针刺联合丁苯酞注射液对急性前循环脑卒中患者溶栓后的神经功能及炎性因子的影响

Effect of Acupuncture Combined with Butylphthalide Injection on Neurological Function and Inflammatory Factors in Patients with Acute Anterior Circulation Stroke after Thrombolytic Therapy

目的观察针刺联合丁苯酞注射液对急性前循环脑卒中患者溶栓后的疗效及炎性因子的影响。方法将80例急性前循环缺血性脑卒中患者随机分为观察组与对照组各40例,两组均采用静脉溶栓及内科常规干预,对照组联合丁苯酞注射液治疗,观察组在对照组基础上联合针刺治疗,两组均治疗2周。比较两组患者治疗前后血同型半胱氨酸(Hcy)和超敏C反应蛋白(hs-CRP)水平变化。采用美国国立卫生研究院卒中量表(NIHSS)、改良Ranking量表(mRS)和改良Barthel指数评定量表(MBI)评价患者神经功能缺损状况、日常生活能力以及独立预后。比较两组治疗前后各评分的变化情况。结果治疗后两组NIHSS、m RS评分及MBI指数均有改善,Hcy和hs-CRP水平均有下降,与对照组比较,观察组NIHSS与mRS评分下降更明显(P<0.05),MBI指数升高更明显(P<0.05),炎症水平明显降低(P<0.05)。观察组总有效率92.50%,优于对照组的74.36%(P<0.05)。结论针刺联合丁苯酞注射液治疗可明显提升前循环AIS溶栓疗效,促进神经功能恢复,提高独立生活水平,改善不良预后,可能与降低外周血Hcy和hs-crp水平减轻局部炎症反应有关。

Objective:To observe the effect and the influence of inflammatory cytokines of acupuncture combined with butylphthalide injection in patients with acute anterior circulation stroke after thrombolysis.Methods:80 patients with acute anterior circulation ischemic stroke were randomly divided into the observation group and control group,with 40 cases in each group.Both groups were treated with intravenous thrombolysis and routine medical intervention.The control group was treated with butylphthalide injection,and the observation group was treated with acupuncture on the basis of the control group.Both groups were treated for 2 weeks.The levels of homocysteine(Hcy)and hypersensitive C-reactive protein(hs-CRP)in two groups were compared before and after treatment.Neurological impairment,daily living ability and independent prognosis were evaluated by the National Institutes of Health Stroke Scale(NIHSS),modified Ranking Scale(mRS)and modified Barthel Index Rating Scale(MBI).Results:After treatment,the NIHSS,m RS scores and MBI index of the two groups improved,and the levels of Hcy and hs-CRP decreased.Compared with the control group,the NIHSS and mRS scores of the observation group decreased more significantly(P<0.05),the MBI index increased more significantly(P<0.05),and the level of inflammation decreased significantly(P<0.05).The total effective rate of the observation group was92.50%,which was better than 74.36%of the control group(P<0.05).Conclusion:The treatment of acupuncture combined with butylphthalide injection can significantly improve the thrombolytic effect of acute ischemic stroke in anterior circulation,promote neurological function recovery,improve independent living standards,and improve poor prognosis,which may be related to reducing the levels of Hcy and hs-CRP in peripheral blood to inhibit local inflammatory reaction.