穴位贴敷对脑梗死恢复期患者神经功能及神经营养因子、神经生长因子、血管活性肠肽表达水平的影响

Effect of Acupoint Application on Neurological Function and Levels of NTF,NGF,and VIP in Patients with Cerebral Infarction in Recovery Period

目的观察穴位贴敷对脑梗死恢复期患者神经功能、神经营养因子(Nucleon therapy facility,NTF)、神经生长因子(Nerve growth factor,NGF)、血管活性肠肽(Vasoactive intestinal peptide,VIP)水平的影响。方法选取2019年9月—2021年9月期间于南京医科大学附属南京医院,南京市第一医院治疗的100例脑梗死恢复期患者,按随机数字表法分为治疗组和对照组,每组各50例。对照组给予常规西医治疗,治疗组给予常规西医联合穴位贴敷治疗。治疗前、后检测两组患者血清可溶性白细胞介素-2受体(soluble interleukin-2 receptor,sIL-2R)、白细胞介素-18(Interleukin-18,IL-18)、白细胞介素-33(Interleukin-33,IL-33)、NGF、NTF、VIP、总抗氧化能力(Total antioxidant capacity,T-AOC)、活性氧(Reactive oxygen species,ROS)、超氧化物歧化酶(Superoxide dismutase,SOD)水平,检测患者大脑中动脉平均血流速度(Vaso Motor,Vm)、阻力指数(Resistance Index,RI),给予患者美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)、脑卒中专门化生存质量量表(Stroke-specific Quality of Life,SS-QOL)评价神经功能及生活质量,比较两组患者临床疗效。结果治疗后两组患者sIL-2R、IL-18、IL-33水平均较治疗前降低,差异有统计学意义(P<0.05);且治疗组sIL-2R、IL-18、IL-33水平较对照组明显降低,差异有统计学意义(P<0.05)。治疗后两组患者T-AOC、SOD水平均较治疗前升高,ROS水平较治疗前降低,差异有统计学意义(P<0.05);且治疗组T-AOC、SOD水平均明显高于对照组,ROS水平明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血清VIP水平均较治疗前降低,NGF、NTF水平均较治疗前升高,差异有统计学意义(P<0.05);且治疗组血清VIP水平明显低于对照组,NGF、NTF水平明显高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者Vm水平均较治疗前升高,RI水平均较治疗前降低,差异有统计学意义(P<0.05);治疗组Vm水平较对照组明显升高,RI水平较对照组明显降低,差异有统计学意义(P<0.05)。治疗后两组患者NIHSS评分均较治疗前降低,SS-QOL评分均较治疗前升高,差异有统计学意义(P<0.05);且治疗组NIHSS评分较对照组明显降低,SS-QOL评分较对照组明显升高,差异有统计学意义(P<0.05)。治疗后治疗组总有效率96.00%(48/50)明显高于对照组84.00%(42/50),差异有统计学意义(P<0.05)。结论穴位贴敷治疗脑梗死恢复期患者,可抑制患者炎性因子,减少氧化应激损伤,改善NTF、NGF、VIP水平及脑循环,提升患者神经功能及临床疗效。

Objective To observe the effect of acupoint application on neurological function and levels of NTF,NGF,and VIP in patients with cerebral infarction in the recovery period.Methods A total of 100 patients with cerebral infarction in the recovery stage who were treated in the Nanjing First Hospital,Nanjing Medical University from September 2019 to September 2021 were included and divided into a study group and a control group by random number table,with 50 patients in each group.The control group was given conventional western medicine for treatment,and the study group was given conventional western medicine combined with acupoint application.The levels of soluble interleukin-2 receptor(sIL-2 R),interleukin(IL)-18(IL-18),IL-33,nerve growth factor(NGF),neurotrophic factor(NTF),vasoactive intestinal peptide(VIP),total antioxidant capacity(T-AOC),reactive oxygen species(ROS),and superoxide dismutase(SOD),the average blood flow velocity(Vm),and resistance index(RI)of the middle cerebral artery of patients in the two groups before and after treatment were detected.The evaluation of the National Institutes of Health Stroke Scale(NIHSS)and the Stroke Specialized Quality of Life Scale(SS-QOL)was conducted in the two groups,and the clinical efficacy of the two groups were compared.Results After treatment,the levels of sIL-2 R,IL-18,and IL-33 in the two groups were decreased(P<0.05),and the levels of sIL-2 R,IL-18,and IL-33 in the study group were significantly lower than those in the control group(P<0.05).After treatment,the levels of T-AOC and SOD were increased and the level of ROS was decreased(P<0.05).The levels of T-AOC and SOD in the study group were significantly higher than those in the control group,and the level of ROS was significantly lower(P<0.05).After treatment,the level of serum VIP in the two groups was decreased,and the levels of NGF and NTF were increased(P<0.05).The level of serum VIP in the study group was significantly lower than that in the control group,and the levels of NGF and NTF were significantly higher(P<0.05).After treatment,the level of Vm the two groups was increased,whereas the level of RI was decreased(P<0.05).The level of Vm in the study group was significantly higher than that in the control group,and the level of RI was significantly lower(P<0.05).After treatment,the NIHSS score and SS-QOL score of the two groups were both increased(P<0.05),and the NIHSS score of the study group was lower and the SS-QOL score of the study group was higher than that of the control group(P<0.05).After treatment,the total effective rate of the study group was 96.00%(48/50),which was significantly higher than that of the control group[84.00%(42/50),P<0.05].Conclusion In the treatment of patients with cerebral infarction in the recovery stage,acupoint application can inhibit the patients′inflammatory factors,reduce oxidative stress damage,improve the levels of NTF,NGF,and VIP and cerebral circulation,and enhance the patients′neurological function and clinical efficacy.