电针治疗急性缺血性卒中及对血浆IL-17、IL-10水平的影响

Electroacupuncture for acute ischemic stroke and its effect on plasma levels of IL-17 and IL-10

目的:比较电针联合西医常规疗法与单纯西医常规疗法治疗急性缺血性卒中(AIS)的临床疗效及对血浆白介素(IL)-17、IL-10水平的影响。方法:将60例AIS患者随机分为观察组(30例,脱落2例)和对照组(30例,脱落4例)。对照组予神经保护、改善脑循环等西医常规治疗,观察组在对照组基础上联合电针治疗,针刺穴取百会、印堂和患侧曲池、足三里、三阴交等,百会-印堂、曲池-合谷、足三里-三阴交连接电针,采用疏密波,频率2 Hz/15 Hz,每日1次,连续治疗10 d。分别于治疗前后观察两组患者美国国立卫生院卒中量表(NIHSS)和改良Barthel指数(MBI)评分,ELISA法检测两组血浆IL-17、IL-10水平。结果:治疗后,两组患者NIHSS评分较治疗前降低、MBI评分较治疗前升高(P<0.01),观察组患者NIHSS评分低于对照组、MBI评分高于对照组(P<0.05);两组患者血浆IL-17水平较治疗前降低、IL-10水平较治疗前升高(P<0.01),观察组患者血浆IL-17水平低于对照组、IL-10水平高于对照组(P<0.05)。结论:电针联合西医常规治疗可改善AIS患者神经功能和日常生活活动能力,疗效优于单纯西医常规治疗,其作用机制可能与调节IL-17/IL-10失衡,进而减轻神经炎性反应有关。

Objective To compare the clinical efficacy on acute ischemic stroke(AIS) between electroacupuncture combined with conventional western medicine therapy and simple conventional western medicine therapy and its effect on plasma levels of interleukin(IL)-17 and IL-10. Methods A total of 60 patients with AIS were randomized into an observation group(30 cases, 2 cases dropped off) and a control group(30 cases, 4 cases dropped off). The control group was treated with conventional western medicine therapy i.e neuroprotection and cerebral circulation improvement. On the basis of the treatment in the control group, in the observation group, acupuncture was applied at Baihui(GV 20), Yintang(GV 24+)and Quchi(LI 11), Zusanli(ST 36), Sanyinjiao(SP 6), etc. on the affected side, Baihui(GV 20)-Yintang(GV 24+),Quchi(LI 11)-Hegu(LI 4) and Zusanli(ST 36)-Sanyinjiao(SP 6) were connected with electroacupuncture, with disperse-dense wave, 2 Hz/15 Hz in frequency, once a day for consecutive 10 days. Before and after treatment, the scores of National Institution of Health stroke scale(NIHSS) and modified Barthel index(MBI) were observed, plasma levels of IL-17 and IL-10 were detected by ELISA method. Results After treatment, NIHSS scores were decreased while MBI scores were increased compared before treatment in both groups(P<0.01);compared with the control group, NIHSS score was decreased while MBI score was increased in the observation group(P<0.05). After treatment, IL-17 levels were decreased while IL-10 levels were increased compared before treatment in both groups(P<0.01);compared with the control group, IL-17level was decreased while IL-10 level was increased in the observation group(P<0.05). Conclusion Electroacupuncture combined with conventional western medinice therapy can improve the nerve function and activity of daily living in patients with AIS, its clinical efficacy is superior to simple conventional western medicine therapy, the mechanism may relate to the regulation on IL-17/IL-10 imbalance.