醒脑开窍针法治疗脑卒中后丘脑痛的疗效及对外周血5-HT、VIP、β-EP水平的影响

Effect of xingnaokaiqiao acupuncture on thalamic pain after stroke and its influence on the levels of peripheral blood 5-HT,VIP,and β-EP

目的:探讨醒脑开窍针法治疗脑卒中后丘脑痛的疗效及对外周血5-羟色胺(5-HT)、血管活性肠肽(VIP)、β-内啡肽(β-EP)水平的影响。方法:选取68例脑卒中后丘脑痛患者为研究对象,按照治疗方案不同分为对照组和研究组,每组各34例。对照组患者采用阿米替林治疗;研究组采用阿米替林+给予醒脑开窍针法治疗,疗程均为4周。比较两组患者临床疗效、疼痛程度[视觉模拟(VAS)评分]、日常生活活动(ADL评分)、血液流变学指标[全血低切黏度、全血高切黏度、纤维蛋白原(FIB)水平]、外周血5-HT、VIP、β-EP水平及不良反应发生情况。结果:研究组患者总有效率高于对照组(P<0.05)。治疗后,两组患者治疗后VAS评分、全血低切黏度、全血高切黏度、FIB及5-HT水平均降低(P<0.05),且研究组低于对照组(P<0.05);ADL评分、VIP及β-EP水平均升高(P<0.05),且研究组高于对照组(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:与单独应用阿米替林相比,阿米替林+醒脑开窍针法治疗脑卒中后丘脑痛的疗效更好,有利于减轻疼痛程度,提高日常生活能力,改善外周血5-HT、VIP、β-EP水平,且安全性好。

Objective:To explore the effect of xingnaokaiqiao acupuncture in the treatment of thalamic pain after stroke and its influence on the levels of peripheral blood 5-hydroxytryptamine(5-HT),vasoactive intestinal peptide(VIP),and β-Endorphin(β-EP).Methods:68 patients with thalamic pain after stroke were selected as the research objects.They were divided into control group and study group according to different treatment methods, 34 cases in each group.The patients in the control group were treated with amitriptyline, and the study group was treated with amitriptyline+Xingnao Kaiqiao acupuncture treatment, the course of treatment was 4 weeks.The clinical efficacy, pain intensity [visual analog(VAS) score],activities of daily living(ADL score),hemorheological indexes [whole blood low shear viscosity, whole blood high shear viscosity and fibrinogen(FIB) levels],peripheral blood 5-HT,VIP,β-EP levels and adverse reactions were compared between the two groups.Results:The total effective rate in the study group was higher than that in the control group(P<0.05).After treatment, the VAS scores, whole blood low shear viscosity, whole blood high shear viscosity, FIB and 5-HT levels of the two groups were lower than those before treatment(P<0.05),and the study group was lower than the control group(P<0.05).ADL score, VIP and β-EP levels increased(P<0.05),and the study group was higher than the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Compared with the single application of amitriptyline, amitriptyline+resuscitation and resuscitation acupuncture has a more significant effect on the treatment of thalamic pain after stroke, which is more conducive to reducing the degree of pain, improving the ability of daily life, and improving the peripheral blood 5-HT,VIP and β-EP levels and has good safety.