.The efficacy,and the National Institutes of Health Stroke Scale(NIHSS),activity of daily living scale(ADL),Fugl Meyer motor function assessment(FMA),acute physiology and chronic health evaluation-II(APACHE II)and Glasgow Coma Scale(GCS)before and after treatment were compared between the two groups.The indexes of cerebral hemodynamics and oxidative stress before and after treatment were compared between the two groups.Results The total effective rate of acupuncture group(91.30%,42/46)was higher than that of conventional group(76.09%,35/46),P<0.05.Before treatment,there was no significant difference in NIHSS,ADL,APACHE II,FMA and GCS scores between the two groups(P>0.05);after treatment,NIHSS,ADL and APACHEⅡscores were lower,FMA and GCS scores were higher in acupuncture group,compared with conventional group(P<0.05).Before treatment,there was no significant difference in systolic peak velocity(Vs),mean blood flow velocity(Vm)and oxidative stress between the two groups(P>0.05);after treatment,Vs and Vm in acupuncture group were higher than those in conventional group(P<0.05),and the levels of oxidative stress in acupuncture group were lower than those in conventional group(P<0.05).Conclusions Early interventional therapy of acupuncture combined with conventional Western medicine is effective in the treatment of critical cerebral hemorrhage.It can improve cerebral hemodynamics,regulate oxidative stress,reduce the severity of the disease,improve neurological function,motor function and coma,and improve the ability of daily living.