Effect of medical care linkage-continuous management mode in patients with posterior circulation cerebral infarction undergoing endovascular interventional therapy

BACKGROUND Acute cerebral infarction is a severe type of ischemic stroke that can be divided into anterior circulation cerebral infarction and posterior circulation cerebral infarction(PCCI).PCCI affects the structure of the posterior circulation brain,because posterior part of the brain,which has more complex anatomical structures and more prone to posterior circulation vascular variation.Therefore,improving the prognosis of PCCI patients is necessary.AIM To explore the effect of medical care linkage-continuous management mode(MCLMM)on endovascular interventional therapy(EIT)for PCCI.METHODS Sixty-nine patients with PCCI who received EIT and conventional nursing intervention were selected as the control group,and 78 patients with PCCI who received EIT and MCLMM intervention were selected as the observation group.The incidence of postoperative complications,compliance and disease selfmanagement behavior after six months of intervention,modified Rankin scale(mRS)and Barthel index(BI)scores in the acute phase and after one year of intervention,and recurrence within one year were compared between the two groups.RESULTS The total incidence rate of postoperative complications in the observation group(7.69%)was lower than that in the control group(18.84%)(P<0.05).The scores for medical compliance behavior(regular medication,appropriate diet,and rehabilitation cooperation rates)and disease self-management behavior(self-will,disease knowledge,and self-care ability)in the observation group were higher than those in the control group(P<0.05).After one year of intervention,in the observation group,the mRS score was significantly lower,and the BI score was significantly higher than those in the control group(P<0.05).The recurrence rate within one year in the observation group(3.85%)was significantly lower than that in the control group(13.04%)(P<0.05).CONCLUSION MCLMM can reduce the incidence of complications after EIT for PCCI,improve patient compliance behavior and disease self-management ability,and promote the recovery of neurological function.

Effect of adjuvant therapy with ginkgo-damole on apoptosis, nerve injury and platelet aggregation of patients with acute cerebral infarction

Objective:To investigate the effect of adjuvant therapy with ginkgo-damole on apoptosis, nerve injury and platelet aggregation of patients with acute cerebral infarction. Methods:A total of 74 patients with acute cerebral infarction treated in our hospital from March 2014 to December 2015 were retrospectively analyzed, and they were divided into ginkgo-damole group and conventional treatment group according to a therapeutic schedule that whether ginkgo-diyidamolum were included. At Week 2 and Week 4 after treatment, contents of apoptosis molecule, nerve injury molecule and index of platelet aggregation in serum were detected. Results:At Week 2 after treatment, contents of soluble Fas, soluble Fas ligand, soluble tumor necrosis factor related apoptosis inducing ligand, S100β, neuron specific enolase, glial fibrillary acidic protein, myelin basic protein, malonaldehyde, endothelin-1, fibrinogen and D-dimer in patients' sera of ginkgo-damole group were significantly lower than those of conventional treatment group. Contents of nitric oxide in sera were obviously higher than that of conventional treatment group. At Week 4 after treatment, contents of soluble Fas, soluble Fas ligand, soluble tumor necrosis factor related apoptosis inducing ligand, S100β, neuron specific enolase, glial fibrillary acidic protein, myelin basic protein, malonaldehyde, endothelin-1, fibrinogen and D-dimer in patients' sera of ginkgo-damole group were significantly lower than those of conventional treatment group. Contents of nitric oxide in sera were obviously higher than that of conventional treatment group. Conclusions:Adjuvant therapy with ginkgo-damole can inhibit the apoptosis of neuron cells and neurogliocyte and reduce the neural function injury and the situation of platelet aggregation.

EFFECT OF ACUPUNCTURE ON PLASMA STRESS HORMONE LEVELS OF HYPOTHALAMUS-PITUITARY-ADRENAL AXIS IN TYPE II DIABETES WITH CONCURRENT ACUTE CEREBRAL INFARCTION PATIENTS

Objective: To observe the effect of acupuncture on the contents of stress hormones of the hypothalamus pituitary adrenal axis (HPA) in treatment of type II diabetes with concurrent acute cerebral infarction patients. Methods: 60 cases of inpatients were randomly and evenly divided into treatment group (conventional medication plus acupuncture) and control (conventional mediation) group. Plasma corticotropin releasing hormone (CRH), adrenocorticotropin hormone (ACTH) and corticosteroid (CS) contents before and after treatment were measured using radioimmunoassay (RIA) and compared with those of healthy subject group (n=30). Results: Plasma CRH, ACTH and CS levels in patients of both treatment group and control group at admission were significant higher than those of normal subject group (P<0.05). After treatment for 15～30 days, results showed that plasma CRH, ACTH and CS levels in both treatment and control groups lowered significantly in comparison with those of pre treatment (P<0.05 or 0.01); while those of treatment group were even more lower (being closer to the normal values) than those of control group (P<0.05 or 0.01). Conclusion: Acupuncture therapy can reduce the stress state of HPA in type II diabetes with concurrent acute cerebral infarction patients, i.e. regulate the neuroendocrine immunological net, which may be one of the mechanisms for acupuncture treatment of cerebral stroke.

CLINICAL OBSERVATION ON THE TREATMENT OF ACUTE CEREBRAL INFARCTION WITH SCALP-ACUPUNCTURE

Abstract: In the present paper, the authors report the findings of scalp-acupuncture treatment of 50 cases of acute cerebral Infarction. A total of 100 patients were randomly divided into scalp acupuncture group (n = 50) and medication control group (n= 50). In the former group, penetration needling from Baihui (GV 20) to Qianding (GV 21) and from Shuaigu(GB 8) to Xuanli (GB 6) was performed, followed by conducting electroacupuncture (EA) stimulation; while in control group, intravenous drip of Ligustrazine injectio 120 mg plus 5% glucose solution 250 mL (once daily, with 14 days being a therapeutic course) was given in the first therapeutic course and then intravenous drip of Piracetum injectio (2 g plus 5% glucose or normal saline 250 mL, once daily, continuously for 14 days) conducted in the second therapeutic course. Results: After treatment, of the 50 cases in scalp acupuncture group, 26 (52%) were recovered basically, 15 (30%) had significant improvement, 7 (14%) had improvement and 2 (4%) failed in the treatment; while of the 50 cases in control group, 15 (30%) recovered basically, 17 (34%) had marked improvement, 16 (32%) had improvement and 2 (4%) failed in the treatment. The integral values of hemiplegia and aphasia of scalp acupuncture group were less than those of control group (P <0.01). It Indicates that the therapeutic effect of scalp acupuncture is superior to that of control group.

Study on the Treatment of Acute Cerebral Infarction by Xuanzhong(GB 39)Toward Sanyinjiao(SP 6)Acupuncture as Main Therapy

Objective： To investigate the effects of acupuncture therapy on acute cerebral infarction. Methods： Eighty patients with acute cerebral infarction were randomly divided into a treatment group of 40 cases and a control group of 40 cases. Xuanzhong（GB 39）-throughSanyinjiao（SP 6） acupuncture was performed as a main treatment. The curative effects were compared between the two groups and the sizes of cerebral infarct, between pretreatment and posttreatment after one course of treatment. Results. The total recovery rate was 88.5% in the treatment group and 57.5% in the control group after one course of treatment. There was a significant difference between the two（P〈 0.05）. The rate of change in the infarct for the better was significantly higher in the treatment group than in the control group. There was also a significant difference（P〈 0.05）, Conclusion： This treatment is an effective method for lowering the rate of apoplectic disability and raising the cure rate,

Comparison of the anti-apoptotic effects of 15-and 35-minute suspended moxibustion after focal cerebral ischemia/reperfusion injury

Heat-sensitive suspended moxibustion has a neuroprotective effect against focal cerebral ischemia/reperfusion injury, but the underly- ing mechanisms remain unclear. The duration of heat-sensitive suspended moxibustion （usually from 30 minutes to 1 hour） is longer than traditional suspended moxibustion （usually 15 minutes）. However, the effects of 15- and 35-minute suspended moxibustion in rats with cerebra/ischemia/reperfusion injury are poorly understood. In this study, we performed 15- or 35-minute suspended moxibustion at acupoint Dazhui （GV14） in an adult rat model of focal cerebral ischemia/reperfusion injury. Infarct volume was evaluated with the 2,3,5-triphenyltetrazolium chloride assay. Histopathological changes and neuronal apoptosis at the injury site were assessed by hematoxy- lin-eosin staining and terminal deoxynucleotidyl transferase dUTP nick end labeling assay. Caspase-9 and caspase-3 expression at the in- jury site was detected using immunofluorescent staining. Bax and Bcl-2 expression at the injury site was assessed using western blot assay. In the 35-minute moxibustion group, infarct volume was decreased, neuronal apoptosis was reduced, caspase-9, caspase-3 and Bax expres- sion was lower, and Bcl-2 expression was increased, compared with the 15-minute moxibustion group. Our findings show that 35-minute moxibustion has a greater anti-apoptotic effect than 15-minute moxibustion after focal cerebral ischemia/reperfusion injury.

Retrospective Analysis of Thrombolysis Therapy for 64 Cases of Acute Myocardial Infarction with Elevated ST Segment

Objective:To explore the cardiac protective effect of integrative therapy in acute myocardial infarction(AMI) with elevated ST segment after reperfusion.Methods:Sixty-four AMI patients who having received decimalization by thrombolysis were assigned to two groups by retrospective analysis,36 patients in the treated group and 28 in the control group.Both were treated by intravenous administering of urokinase for thrombolysis,and to the treated group,intravenous dripping of Xueshuantong Injection(血栓通注射液,XST) ...

Effect of Tianhuang Granule(田黄冲剂) on Intracranial Pressure and Serum Matrix Metalloproteinase-9 in Patients with Acute Cerebral Hemorrhage

Objective： To study the effect and mechanism of Tianhuang Granule （田黄冲剂, THG） on hydrocephalus in the patients with acute cerebral hemorrhage （ACH） through intracranial pressure （ICP） monitoring, serum matrix metalloproteinase-9 （MMP-9） level observation, and National Institutes of Health Stroke Scale （NIHSS） scoring （for nerve function deficit）. Methods： Sixty patients with ACH were equally randomized into two groups by lottery, the control group and the THG group; all were treated with conventional therapy, but to the patients in the THG group, THG was given orally in addition for 28 days. Changes of ICP, MMP-9 expression, and NIHSS scores, as well as the degree of cerebral hematoma and hydrocephalus （by cranial CT scanning） in the patients, were estimated and compared. Results： （1） ICP was lowered more significantly in the THG group, showing a significant difference between groups on day 7 （P〈0.05）. （2） MMP-9 expression was down-regulated in the THG group more significantly and earlier than that in the control group. （3） The degrees of cerebral hematoma and hydrocephalus in the THG group on day 7 were reduced significantly as compared with those on day 3 （P〈0.05）, but in the control group, the day of significant reduction was delayed to day 14, and the degrees on day 7 and day 14 in the two groups were significantly different （P〈0.05 and P〈0.01）. （4） NIHSS score was significantly lower in the THG group than that in the control group on day 14 and day 28 （P〈0.05 and P〈0.01）. Conclusion： THG can effectively lower ICP, down-regulate MMP-9 expression, promote the absorption of cerebral hematoma and hydrocephalus, and improve the nerve function, showing a clinical effectiveness than conventional therapy.

脑肠同调论针刺治疗急性脑梗死血清代谢组学研究

目的 分析脑肠同调论针刺治疗急性脑梗死的血清代谢组学的影响。方法 纳入2018年3月—2022年12月医院收治的急性脑梗死患者126例作为研究对象,随机数字表法分为两组,对照组63例采用常规疗法,观察组63例在此基础上采用脑肠同调论针刺治疗,对比两组治疗效果、神经功能,炎症因子水平以及对血清代谢组学的影响。结果 观察组总有效率为96.83%(61/63),远高于对照组的80.96%(57/63),神经功能缺损评分(NIHSS)评分低于对照组(P<0.05);治疗后观察组白介素-17(Interleukin-17,IL-17)、超敏C反应蛋白(hypersensitive C-reactive protein, hs-CRP)、血浆氧化三甲胺(trimethylamine oxide, TMAO)水平均低于对照组(P<0.05);治疗后观察组苯丙氨酸、溶血卵磷脂、焦谷氨酸水平低于对照组(P<0.05)。结论 脑肠同调论针刺治疗急性脑梗死效果明确,可减轻患者炎症反应,调节其肠道菌群代谢产物水平及氨基酸、磷脂代谢障碍等,使紊乱的代谢趋于正常,以达促进神经功能恢复,改善患者预后的目的,有较高应用价值。

醒脑开窍针刺法联合中药治疗脑梗死后轻度认知障碍的疗效观察

目的 观察醒脑开窍针刺法联合补肾益髓汤治疗脑梗死后轻度认知障碍的临床疗效。方法 将80例脑梗死后轻度认知障碍的患者随机分为研究组(40例)和对照组(40例)。两组均予基础治疗,研究组在基础治疗外另予醒脑开窍针刺法联合补肾益髓汤治疗。比较两组临床疗效,观察两组治疗前后简易精神状态检查表(mini-mental state examination,MMSE)、蒙特利尔认知评估(Montreal cognitive assessment,MoCA)和Rivermead行为记忆测验(Rivermead behavioural memory test,RBMT)的评分变化,观察两组治疗前后连线测验-B(trail making test-B,TMT-B)结果、血清淀粉样蛋白A(serum amyloid A,SAA)和β-淀粉样蛋白(amyloid β-protein,Aβ)水平以及脑微循环指标(颈总动脉的平均血流量、最大血流速度、最小血流速度、临界压力、脉搏速度、特性阻抗、外周阻力和动态阻力)的变化。结果 研究组总有效率高于对照组(P<0.05)。治疗后,两组MMSE、MoCA和RBMT评分均高于同组治疗前(P<0.05),且研究组上述评分均高于对照组(P<0.05)。治疗后,两组TMT-B结果以及SAA和Aβ水平均优于同组治疗前(P<0.05),且研究组上述指标优于对照组(P<0.05)。治疗后,两组脑微循环指标均较治疗前改善(P<0.05),且研究组优于对照组(P<0.05)。结论 在基础治疗以上,采用醒脑开窍针刺法联合补肾益髓汤治疗脑梗死后轻度认知障碍可提高临床疗效,能进一步改善患者认知功能,并调节SAA和Aβ水平。

急性脑梗死介入治疗联合静脉溶栓治疗的效果观察

目的 探究介入治疗联合静脉溶栓对急性脑梗死患者的治疗效果。方法 80例急性脑梗死患者,合理且随机划分为对照组和观察组,每组40例。对照组采取静脉溶栓治疗,观察组在对照组基础上采用介入治疗。比较两组患者神经功能缺损评分、血清学相关指标(神经生长因子、神经元特异性烯醇化酶、脑钠肽)、活化部分凝血活酶时间、凝血酶原时间、凝血酶时间、纤维蛋白原、并发症发生情况。结果 观察组患者治疗后1 d、7 d、2周神经功能缺损评分均低于对照组(P<0.05)。治疗后,两组患者神经生长因子、神经元特异性烯醇化酶、脑钠肽水平均下降,且观察组患者神经生长因子(95.31±9.65)ng/ml、神经元特异性烯醇化酶(10.26±1.37)μg/L、脑钠肽(157.43±13.25)ng/L均低于对照组的(116.38±10.46)ng/ml、(15.86±1.86)μg/L、(189.46±17.78)ng/L(P<0.05)。治疗后,观察组患者活化部分凝血活酶时间(35.43±2.21)s、凝血酶原时间(13.26±1.53)s、凝血酶时间(17.46±2.24)s比对照组的(30.48±2.15)、(10.93±1.29)、(15.55±1.87)s更长,纤维蛋白原(2.44±0.43)g/L比对照组的(4.21±0.64)g/L更低(P<0.05)。观察组并发症发生率5.00%比对照组的25.00%更低(P<0.05)。结论 针对急性脑梗死患者,采取静脉溶栓联合介入治疗可有效改善患者神经功能及血清学状况,且可以有效改善活化部分凝血活酶时间等相关临床指标,减少相关并发症的发生,该治疗方案临床应用效果理想,预后效果良好,值得在临床广泛推广。

介入溶栓治疗颅内大血管狭窄急性闭塞致脑梗死的疗效及对患者血清BDNF GAP-43和NGF的影响

目的 探讨介入溶栓治疗颅内大血管狭窄急性闭塞致脑梗死的临床疗效及对患者血清脑源性神经营养因子(BDNF)、神经生长相关蛋白43(GAP-43)和神经生长因子(NGF)水平的影响。方法 将56例颅内大血管狭窄急性闭塞致脑梗死患者按治疗方法分为对照组(28例)和研究组(28例)。对照组患者给予常规治疗,研究组患者在对照组基础上给予介入溶栓治疗。比较两组临床疗效以及不良事件发生率,比较治疗前后两组患者美国国立卫生研究院卒中量表(NHISS)评分、脑血流灌注指标、生存质量综合评定问卷简表(WHOQOL-BREF)评分及血清BDNF、GAP-43和NGF水平。结果 治疗后两组患者NHISS评分均较治疗前降低,且研究组低于对照组(P<0.01);治疗后两组患者脑血流量(CBF)、脑血容量(CBV)、脑血流平均通过时间(MTT)均较治疗前升高,且研究组高于对照组(P<0.01)。治疗后,研究组患者WHOQDL-BREF各维度评分均高于对照组(P<0.01)。治疗后,两组患者血清BDNF、GAP-43和NGF水平均较治疗前升高,且研究组高于对照组(P<0.01)。研究组患者临床总有效率高于对照组(P<0.05),两组患者不良事件发生率比较差异无统计学意义(P>0.05)。结论 介入溶栓治疗颅内大血管狭窄急性闭塞致脑梗死能够显著改善患者神经缺损程度,改善脑部供血,提高其生活质量,疗效显著。

中药黄芪的药理作用分析及临床应用效果

目的分析中药黄芪的药理作用及其临床应用效果。方法选取2022年10月—2023年10月青岛大学附属泰安市中心医院采用黄芪治疗的88例患者作为观察组,另选择同期应用西医治疗的88例作为对照组,观察运用中药黄芪后患者的临床疗效。结果观察组(95.45%)急性心肌梗死合并心力衰竭总有效率高于对照组(72.73%)(P<0.05)。观察组(90.91%)扩张型心肌病伴心力衰竭总有效率高于对照组(68.18%)(P<0.05)。观察组糖尿病周围神经病变总有效率(100%)高于对照组(77.27%)(P<0.05)。观察组脑血栓总有效率(95.45%)高于对照组(68.18%)(P<0.05)。结论中药黄芪在治疗糖尿病周围神经病变、急性心肌梗死伴心衰、脑血栓后遗症以及扩张型心肌病合并心力衰竭患者中疗效较理想,为临床治疗提供有力依据,同时也为中药在心血管和神经系统疾病治疗中的应用提供新思路。但仍需要进一步的研究来验证其机制和安全性。

血清Cx43、Gal-9水平对老年急性脑梗死患者超早期静脉溶栓治疗预后的评估价值

目的探讨血清间隙连接蛋白43(Cx43)、半乳糖凝集素-9(Gal-9)水平对老年急性脑梗死(ACI)患者超早期静脉溶栓治疗预后的评估价值。方法选取2020年9月至2022年9月在该院行超早期静脉溶栓治疗的106例老年ACI患者作为研究组,另外选取同期来该院体检的100例体检健康者作为健康组。采用酶联免疫吸附试验(ELISA)检测所有研究对象的血清Cx43、Gal-9水平。治疗2周后参考美国国立卫生院卒中量表(NIHSS)评分将106例老年ACI患者分为预后良好组(81例)与预后不良组(25例)。采用受试者工作特征(ROC)曲线分析血清Cx43、Gal-9水平对老年ACI患者超早期静脉溶栓治疗预后的评估价值,采用多因素Logistic回归分析探讨老年ACI患者超早期静脉溶栓治疗预后不良的影响因素。结果研究组血清Cx43、Gal-9水平高于健康组(P<0.05);预后不良组血清Cx43、Gal-9水平高于预后良好组(P<0.05);血清Cx43、Gal-9预测老年ACI患者预后不良的曲线下面积(AUC)分别为0.721(95%CI:0.673~0.758)、0.837(95%CI:0.787~0.886),二者联合预测的AUC为0.901(95%CI:0.857~0.946)。预后不良组高血压占比高于预后良好组(P<0.05);多因素Logistic回归分析显示,高血压(OR=3.487,95%CI:1.564~7.773),血清Cx43≥106.53 pg/mL(OR=4.586,95%CI:1.982~10.611),血清Gal-9≥11.84 ng/mL(OR=4.345,95%CI:1.957~9.648)是老年ACI患者超早期静脉溶栓治疗预后不良的危险因素(P<0.05)。结论血清Cx43、Gal-9在老年ACI患者中均呈高表达,可用于评估老年ACI患者超早期静脉溶栓治疗的预后,二者联合检测的评估价值更高。

头体针结合的电针疗法治疗急性脑梗死临床观察

目的观察电针治疗急性脑梗死的临床效果和对神经功能、神经炎性因子水平的影响。方法选取济宁医学院附属医院2021年11月1日—2022年11月1日收治的急性脑梗死患者60例,随机分为对照组和电针组,各30例。对照组给予西医常规疗法,电针组给予头体针结合的电针疗法,观察两组临床疗效、神经功能缺损程度及神经炎性因子表达水平。结果电针组总有效率为92.86%(26/28),高于对照组的68.97%(20/29)(P<0.05)。治疗后,两组神经功能缺损程度及神经炎性因子[白细胞介素-10(IL-10)、肿瘤坏死因子-ɑ(TNF-ɑ)、白细胞介素-17(IL-17)]水平均较治疗前有好转,且电针组均更优(P<0.05)。结论电针疗法对急性脑梗死有较好临床效果,能显著改善患者神经功能和炎性因子水平,提高其生活质量,且安全可靠,值得推广。

DWI-ASPECTS评分联合血清Hcy、LDL-C、Lp-PLA2对急性脑梗死静脉溶栓患者预后不良的预测价值

目的分析弥散加权成像-阿尔伯塔卒中项目早期计算机断层扫描(DWI-ASPECTS)评分联合血清同型半胱氨酸(Hcy)、低密度脂蛋白胆固醇(LDL-C)、脂蛋白磷脂酶A2(Lp-PLA2)对急性脑梗死(ACI)静脉溶栓患者预后不良的预测价值。方法回顾性分析2021年3月至2023年9月山东大学齐鲁医院德州医院收治的102例ACI患者的临床资料,静脉溶栓3个月后以改良Rankin量表(mRS)评估患者预后,根据mRS评分将患者分为预后良好组(mRS评分≤2分)与预后不良组(mRS评分>2分)。比较两组基线资料及血清Hcy、LDL-C、Lp-PLA2水平及DWI-ASPECTS评分。绘制受试者工作特征(ROC)曲线分析DWI-ASPECTS评分联合血清Hcy、LDL-C、Lp-PLA2对ACI静脉溶栓患者预后不良的预测价值。结果预后不良组有35例患者,预后良好组有67例患者。预后不良组美国国立卫生研究院卒中量表(NIHSS)评分及Hcy、LDL-C、Lp-PLA2水平高于预后良好组,DWI-ASPECTS评分低于预后良好组,差异均有统计学意义(P<0.05)。ROC曲线分析结果显示,DWI-ASPECTS评分联合Hcy、LDL-C、Lp-PLA2评估ACI静脉溶栓患者预后不良的曲线下面积(AUC)大于DWI-ASPECTS评分、Hcy、LDL-C、Lp-PLA2单独预测的AUC(Z=3.548、3.316、3.996、4.009,P<0.05)。结论DWI-ASPECTS评分及血清Hcy、LDL-C、Lp-PLA2均对ACI静脉溶栓患者预后不良具有一定的预测价值,且其联合检测可提高预测价值。

中医临床路径管理模式下急性脑梗死的临床观察

目的 系统性评估急性脑梗死患者应用中医临床路径管理的效果。方法 选取2022年1月—2023年1月接受治疗的急性脑梗死患者60例,采用信封法随机分为对照组和试验组,各30例。对照组应用常规临床治疗方案,试验组应用中医临床路径管理治疗方案,观察2组患者治疗前后神经功能缺损程度、日常生活能力指数及临床效果变化情况。结果 试验组总有效率为96.67%(29/30),高于对照组的80.00%(24/30)(P<0.05)。治疗后,试验组神经功能缺损程度、日常生活能力指数均优于对照组(P<0.05)。结论 急性脑梗死患者入院后接受中医临床路径管理治疗方案,可更具针对性、高效性地施以临床治疗,提高医护患间协同效果、增进患者愈后神经功能恢复、改善患者自理生活能力、降低患者临床治疗经济负担,效果显著,值得临床推广。

益气通脉汤联合针刺治疗气虚血瘀型急性脑梗死临床观察

目的探讨益气通脉汤联合针刺疗法对气虚血瘀型急性脑梗死患者血液流变学及血清相关指标的影响。方法将2021年6月—2022年6月泉州市中医院内科收治的气虚血瘀型急性脑梗死患者80例作为观察对象,按随机数字表法分成对照组(40例)、研究组(40例)。两组均行常规西医治疗,研究组同时采用益气通脉汤联合针刺治疗,对比两组治疗前后血液流变学、血清相关指标水平和不良反应发生率。结果与治疗前相比,治疗2周后,两组纤维蛋白原、高切血黏度、D-二聚体、血浆黏度及血清低氧诱导因子-1α(HIF-1α)水平均下降,且研究组较对照组更低,两组血清血管内皮生长因子(VEGF)水平均升高,且研究组较对照组更高,差异有统计学意义(P<0.05);两组不良反应发生率差异无统计学意义(P>0.05)。结论气虚血瘀型急性脑梗死患者接受益气通脉汤联合针刺治疗能更好地调控血液流变学指标和血清相关指标,改善脑血液循环,加快病情恢复,且安全性高。

经颅超声神经肌肉刺激联合醒脑开窍针法对脑梗死偏瘫患者下肢功能的影响

目的观察经颅超声神经肌肉刺激(TUS-NMES)联合醒脑开窍针法对脑梗死偏瘫患者下肢功能的影响。方法将120例脑梗死偏瘫患者随机分为对照组和治疗组,每组60例。对照组采用醒脑开窍针法治疗,治疗组在对照组基础上辅以TUS-NMES治疗。3周后采用Fugl-Meyer评定量表(FMA)、改良Barthel指数(MBI)、功能性步行量表(FAC)、Brunnstrom评定量表进行疗效评定。结果经过3周治疗,2组患者FMA评分、MBI评分、FAC分级及下肢Brunnstrom分级均较治疗前明显改善,且治疗组均明显优于对照组(P<0.05)。结论TUS-NMES联合醒脑开窍针法可以明显改善脑梗死偏瘫患者的下肢运动功能、日常生活活动能力及步行能力。