醒脑开窍针法联合高压氧治疗微意识状态临床研究

Clinical Study of Xingnao Kaiqiao Acupuncture Combined with Hyperbaric Oxygen on Minimally Conscious State

目的探讨醒脑开窍针法联合高压氧治疗微意识状态(minimally conscious state,MCS)患者的临床疗效。方法选取2019年1月—2022年3月本院康复医学中心收治的MCS患者66例,随机分为3组,每组22例。3组患者均给予常规内科处理及常规康复治疗,高压氧组采用高压氧舱治疗,针刺组采用醒脑开窍针法治疗,高压氧联合针刺组在高压氧治疗后进行醒脑开窍针法治疗。比较3组患者治疗前后失匹配负波(mismatch negativity,MMN)潜伏期及波幅、血清炎症因子水平、修订的昏迷恢复量表(coma recovery scale-revised,CRS-R)及中文版切尔西物理功能评估量表(the Chelsea critical care physical assessment tool,CPAx)评分。结果治疗后,高压氧联合针刺组MMN潜伏期、炎症因子水平显著低于针刺组及高压氧组(P<0.05),MMN振幅、CRS-R及中文版CPAx评分显著高于另外2组(P<0.05)。结论醒脑开窍针法联合高压氧治疗MCS可显著改善患者的意识状态,降低炎症因子水平,提高物理功能,临床疗效确切。

Objective To explore the clinical efficacy of Xingnao Kaiqiao acupuncture combined with hyperbaric oxygen in patients with minimally conscious state(MCS).Methods Sixty-six patients with MCS admitted to the rehabilitation medical center of our hospital from January 2019 to March 2022 were randomly divided into 3 groups and 22 patients in each group.All patients in 3 groups were given conventional medical treatment and routine rehabilitation treatment,the hyperbaric oxygen group was treated with hyperbaric oxygen chamber,the acupuncture group was treated with acupuncture,and the hyperbaric oxygen combined with acupuncture group was treated with acupuncture after hyperbaric oxygen treatment.Compare the latency and amplitude of mismatch negativity(MMN),serum levels of inflammatory factors,the coma recovery scale-revised(CRS-R),and the Chelsea critical care physical assessment tool(CPAx)in the Chinese version.Results After treatment,MMN latency and inflammatory factor levels in the hyperbaric oxygen combined with acupuncture group were significantly lower than those in the acupuncture group and the hyperbaric oxygen group(P<0.05),and MMN amplitude,CRS-R and CPAx in the Chinese version scores were significantly higher than those in the other two groups(P<0.05).Conclusion The treatment of MCS with Xingnao Kaiqiao acupuncture combined with hyperbaric oxygen could significantly improve the state of consciousness,reduce the level of inflammatory factors,improve the physical function,and has the exact clinical effect.