针药联合对外伤性截瘫患者运动功能及神经肽的影响

Effect of Needle and Medicine Combination on Movement Function and Neuropeptide for Traumatic Paraplegia Patients

目的:观察针药联合对外伤性截瘫患者临床疗效、运动功能及神经肽的影响。方法:将2012年8月~2015年2月我院外伤科收治的86例外伤性截瘫患者采用随机数字表法分为观察组和对照组各43例,对照组给予针灸夹脊穴治疗,观察组在对照组基础上另联合健步疗瘫汤治疗,观察治疗后2组临床疗效、运动功能(ASIA运动评分)、血浆神经肽[强啡肽A(DYNA)、精氨酸加压素(AVP)、β-内啡肽(β-EP)]、功能独立性(FCA评分)及安全性。结果:治疗后观察组总有效率88.37%较对照组69.77%显著高,差异显著(P<0.05);治疗前2组ASIA运动功能评分、DYNA、AVP、β-EP、FCA评分相较无明显差异(P>0.05);治疗后两组ASIA运动功能评分、DYNA、AVP、β-EP、FCA评分较治疗前显著升高,且治疗后观察组各项评分升高较对照组显著,差异均显著(P<0.05)。结论:健步疗瘫汤联合针灸夹脊穴对外伤性截瘫患者临床积极作用显著,可有效改善患者运动功能及神经功能,联合方案值得临床推广应用。

Objective: Discussing the clinical curative effect of needle and medicine combination for patients with traumatic paraplegia,motor function and the influence of neuropeptides. Methods: From August 2012 to February 2015,86 patients with traumatic paraplegia in our hospital were randomly divided into observation group and controlled group with 43 cases in each group.The controlled group was treated with acupuncture at Jiaji points,while the observation group were additionally treated with Jianbu Liaotan Decoction. The clinical efficacy,motor function( ASIA score),plasma neuropeptide [dynorphin A( DYNA),arginine vasopressin( AVP),β-endorphin peptide( β-EP) ],functional independence( FCA score) and safety were observed. Results: The total effective rate of treatment was significantly higher in the observation group( 88. 37%) than in the controlled group( 69. 77%)( P<0. 05). There was no significant difference in ASIA motor function scores,DYNA,AVP,β-EP and FCA score between the two groups before treatment( P>0. 05). After treatment,the above indexes were significantly higher than those before treatment,and the changes in the observation group were significantly greater than those in the controlled group( P<0. 05). Conclusion: Jianbu Liaotan Decoction combined with acupuncture at Jiaji points is significantly effective in the treatment of patients with traumatic paraplegia. It can effectively improve the motor function and nerve function in patients.