王金海;赵敏;鲍英存;商俊芳;鄢琦;张振昶;杜小正;姜华;张武德;
WANG Jin-hai;ZHAO Min;BAO Ying-cun;SHANG Jun-fang;YAN Qi;ZHANG Zhen-chang;DU Xiao-zheng;JIANG Hua;ZHANG Wu-de;Department of Chinese Medicine,the Second Hospital of Lanzhou University;Department of Neurology,the Second Hospital of Lanzhou University;Medical Technical College,Gansu College of Traditional Chinese Medicine;

• 1:兰州大学第二医院中医科
• 2:兰州大学第二医院神经内科
• 3:甘肃中医学院医学技术学院

摘要(Abstract)：

目的:观察头穴透刺对急性脑梗死患者血清超敏C反应蛋白(hs-CRP)、肿瘤坏死因子(TNF)-α、白介素(IL)-6、IL-1β水平的影响,探讨头针治疗急性脑梗死的机制。方法:将符合纳入标准的61例急性脑梗死患者采用分层区组随机法分为头针组31例,对照组30例。对照组采用常规西医治疗,头针组在对照组治疗的基础上加用头穴透刺,取双侧顶颞前斜线、顶颞后斜线行透穴治疗,每日1次,共7d。于治疗前、第3天、第7天,ELISA法检测血清hs-CRP、TNF-α、IL-6、IL-1β水平;于治疗前、第7天采用脑卒中临床神经功能缺损程度评分量表(NDS)行神经功能缺损评分,评价临床疗效。结果:治疗后两组患者血清hs-CRP、TNF-α、IL-6、IL-1β水平均较治疗前明显降低(P<0.05,P<0.01),且第3天、第7天头针组血清hs-CRP、TNF-α、IL-6、IL-1β水平明显低于对照组(P<0.05,P<0.01)。血清hs-CRP水平与患者NDS评分呈正相关(r=0.497,P<0.01)。试验结束时两组患者NDS评分均明显低于治疗前(P<0.05,P<0.01),且头针组明显低于对照组(P<0.05)。临床有效率分别为头针组96.8%(30/31),对照组86.7%(26/30),头针组优于对照组(P<0.05)。结论:头针可降低急性脑梗死患者血清hs-CRP、TNF-α、IL-6和IL-1β水平,控制脑血管炎性反应。
Objective To observe the influence of scalp acupuncture on levels of high-sensitivity C-reactive protein(hsCRP),TNF-α,IL-6,and IL-1βlevels in patients with acute cerebral infarction(ACI),so as to investigate its mechanism underlying improvement of ACI.Methods A total of 61 patients with ACI were randomly allocated to scalp acupuncture group(n=31)and control(medication)group(n=30).The patients of the control group were routinely treated by administration of Aspirin,Danhong injection,Cytidine Diphosphate for neurotrophy,blood pressure-control and blood-fat lowering medicines,etc.,while those of the scalp acupuncture group were treated by routine treatment with the medicines mentioned above plus daily scalp acupuncture stimulation of bilateral Dingnieqianxiexian[MS 6,penetrative needling from Qianding(GV 21)to Xuanli(GB 6)]and Dingniehouxiexian[MS 7,from Baihui(GV 20)to Qubin(GB 7)].The treatment was conducted once daily for 7days.Serum hsCRP,TNF-α,IL-6,and IL-1βcontents were assayed by using enzyme linked immunosorbnent assay(ELISA).The therapeutic effects of scalp acupuncture were evaluated by using clinical neurological disfunction scale(NDS,0-45 points for consciousness,gazing,facial palsy,speech,myodynamia,walking-ability).Results(1)Of the 30 and 31cases in the control and scalp acupuncture groups,5(16.7%)and 8(25.8%)were basically controlled,9(30.0%)and 16(51.6%)experienced remarkable improvement in their symptoms,12(40.0%)and 6(19.4%)were improved,4(13.3%)and 1(3.2%)failed,with the effective rates being 86.7% and 96.8%,respectively.The increased levels of serum hs-CRP,TNF-α,IL-6and IL-1βin ACI patients were reversed on the 3rd and 7th day after scalp acupuncture treatment(P<0.05,P<0.01).(2)A positive correlation existed between the NDS score and the serum levels of hs-CRP(r=0.497,P<0.01).(3)NDS scores were obviously decreased in both groups on the 7th day after the treatment compared with their baseline data(P<0.05,P<0.01).Conclusion Scalp acupuncture treatment can improve the ACI patients' clinical symptoms,probably by reducing ACI induced inflammatory reactions.

关键词(KeyWords)： 头针;急性脑梗死;超敏C反应蛋白;肿瘤坏死因子-α;白介素-6;白介素-1β
Scalp acupuncture;ACI;hs-CRP;TNF-α;IL-6;IL-1β

Abstract:

Keywords:

基金项目(Foundation):

作者(Authors): 王金海;赵敏;鲍英存;商俊芳;鄢琦;张振昶;杜小正;姜华;张武德;
WANG Jin-hai;ZHAO Min;BAO Ying-cun;SHANG Jun-fang;YAN Qi;ZHANG Zhen-chang;DU Xiao-zheng;JIANG Hua;ZHANG Wu-de;Department of Chinese Medicine,the Second Hospital of Lanzhou University;Department of Neurology,the Second Hospital of Lanzhou University;Medical Technical College,Gansu College of Traditional Chinese Medicine;

DOI: 10.13702/j.1000-0607.2016.01.015

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