摘要
目的:探讨针刺结合尼莫地平对急性脑出血患者血流动力学、神经功能及血清肿瘤坏死因子-α(TNF-α)、转化生长因子-β1(TGF-β1)、细胞间黏附分子-1(ICAM-1)表达的影响。方法:选取2015年7月至2018年1月河南中医药大学第一附属医院收治的急性脑出血患者90例作为研究对象,均接受保守治疗。回顾性分析其治疗方案并分为对照组(n=47)和针刺组(n=43):对照组在常规对症支持治疗同时加入尼莫地平治疗;针刺组在对照组治疗基础上加入针刺治疗。治疗前后监测2组患者的血流动力学,计算美国国立卫生研究院卒中量表(NIHSS)评分值并检测血清中神经功能相关指标神经元特异性烯醇化酶(NSE)、脑源性神经营养因子(BDNF)的水平,炎性反应递质TNF-α、TGF-β1、ICAM-1的表达情况。结果:治疗前,2组患者血流动力学参数Vm、RI、PI水平,NIHSS评分值及血清神经功能指标NSE、BDNF水平,血清中炎性反应递质TNF-α、TGF-β1、ICAM-1差异无统计学意义(t=0.054、0.236、-0.632、0.455、0.204、0.542、0.111、-0.371、0.189,P>0.05)。治疗1个疗程后,针刺组Vm、PI的水平高于对照组,RI的水平低于对照组;NIHSS评分值及NSE水平低于对照组,BDNF水平高于对照组;血清中TNF-α、TGF-β1、ICAM-1水平低于对照组(t=2.025、2.372、-3.318、-14.538、-18.922、11.969、-10.234、-5.166、-8.439,P均<0.05)。结论:针刺治疗可进一步优化急性脑出血患者的脑血流动力学状态并减轻神经功能损伤,抑制机体过度炎性反应,是一种可靠的中医治疗手段。
Objective: To study the effects of acupuncture combined with nimodipine on hemodynamic state,neurological function and expression of serum TNF-α,TGF-β 1 and ICAM-1 in patients with acute cerebral hemorrhage. Methods: A total of 90 cases of acute cerebral hemorrhage patients admitted in The First Affiliated Hospital of Henan University of Chinese Medicine from July 2015 to January 2018 were selected as research subjects,and received conservative treatment.Treatment schemes were retrospectively analyzed and all patients were divided into a control group ( n =47) underwent routine symptomatic support treatment and nimodipine,and a acupuncture group ( n =43) added acupuncture treatment on the basis of the control group.The hemodynamic state of the 2 groups was monitored before and after treatment.The National Institutes of Health Stroke Scale (NIHSS) score was calculated and serum contents of neuron specific enolase (NSE),brain derived neurotrophic factor (BDNF) were detected.The expression of inflammatory mediator such as tumor necrosis factors α(TNF-α),transforming growth factor β 1 (TGF-β 1) and intercellular adhesion molecule-1 (ICAM-1) were measured. Results: Before treatment,there were no statistical difference between 2 groups in hemodynamic parameters V m,RI,PI,score of NIHSS and serum contents of NSE and BDNF,and serum contents of TNF-a,TGF-β 1,ICAM-1 ( t =0.054,0.236,-0.632,0.455,0.204,0.542,0.111,-0.371,0.189, P >0.05).After 1 course of treatment,levels of V m and PI in the acupuncture group were higher than those in the control group,and level of RI was lower than that in the control group.Score of NIHSS and serum content of NSE were lower than those in the control group,and content of BDNF was higher than that in the control group;serum contents of TNF-a,TGF-β 1 and ICAM-1 in the acupuncture group were lower than those in control group ( t =2.025,2.372,-3.318,-14.538,-18.922,11.969,-10.234,-5.166,-8.439, P <0.05). Conclusion: Acupuncture can further optimize the cerebral hemodynamic state of acute cerebral hemorrhage patients,reduce the injury of nerve function and inhibit the excessive inflammatory reaction of the body.It is a reliable means of traditional Chinese medicine treatment.
作者
姜守军
钱百成
张振铎
徐晓妍
Jiang Shoujun;Qian Baicheng;Zhang Zhenduo;Xu Xiaoyan(The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000,China)
出处
《世界中医药》
CAS
2019年第5期1290-1293,1297,共5页
World Chinese Medicine
基金
河南省中医药管理局课题(2016ZY2005)
关键词
急性脑出血
针刺
尼莫地平
血流动力学
神经功能
炎性反应
Acute cerebral hemorrhage
Acupuncture
Nimodipine
Hemodynamics
Nerve function
Inflammatory reaction
