醒脑开窍针刺联合通窍活血汤对脑卒中后癫痫患者脑血流动力学指标及氧化应激指标的影响

Effect of Xingnao Kaiqiao acupuncture combined with Tongqiao Huoxue Decoction on cerebral hemodynamic and oxidative stress indicators in post-stroke epilepsy patients

关键词:  脑卒中  癫痫  针刺  通窍活血汤  脑血流动力学  氧化应激

Key words:  stroke  epilepsy  acupuncture  Tongqiao Huoxue Decoction  cerebral hemodynamics  oxidative stress

摘要:

[目的] 探究醒脑开窍针刺联合通窍活血汤对脑卒中后癫痫（EP）患者脑血流动力学指标及氧化应激指标的影响。[方法] 共纳入甘肃省庆阳市中医医院收治的80例脑卒中后EP患者，时间为2021年5月—2024年1月，以随机数表法分为对照组（40例）和观察组（40例）。对照组予以常规西医治疗，观察组予以醒脑开窍针刺联合通窍活血汤治疗，治疗2个月，比较两组疗效；于治疗前后比较两组EP发作情况、氧化应激指标[丙二醛（MDA）、一氧化氮合酶（NOS）、超氧化物歧化酶（SOD）]、脑血流动力学指标[双侧大脑中动脉（MCA）的平均血流速度（Vm）、最大峰值流速（Vs）、压力指数（PA）、阻力指数（RI）]；并记录不良反应发生情况。[结果] 与对照组（77.50 %）相比，观察组（95.00 %）总有效率更高（P＜0.05）；治疗后，观察组EP发作次数少于对照组，持续时间短于对照组（P＜0.05）；治疗后，两组血清MDA水平下降，两组NOS、SOD水平提高，且观察组变化更明显（P＜0.05）；治疗后，两组双侧MAC的Vm、Vs值提高，PA值下降，且观察组变化更明显（P＜0.05）。两组不良反应发生率比较，差异无统计学意义（P＞0.05）。[结论] 醒脑开窍针刺联合通窍活血汤应用于脑卒中后EP患者中，可提高疗效，减轻氧化应激程度，改善脑血流动力学，减轻EP程度。

Abstract:

[Objective] To investigate the effects of Xingnao Kaiqiao acupuncture combined with Tongqiao Huoxue Decoction on cerebral hemodynamics and oxidative stress indicators in patients with post-stroke epilepsy（EP）. [Methods] A total of 80 post-stroke EP patients admitted to Qingyang Traditional Chinese Medicine Hospital from May 2021 to January 2024 were randomly divided into control group（40 cases） and observation group（40 cases）. The control group was treated with conventional Western medicine，while the observation group received additional Xingnao Kaiqiao acupuncture and Tongqiao Huoxue Decoction for 2 months. Efficacy was compared between the two groups. EP episodes，oxidative stress index [malondialdehyde（MDA），nitric oxide synthase（NOS），superoxide dismutase（SOD）]，cerebral hemodynamic index [mean blood flow velocity（Vm） of bilateral middle cerebral artery（MCA），maximum peak flow velocity（Vs），pressure index（PA），resistance index（RI）] were compared before and after treatment. Adverse reactions were recorded. [Results] The total effective rate was significantly higher in the observation group（95.00%） than in the control group（77.50%，P<0.05）. After treatment，the observation group had fewer EP episodes shorter than the control group（P<0.05），and MDA levels in the two groups changed more significantly（P<0.05）. After treatment，the Vm and Vs values of bilateral MAC in both groups increased，the PA value decreased，and the observation group changed more significantly（P<0.05）. No significant difference in adverse reactions was observed（P>0.05）. [Conclusion] Xingnao Kaiqiao acupuncture combined with Tongqiao Huoxue Decoction can improve therapeutic efficacy，alleviate oxidative stress，enhance cerebral hemodynamics，and reduce seizure severity in post-stroke EP patients.