熄风通瘀开窍方联合电针治疗急性脑梗死临床疗效及机制

Therapeutic effect and mechanism of Xifeng Tongyu Kaiqiao Recipe combined with electroacupuncture on acute cerebral infarction

关键词:  熄风通瘀开窍方  电针  急性脑梗死  炎症  氧化应激  神经功能

Key words:  Xifeng Tongyu Kaiqiao Recipe  electro-acupuncture  acute cerebral infarction  inflammation  oxidative stress  nerve function

摘要:

[目的] 探讨熄风通瘀开窍方联合电针治疗急性脑梗死临床疗效及机制。[方法] 将164例急性脑梗死患者采用随机数字表分为4组，对照组（41例，常规西医治疗）、电针组（41例，常规西医+电针治疗）、汤剂组（41例，常规西医+熄风通瘀开窍方治疗）、联合组（41例，常规西医+熄风通瘀开窍方+电针治疗）。对比4组治疗前、1周后、2周后炎症[肿瘤坏死因子-α（TNF-α）超敏C反应蛋白（hs-CRP）、白介素-1β（IL-1β）]、氧化应激[丙二醛（MDA）、超氧化物歧化酶（SOD）、一氧化氮（NO）、谷胱甘肽过氧化物酶（GSH-Px）]、神经功能[美国国立卫生院神经功能缺损量表（NIHSS）]变化，病情转归情况。[结果] 血清炎症因子、氧化应激指标及NIHSS评分经重复测量方差分析差异均有统计学意义（P<0.05）；4组1、2周后血清炎症因子、MDA水平、NIHSS评分均低于治疗前（P<0.05），2周后均低于1周后（P<0.05），且1周后、2周后联合组均低于其余3组（P<0.05），电针组、汤剂组均低于对照组（P<0.05）；4组1周后、2周后血清SOD、NO和GSH-Px均高于治疗前（P<0.05），2周后均高于1周后（P<0.05），且1、2周后联合组均高于其余3组（P<0.05），电针组、汤剂组均高于对照组（P<0.05）；联合组预后良好率高于其余3组（P<0.01）。[结论] 熄风通瘀开窍方和电针均可减轻急性脑梗死患者的炎症、氧化应激及神经功能缺损程度，两者联合效果更佳且可有效促进病情转归。

Abstract:

[Objective] To explore the effect of Xifeng Tongyu Kaiqiao Recipe combined with electro-acupuncture on the patients with acute cerebral infarction.[Methods] The 164 patients with acute cerebral infarction were randomly divided into control group (41 cases, routine Western medicine treatment), electro-acupuncture group (41 cases, routine Western medicine+electroacupuncture treatment), decoction group (41 cases, routine Western medicine+Xifeng Tongyu Kaiqiao Recipe), combined group (41 cases, routine Western medicine+ Xifeng Tongyu Kaiqiao Recipe+electro-acupuncture). The changes of inflammation[tumor necrosis factor-α (TNF-α), high sensitivity C-reactive protein (hs-CRP), interleukin-1 β (IL-1β)], oxidative stress[malondialdehyde (MDA), superoxide dismutase (SOD), nitric oxide (NO), glutathione peroxidase (GSH-Px)] and neurological function (NIHSS) before treatment, 1 week and 2 weeks after treatment, prognosis of the disease were compared among the 4 groups.[Results] There were statistically significant differences in the serum inflammatory factors, oxidative stress indexes and NIHSS scores by variance by repeated measurement analysis (P<0.05). After 1 week and 2 weeks, serum inflammatory factors, MDA levels and NIHSS scores of the four groups were lower than those before treatment (P<0.05), and those after 2 weeks were lower than those after 1 week (P<0.05), which in the combination group were lower than those in the other three groups after 1 week and 2 weeks (P<0.05), and those in the electro-acupuncture group and decoction group were lower than those in the control group (P<0.05). The serum SOD, NO and GSH PX in the four groups after 1 week and 2 weeks were higher than those before treatment (P<0.05), and those after 2 weeks were higher than those after 1 week (P<0.05), and those in the combination group after 1 week and 2 weeks were higher than those in the other three groups (P<0.05), and those in the electro-acupuncture group and decoction group were higher than those in the control group (P<0.05). The good prognosis rates of the combined group, electro-acupuncture group, which in the combination group was higher than those of the other three groups (P<0.05).[Conclusion] Xifeng Tongyu Kaiqiao Recipe and electro-acupuncture can reduce the inflammation, oxidative stress and neurological deficit in patients with acute cerebral infarction, and the combination of the two has better effect and can effectively promote the prognosis of the disease.