中医针灸联合丁苯酞序贯疗法治疗缺血性脑卒中的效果

Effects of acupuncture and moxibustion combined with sequential therapy of butylphthalide on ischemic stroke

目的观察中医针灸联合丁苯酞序贯疗法治疗缺血性脑卒中的效果。方法选取106例缺血性脑卒中患者为研究对象,采用随机数字表法将其分为西医组和中西医组,每组53例。西医组采用常规西药和丁苯酞序贯疗法治疗,中西医组采用中医针灸联合丁苯酞序贯疗法治疗。比较两组治疗前后的炎症指标、脑血流动力学、侧支循环功能、脑神经功能康复情况。结果治疗后,中西医组的核因子κB(NF-κB)、Toll样受体4(TLR4)mRNA、Toll样受体2(TLR2)mRNA表达水平均低于西医组,差异有统计学意义(P<0.05);中西医组脑血流量(CBF)、脑血容量(CBV)均高于西医组(P<0.05);中西医组血流平均通过时间(MTT)、最大剩余功能时间(Tmax)均短于西医组(P<0.05),计算低灌注指数(HIR)低于西医组(P<0.05);中西医组的神经元烯醇化酶(NSE)、中枢神经特异蛋白(S100β)均低于西医组(P<0.05)。结论中医针灸联合丁苯酞序贯疗法可有效减轻缺血性脑卒中患者的炎症反应,对促进其脑血流动力学、侧支循环功能及脑神经功能康复均有积极意义。

Objective To observe the effect of acupuncture and moxibustion combined with sequential therapy of butylphthalide in patients with ischemic stroke.Methods 106 patients with ischemic stroke were selected as the research subjects and divided into the Western medicine group and traditional Chinese and Western medicine group using the number table method,with 53 cases in each group.The Western medicine group were treated with conventional western medicine and butylphthalide sequential therapy,while the traditional Chinese and Western medicine group were treated with Chinese medicine acupuncture and moxibustion.The inflammatory indicators,cerebral hemodynamic indicators,collateral circulation function,and neurological rehabilitation before and after treatment were compared between the two groups.Results After treatment,the nuclear factors-κB(NF-κB),expression levels of Toll like receptor 4(TLR4)mRNA and Toll like receptor 2(TLR2)mRNA in the traditional Chinese and Western medicine groups were lower than those in the Western medicine group,and the differences were statistically significant(P<0.05).The cerebral blood flow(CBF)and cerebral blood volume(CBV)in the traditional Chinese and Western medicine groups were higher than those in the Western medicine group(P<0.05).The mean transit time(MTT)and maximum remaining functional time(Tmax)of blood flow in the traditional Chinese and Western medicine groups was lower than that in the Western medicine group(P<0.05),as well as the calculated hypoperfusion index(HIR)were lower than those in the Western medicine group(P<0.05).The levels of neuronal enolase(NSE)and central nervous system specific protein(S100β)in the traditional Chinese and Western medicine groups were lower than those in the Western medicine group(P<0.05).Conclusion Acupuncture and moxibustion combined with sequential therapy of butylphthalide in traditional Chinese medicine can effectively reduce the inflammatory reaction in patients with ischemic stroke,and has positive significance in promoting their cerebral hemodynamics,collateral circulation function and rehabilitation of cerebral nerve function.