刺血醒脑法对急性脑梗死患者脑血流动力学及血清VEGF、bFGF的影响

Effect of Cixue Xingnao Method on Cerebral Hemodynamics in Patients with Acute Cerebral Infarction

目的观察刺血醒脑法对急性脑梗死患者脑血流动力学及血清VEGF、bFGF的影响,探讨此方案的临床价值及机理。方法将62例急性脑梗死患者按照随机数字表法分成治疗组与对照组各31例。对照组予以规范化西医治疗联合康复治疗,治疗组在对照组的基础上增加刺血醒脑法。刺血的穴位为患侧的十宣穴、涌泉穴、少冲穴及百会穴,每日1次,治疗时间为14 d。在研究期间,记录治疗前和治疗后急性脑梗死患者NIHSS、Barthel评分的改变情况,血清VEGF、bFGF数值的变化情况,并采用经颅多普勒超声(TCD)记录治疗前和治疗后的脑血流动力学情况。结果治疗后两组NIHSS评分均较治疗前降低(P<0.05),且治疗组较对照组降低更显著(P<0.05);治疗后两组Barthel评分均较治疗前升高(P<0.05),且治疗组较对照组升高更显著(P<0.05);治疗后两组病灶侧大脑中动脉Vd、Vs、Vm比治疗前明显增快(P<0.05),且治疗组明显优于对照组(P<0.05);治疗后两组PI和RI较治疗前均明显降低,但两组降低程度相当(P>0.05);治疗后两组VEGF、bFGF较治疗前显著升高(P<0.05),且治疗组明显优于对照组(P<0.05)。结论刺血醒脑法可有效改善ACI患者神经功能缺损程度和生活质量,机制可能与改善脑血流动力学、促进血管新生等有关。

Objective:To observe the effects of Cixue Xingnao Method on cerebral hemodynamics and serum VEGF and bFGF in patients with acute cerebral infarction,to investigate the clinical value and possible mecha⁃nism of this protocol.Methods:A total of 62 patients with acute cerebral infarction were selected and divided in⁃to 31 patients each in the treatment group and control group according to the random number table method.The control group was given standardized western medical treatment combined with rehabilitation therapy,and the treat⁃ment group was given Cixue Xingnao Method on the basis of the control group.The acupuncture points were Shixu⁃an,Yongquan,Shaochong and Baihui acupoints on the affected side once a day for 14 days.During the study peri⁃od,changes in NIHSS and Barthel scores,changes in serum VEGF and bFGF values in patients with acute cere⁃bral infarction before and after treatment were recorded,and cerebral hemodynamics before and after treatment were recorded using transcranial Doppler ultrasound(TCD).Results:The NIHSS score decreased in both groups after treatment compared with that before treatment(P<0.05),and the decrease was more significant in the treat⁃ment group than in the control group(P<0.05);the Barthel score increased in both groups after treatment com⁃pared with that before treatment(P<0.05),and the increase was more significant in the treatment group than in the control group(P<0.05);Vd,Vs,and Vm of the middle cerebral artery on the side of the lesion were significant⁃ly faster in both groups after treatment than before treatment(P<0.05),and the treatment group was significantly better than the control group(P<0.05);PI and RI were significantly lower in both groups after treatment than be⁃fore treatment,but the degree of reduction was comparable in both groups(P>0.05);VEGF and bFGF were signifi⁃cantly higher in both groups after treatment than before treatment(P<0.05),and the treatment group was signifi⁃cantly better than the control group(P<0.05).Conclusion:Cixue Xingnao Method can effectively improve neuro⁃logical impairment and living quality of ACI patients.Its mechanism might be relevant to the improvement of cere⁃bral blood circulation and vascular renewal.