通调针刺法联合芪蛭三七汤治疗脑卒中后运动障碍及对血清BDNF、NPY水平的影响

Effect of Dredging and Regulating Acupuncture Combined with Qizhi Sanqi Decoction(芪蛭三七汤)on Poststroke Motility Disorder and Its Influence on Serum Levels of BDNF and NPY

目的探讨通调针刺法联合芪蛭三七汤治疗脑卒中后运动障碍的效果及对血清脑源性神经营养因子(brain derived neurotrophic factor,BDNF)、神经肽Y(neuropeptide,NPY)水平的影响。方法选取2019年9月—2022年8月医院收治的102例脑卒中后运动障碍患者,依照随机数表法分为研究组(n=51例)和对照组(n=51例),对照组采用基础康复训练治疗,研究组另给予通调针刺法联合芪蛭三七汤治疗,比较两组患者中医症状评分,临床疗效,Fugl-Meyer运动功能量表(Fugl Meyer Motor Function Assessment,FMA)评分、Berg平衡量表(Berg Balance Scale,BBS)评分、改良Barthel指数、美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分,血清BDNF、NPY水平及不良反应。结果治疗后,两组患者半身不遂、偏身障碍、意识模糊、口舌歪斜、气短乏力、手足肿胀评分均降低(P<0.05),且研究组半身不遂、偏身障碍、意识模糊、口舌歪斜、气短乏力、手足肿胀评分均低于对照组(P<0.05);研究组总有效率高于对照组,差异有统计学意义(P<0.05);治疗后,两组患者FMA评分和BBS评分均升高(P<0.05),且研究组更高(P<0.05);治疗后,两组患者改良Barthel指数均升高(P<0.05),且研究组更高(P<0.05),两组NIHSS评分均降低(P<0.05),且研究组更低,差异有统计学意义(P<0.05);治疗后,两组血清BDNF水平均升高(P<0.05),且研究组更高,差异有统计学意义(P<0.05),两组血清NPY水平均降低(P<0.05),且研究组更低,差异有统计学意义(P<0.05);不良反应发生率比较,差异无统计学意义(P>0.05)。结论通调针刺法联合芪蛭三七汤用于治疗脑卒中后运动障碍患者疗效确切,能够改善运动障碍及BDNF、NPY水平。

Objective To explore the effect of dredging and regulating acupuncture combined with Qizhi Sanqi Decoction(芪蛭三七汤)on motor dysfunction after stroke and its influences on the levels of serum brain derived neurotrophic factor(BDNF)and neuropeptide Y(NPY).Methods A total of 102 patients with post-stroke dyskinesia admitted to the hospital from September 2019 to August 2022 were selected and randomly divided into the study group(51 cases)and control group(51 cases).The con-trol group was treated with basic rehabilitation training,and the study group was treated with dredging and regulating acupuncture combined with Qizhi Sanqi Decoction.The TCM symptom score,clinical efficacy,Fugl Meyer Motor Function Assessment(FMA)score,Berg Balance Scale(BBS)score,modified Barthel index,National Institutes of Health Stroke Scale(NIHSS)score,serum levels of brain derived neurotrophic factor(BDNF)andneuropeptide(NPY)and adverse reactions were compared in both groups.Results After treatment,the scores of hemiplegia,deviation of body,confusion,deviation of tongue and mouth,shortness of breath and fatigueand hand and foot swelling in the two groups were decreased(P<0.05),and the scores of hemiplegia,deviation of body,confusion,deviation of tongue and mouth,shortness of breath and fatigueand hand and foot swelling in the study group were lower than those in the control group(P<0.05).The total effective rate of the study group was higher than that of the control group(P<0.05).After treatment,the FMA score and BBS score of patients in both groups were increased(P<0.05),and the FMA score and BBS score in the study group were higher than those in the control group(P<0.05).After treatment,the improved Barthel index of patients in both groups increased(P<0.05),and the improved Barthel index in the study group was higher than that in the control group(P<0.05).NIHSS scores of patients in both groups were decreased(P<0.05),and NIHSS scores in the study group were lower than those in the control group(P<0.05).After treatment,the serum BDNFlevels in both groups were increased(P<0.05),and the levelof serum BDNF in the study group was higher than that in the control group(P<0.05).The serum NPY levels in both groups were decreased(P<0.05),and the serum NPY level in the study group was lower than that in the control group(P<0.05).The incidence of adverse reactions in both groups was not statistically significant(P>0.05).Conclusion:Dredging and regulating acupuncture combined with Qizhi Sanqi Decoction can improve the clinical symp-toms of patients with motor disorders after strokewith definite effect,and it can improve the motor function and serum levels of BD-NF and NPY,which is safe and reliable.