循经灸联合温和灸对缺血性脑卒中患者康复的影响

周琳; 郭秀君; 吴琼; 戴彦祺; 黄莉; 姚瑶; 惠振

doi:10.14148/j.issn.1672-0482.2022.0059

循经灸联合温和灸对缺血性脑卒中患者康复的影响

doi: 10.14148/j.issn.1672-0482.2022.0059

周琳^1,,
郭秀君^2, ,,
吴琼²,
戴彦祺¹,
黄莉¹,
姚瑶¹,
惠振³

1.
南京中医药大学护理学院, 江苏南京 210023
2.
南京市中医院护理部, 江苏南京 210001
3.
南京市中医院脑病科, 江苏南京 210001

基金项目:

国家自然科学基金青年科学基金项目 81703975

南京中医药大学江苏护理学优势学科第三期开放课题 2019YSHL099

世界中医药联合会护理专业委员会开放课题 SZLHLA-1902

详细信息

作者简介:
周琳, 女, 硕士研究生, E-mail: 20190605@njucm.edu.cn

通讯作者:
郭秀君, 女, 教授, 主任护师, 主要从事中医护理研究, E-mail: sfy033@njucm.edu.cn

中图分类号: R255.2
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- 文章访问数: 210
- HTML全文浏览量: 35
- PDF下载量: 20
- 被引次数: 0
出版历程
- 收稿日期: 2021-07-27
- 网络出版日期: 2022-01-19
- 发布日期: 2022-01-15

Effect of Meridian Moxibustion Combined with Warming Moxibustion on the Rehabilitation of Ischemic Stroke Patients

ZHOU Lin^1
,,
GUO Xiu-jun^{2
, ,},
WU Qiong²,
DAI Yan-qi¹,
HUANG Li¹,
YAO Yao¹,
HUI Zhen³

1.
School of Nursing, Nanjing University of Chinese Medicine, Nanjing 210023, China
2.
Nursing Department, Nanjing TCM Hospital, Nanjing 210001, China
3.
Encephalopathy Department, Nanjing TCM Hospital, Nanjing 210001, China

摘要

摘要: 目的观察循经灸联合温和灸对缺血性脑卒中患者康复的影响。方法将92例缺血性脑卒中患者随机分为对照组和试验组各46例。对照组给予常规治疗(抗血小板聚集、降压、降糖、降脂和脑保护), 试验组在此基础上给予循经灸联合温和灸干预。分别于治疗前(T₀)、治疗7天(T₁)、治疗14天(T₂)、治疗28天(T₃)采用美国国立卫生研究院卒中量表(NIHSS评分)、日常生活活动能力评分(BI评分)、简化Fugl-Meyer运动功能评分(FMA评分)对2组患者进行疗效评定。治疗前后ELISA法检测血清血管内皮生长因子(Vascular endothelial growth factor, VEGF)、血管生成素1(Angiopoietin-1, Ang-1)含量, 免疫透射比浊法检测高敏C反应蛋白(Hypersensitive C reactive protein，hs-CRP)含量。结果治疗后, 对照组T₂、T₃时间点及试验组T₁、T₂、T₃时间点NIHSS评分明显降低(P < 0.05, P < 0.01)，对照组T₁、T₂、T₃时间点及试验组T₂、T₃时间点BI评分显著增加(P < 0.01)，试验组T₂、T₃时间点NIHSS评分、BI评分优于对照组(P < 0.05, P < 0.01);2组患者FMA评分均显著增加(P < 0.01)，试验组优于对照组(P < 0.05, P < 0.01);2组患者血清VEGF、Ang-1均升高, 血清hs-CRP均降低(P < 0.05, P < 0.01), 试验组血清VEGF水平高于对照组(P < 0.01), hs-CRP水平低于对照组(P < 0.05)。结论循经灸联合温和灸可改善缺血性脑卒中患者神经功能, 提高日常生活活动能力, 促进肢体康复, 可能与调节血管生长因子表达、降低炎症反应有关。
- 缺血性脑卒中 /
- 循经灸 /
- 温和灸 /
- 康复
Abstract: OBJECTIVE To observe the effect of meridian moxibustion on the rehabilitation of patients with ischemic stroke. METHODS A total of 92 patients with ischemic stroke were randomly divided into a control group and a treatment group of 46 cases each. The control group was given conventional treatment (anti-platelet aggregation, antihypertensive, glucose-reducing, lipid-lowering and cerebral protection), while the experimental group was given the meridian moxibustion intervention on top of this. The efficacy of the treatment was evaluated in both groups before (T₀), 7 days after (T₁), 14 days after (T₂) and 28 days after (T₃) using the National Institutes of Health Stroke Scale (NIHSS), activities of daily living (BI index) and simplified Fugl-Meyer motor assessments (FMA). Besides, serum levels of vascular endothelial growth factor (VEGF) and angiopoietin 1 (Ang-1) were measured by ELISA and high-sensitivity c-reactive protein (hs-CRP) by immunity transmission turbidity before and after treatment. RESULTS After treatment, The NIHSS score decreased with statistical differences in the control group at time points of T₂, T₃ and in the treatment group at time points of T₁, T₂, T₃ (P < 0.05, P < 0.01). The BI score increased significantly in the control group at time points of T₁, T₂, T₃ and in the treatment group at time points of T₂, T₃ (P < 0.01). At time points of T₂ and T₃, Better NIHSS score and BI score were seen in the treatment group than those in the control group with statistically significant differences (P < 0.05, P < 0.01). Both groups had significantly increased FMA scores (P < 0.01) and the treatment group was better than the control group (P < 0.05, P < 0.01). In addition, serum VEGF and Ang-1 were increased and serum hs-CRP was decreased in both groups (P < 0.05, P < 0.01), the serum VEGF level in the treatment group was higher than that in the control group (P < 0.01), and the hs-CRP level was lower than that in the control group (P < 0.05). CONCLUSION Meridian moxibustion can improve neurological function, enhance the ability of daily living activities, and promote limb rehabilitation in patients with ischemic stroke. The therapeutic effects may be related to regulating vascular growth factor expression and reducing the inflammatory response.
- ischemic stroke /
- meridian moxibustion /
- warming moxibustion /
- rehabilitation

HTML全文

表 1 2组患者治疗前后NIHSS评分比较(x±s, n=46)

Table 1. Comparison of NIHSS scores before and after treatment between the 2 groups (x±s, n=46)

组别	T₀	T₁	T₂	T₃
对照组	7.59±4.25	6.72±3.36	5.78±3.24^*	4.78±3.13^**
试验组	7.76±3.21	5.72±2.88^**	4.20±2.83^**#	3.04±2.26^**##
注: 行重复测量方差分析, F_组间=4.414, P < 0.05;F_时间=39.749, P < 0.01;F_交互=2.860, P>0.05。与T₀比较, ^P < 0.05, ^*P < 0.01;组间比较, ^#P < 0.05, ^##P < 0.01。

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表 2 2组患者治疗前后BI评分比较(x±s, n=46)

Table 2. Comparison of BI scores before and after treatment between the 2 groups (x±s, n=46)

组别	T₀	T₁	T₂	T₃
对照组	61.41±16.99	67.04±13.93^**	70.11±14.70^**	75.76±15.60^**
试验组	65.00±22.97	68.04±20.23	78.80±14.88^**##	84.13±12.62^**##
注: 行重复测量方差分析, F_组间=3.979, P < 0.05;F_时间=34.992, P < 0.01;F_交互=2.159, P>0.05。与T₀比较, ^**P < 0.01;组间比较, ^##P < 0.01。

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表 3 2组患者治疗前后FMA评分比较(x±s, n=46)

Table 3. Comparison of FMA scores before and after treatment between the 2 groups (x±s, n=46)

组别	T₀	T₁	T₂	T₃
对照组	62.93±8.53	67.80±8.73^**	71.13±7.25^**	74.17±8.70^**
试验组	62.76±7.61	72.00±7.12^**#	74.67±4.85^**##	80.48±7.58^**##
注: 行重复测量方差分析, F_组间=6.026, P < 0.05;F_时间=204.657, P < 0.01;F_交互=10.065, P < 0.01。与T₀比较, ^**P < 0.01;组间比较, ^#P < 0.05, ^##P < 0.01。

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表 4 2组患者治疗前后血清VEGF、Ang-1、hs-CRP水平比较(x±s, n=46)

Table 4. Comparison of VEGF, Ang-1, and hs-CRP levels before and after treatment between the 2 groups (x±s, n=46)

组别	时间	VEGF/(pg·mL^-1)	Ang-1/(μg·L^-1)	hs-CRP/(mg·L^-1)
对照组	治疗前	225.83±67.81	8.68±2.56	5.20±4.60
	治疗后	261.31±86.75^*	10.38±2.71^**	3.80±3.34^*
试验组	治疗前	240.49±59.40	8.33±2.65	4.92±3.53
	治疗后	309.82±79.21^**##	11.21±1.98^**	2.47±2.03^**#
注: 组内比较, ^P < 0.05, ^*P < 0.01;组间比较, ^#P < 0.05, ^##P < 0.01。

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