循经灸联合温和灸对缺血性脑卒中患者康复的影响

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

    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。

     

    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.

     

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