针刺疗法辅助治疗格林-巴利综合征的临床研究

黄建福; 刘建浩; 王波; 王天磊; 徐琼

doi:10.14148/j.issn.1672-0482.2022.0696

针刺疗法辅助治疗格林-巴利综合征的临床研究

doi: 10.14148/j.issn.1672-0482.2022.0696

三亚市中医院针灸科, 海南三亚 572000

基金项目:

海南省自然科学基金面上项目 817399

详细信息

作者简介:
黄建福, 男, 主治医师, E-mail: tiaowenyi3@163.com

通讯作者:
刘建浩, 男, 主任医师, 主要从事中医针灸学的研究, E-mail: liujianhao168@163.com

中图分类号: R246.6
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- 文章访问数: 114
- HTML全文浏览量: 15
- PDF下载量: 12
- 被引次数: 0
出版历程
- 收稿日期: 2021-03-28
- 网络出版日期: 2022-08-05
- 发布日期: 2022-08-10

Clinical Study of Acupuncture Therapy as An Auxiliary Treatment for Guillain-Barre Syndrome

Acupuncture and Moxibustion Department, Sanya Traditional Chinese Medicine Hospital, Sanya 572000, China

摘要

摘要: 目的观察针刺疗法辅助治疗格林巴利综合征(GBS)的临床疗效。方法以三亚市中医院2019年2月—2021年10月收治的169例GBS患者为研究对象, 随机数字表法分为对照组(83例)和观察组(86例), 其中西药对照组50例, 西药观察组50例, 中药对照组33例, 中药观察组36例。对照组给予常规西药或中药治疗, 观察组在对照组治疗基础上另给予针刺辅助治疗, 疗程4周。比较治疗前后对照组和观察组四肢肌力、神经功能[运动神经传导速度(MCV)、感觉神经传导速度(SCV)]、中医证候积分、临床疗效、血清炎性因子[白介素-10(IL-10)、白介素-18(IL-18)]水平及安全性指标变化情况。结果治疗后, 西药、中药观察组四肢肌力明显升高(P < 0.05, P < 0.01), 优于对照组(P < 0.05);西药、中药观察组正中神经、胫神经MCV、SCV明显升高(P < 0.05), 优于对照组(P < 0.05);西药、中药观察组中医证候评分明显低于治疗前, 并低于对照组(P < 0.05);西药、中药观察组治疗总体有效率明显高于对照组(P < 0.05);西药、中药观察组IL-10水平明显升高(P < 0.01), 并高于对照组(P < 0.05), IL-18明显降低(P < 0.01), 并低于对照组(P < 0.05);各组均无明显并发症。结论针刺辅助疗法能够明显提高西药、中药治疗的临床疗效, 改善患者肌力、神经功能及临床症状, 恢复患者血清炎症因子水平。
- 格林巴利综合征 /
- 针刺 /
- 辅助治疗
Abstract: OBJECTIVE To observe the clinical efficacy of acupuncture therapy in the auxiliary treatment of Guillain-Barre syndrome (GBS). METHODS A total of 169 patients with GBS admitted to Sanya TCM Hospital from February 2019 to October 2021 were studied, and were divided into control group (83 cases) and observation group (86 cases) by random number table method. There were 50 cases in the western medicine control group, 50 cases in the western medicine observation group, 33 cases in the Chinese medicine control group, and 36 cases in the Chinese medicine observation group. The control group was treated with conventional western or Chinese medicine therapies, while the observation group was given acupuncture-auxiliary treatment based on the therapies in the control group. The treatment course lasted four weeks. In addition, we compared the muscle strength of the limbs, nerve function [motor nerve conduction velocity (MCV), sensory nerve conduction velocity (SCV)], traditional Chinese medicine (TCM) syndrome scores, clinical efficacy, serum inflammatory factors [interleukin-10 (IL-10), interleukin-18 (IL-18)] levels, as well as safety indexes in the control group and the observation group before and after treatment. RESULTS After treatment, the muscle strength of the of limbs was significantly increased in the western and Chinese medicine observation groups (P < 0.05, P < 0.01), whose results were better than those in the control group (P < 0.05). Besides, the MCV and SCV of the median nerve and tibial nerve were significantly increased in the western and Chinese medicine observation groups (P < 0.05), whose results were also better than those in the control group (P < 0.05). In addition, TCM syndrome scores were significantly reduced in the western and Chinese medicine observation groups compared to pre-treatment results and lower than those in the control group (P < 0.05). The total effective rates of treatment in the western and Chinese medicine observation groups were significantly increased than those in the control group (P < 0.05). on top of that, the IL-10 levels in the western and Chinese medicine observation groups were significantly increased (P < 0.01) and higher than those in the control group (P < 0.05), while IL-18 levels were significantly reduced (P < 0.01) and lower than those in the control group (P < 0.05). There were no notable complications in all groups. CONCLUSION Acupuncture auxiliary therapy can significantly optimize the clinical efficacy of western and Chinese medicine treatment. Besides, it can improve patients' muscle strength and neurological function, mitigate clinical syndromes, and restore patients' serum inflammatory factor levels.
- Guillain-Barre syndrome /
- acupuncture /
- auxiliary treatment

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图 1 4组患者治疗前后四肢肌力得分比较

注: 组内比较, ^*P < 0.05, ^**P < 0.01;组间比较, ^ΔP < 0.05。x±s，n_{西药对照组}=50, n_{西药观察组}=50, n_{中药对照组}=33, n_{中药观察组}=36。

Figure 1. Comparison of muscle strength scores of the four groups of patients before and after treatment

下载: 全尺寸图片幻灯片

图 2 4组患者治疗前后神经功能比较

注: 组内比较, ^*P < 0.05;组间比较, ^ΔP < 0.05。x±s，n_{西药对照组}=50, n_{西药观察组}=50, n_{中药对照组}=33, n_{中药观察组}=36。

Figure 2. Comparison of neurological function of the four groups before and after treatment

下载: 全尺寸图片幻灯片

图 3 4组患者治疗前后中医证候积分比较

注: 组内比较, ^*P < 0.05;组间比较, ^ΔP < 0.05。x±s，n_{西药对照组}=50, n_{西药观察组}=50, n_{中药对照组}=33, n_{中药观察组}=36。

Figure 3. Comparison of TCM syndrome scores of the four groups before and after treatment

下载: 全尺寸图片幻灯片

表 1 4组患者基线资料比较(x±s)

Table 1. Comparison of baseline information of patients in the four groups (x±s)

组别	例数	性别		年龄/岁	病程/月	休斯功能分级量表
组别	例数	男	女	年龄/岁	病程/月	1级	2级	3级	4级
西药对照组	50	29	21	28.53±5.49	9.16±2.63	6	17	20	7
西药观察组	50	30	20	28.23±5.54	9.28±2.69	6	16	21	7
中药对照组	33	18	15	31.46±6.21	8.48±2.41	5	11	13	4
中药观察组	36	20	16	30.23±4.93	8.75±1.43	4	14	15	3
注: 病情严重程度采用休斯功能分级量表(Hughes functional grading scale, HFGS)^[11]评分: 6分为死亡; 5分为需要呼吸机辅助呼吸; 4分为卧床; 3分为步行5 m需要帮助; 2分为可自行行走; 1分为轻微症状或体征; 0分为正常。4级: 评分≤1分, 3级: 2~3分, 2级: 3~4分, 1级: >4分。

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表 2 4组患者治疗后中医临床疗效比较

Table 2. Comparison of clinical efficacy of TCM after treatment in the four groups

组别	例数	治愈	好转	未愈	有效率/%
西药观察组	50	28	21	1	98.00^*
西药对照组	50	20	19	11	78.00
中药对照组	33	11	15	7	78.79
中药观察组	36	14	19	3	91.67^*
注: 组间比较, χ_西药组²=5.28, χ_中药组²=5.13, ^*P < 0.05。

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表 3 4组患者治疗前后血清炎性因子水平比较(x±s, pg·mL^-1)

Table 3. Comparison of serum inflammatory factors before and after treatment in the four groups (x±s, pg·mL^-1)

组别	例数	时间	IL-10	IL-18
西药对照组	50	治疗前	46.23±5.94	135.43±28.47
西药对照组	50	治疗后	67.42±5.51^**	66.47±15.33^**
西药观察组	50	治疗前	46.15±5.84	135.52±28.54
西药观察组	50	治疗后	69.28±6.04^**Δ	62.24±17.62^**Δ
中药对照组	33	治疗前	45.28±6.31	134.86±26.97
中药对照组	33	治疗后	68.53±4.84^**	63.87±6.74^**
中药观察组	36	治疗前	45.83±5.59	135.93±27.35
中药观察组	36	治疗后	70.06±5.62^**Δ	60.64±9.32^**Δ
注: 组内比较, ^**P < 0.01;组间比较, ^ΔP < 0.05。

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表 4 4组患者治疗前后安全性比较(x±s)

Table 4. Comparison of safety indexes before and after treatment in the four groups (x±s)

组别	例数	时间	WBC/(10⁹·L^-1)	AST/(U·L^-1)	ALT/(U·L^-1)	GGT/(U·L^-1)	CR/(μmol·L^-1)	BUN/(μmol·L^-1)	UA/(μmol·L^-1)
西药对照组	50	治疗前	5.96±1.69	25.12±2.91	27.65±3.23	14.13±4.36	81.12±11.78	4.53±0.70	230.19±31.59
西药对照组	50	治疗后	5.95±1.70	25.71±3.23	28.35±3.48	13.43±4.87	84.32±12.28	3.31±0.63	254.59±30.69
西药观察组	50	治疗前治疗后	6.02±1.61	24.78±2.87	24.56±3.15	13.93±4.96	70.04±14.91	3.91±0.76	274.61±38.72
西药观察组	50	治疗后	6.13±1.65	23.56±2.48	26.75±3.82	15.34±5.28	66.64±15.12	4.82±0.55	273.71±41.81
中药对照组	33	治疗前	6.05±1.67	25.98±3.13	27.62±4.21	13.85±4.12	78.21±13.22	4.31±0.59	246.39±32.78
中药对照组	33	治疗后	6.07±1.71	26.85±3.23	26.91±4.13	14.58±4.43	72.65±11.84	4.28±0.42	228.82±37.58
中药观察组	36	治疗前	5.98±1.69	25.51±3.02	26.05±3.78	13.55±4.17	67.81±15.82	5.71±0.47	258.57±31.63
中药观察组	36	治疗后	6.08±1.72	25.39±2.94	24.84±4.27	13.42±4.23	69.74±16.81	6.20±0.23	283.72±32.72

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