针刺心俞、厥阴俞穴结合药物治疗急性缺血性脑卒中的临床研究

Clinical Study on the Protective Effect of Acupuncture of BL-15 and BL-14 Combined with Medication on Cardio-cerebral Functions in Patients with Acute Ischemic Stroke

目的 :研究针刺心俞、厥阴俞穴结合药物对急性缺血性脑卒中 (简称AIS)患者的心脑功能损害的保护作用。方法 :将 40例患者按入院的先后顺序随机分为两组 :心俞、厥阴俞穴结合药物组 2 0例 (治疗组 )及单纯药物组 2 0例 (对照组 ) ,观察治疗前后头颅CT脑梗塞体积、心电图、降钙素基因相关肽 (CGRP)、血栓素B2 (TXB2 )、6 酮 前列腺素 1a( 6 Keto PGF1a)以及神经功能缺损评分和临床疗效等指标的变化。结果 :与对照组比较 ,治疗组在下列指标上优于对照组 :脑梗塞体积(P <0 0 1 )、心电图 (P <0 0 1 )、CGRP(P <0 0 1 )、TXB2 (P <0 0 0 1 )、6 Keto PGF1a(P <0 0 1 )、神经功能缺损评分 (P <0 0 0 1 )、临床疗效 (P <0 0 5)。结论 :针刺心俞。

Objective:To study the protective effect of acupuncture combined with medication on cardiac and cerebral functions in patients suffering from acute ischemic stroke (AIS). Methods: 40 ischemic apoplectic patients were randomly divided into treatment group (n=20) which was treated by acupuncture of bilateral Xinshu (BL 15) and Jueyinshu (BL 14, once daily, ten sessions being a therapeutic course and 3 days' rest between two courses) combined with medication (20% mannitol, low molecular dextran, compound red sage root injection, persantine and aspirin) and control group (n=20) which was treated with simple medication (same medicines mentioned above). After 20 days' treatment, the therapeutic effect was evaluated. Changes of indices such as the volume of cerebral infarction, ECG-ST and T waves, heart rate (HR), plasma calcitonin gene-related peptide (CGRP), thromboxane B 2 (TXB 2) and 6-Keto-(prostaglandin) PGF1a contents, scores of neurological defect and clinical therapeutic effects were observed. Results: Following 2 courses of treatment, self-comparison of two groups showed that in comparison with pre-treatment, the cerebral infarction volume, HR and TXB 2 of treatment group were decreased significantly (P<0.05～0.01),while no striking changes were found in cerebral infarction volume, HR, ECG-ST and T-wave amplitude, plasma CGRP, TXB 2, and 6-Keto- PGF1a contents of control group (P>0.05). In addition, after treatment, the depressed ECG-ST and T-wave amplitudes of treatment group were elevated significantly compared with pre-treatment (P<0.05). Plasma CGRP concentrations of two groups both increased significantly (P<0.01～0.001), while the increased value of treatment group was evidently higher than that of control group (P<0.01). Compared with pre-treatment, plasma TXB 2 and 6-Keto-PGF1a of treatment and control groups increased and decreased significantly and separately (P<0.05). Following treatment, the scores for neurological defect of two groups both decreased significantly, while the decreased values of treatment group was significantly bigger than that of control group (P<0.001). The total effective rate (70%) of treatment group was considerably higher than that (20%) of control group (P<0.05). Conclusion: The protective effect of acupuncture plus medication on cardiac and cerebral functions in patients with ischemic stroke is significantly superior to that of simple medication.