摘要
目的探究针刺联合通窍涤痰汤对缺血性脑卒中急性期患者神经因子、凝血指标及血流动力学的影响。方法选取2022年1月至2023年8月该院收治的82例缺血性脑卒中急性期患者作为研究对象,按照随机数字表法分为联合组和对照组,每组41例。比较两组治疗前后治疗总有效率。比较两组治疗前后神经因子[脑源性神经营养因子(BDNF)、神经生长因子(NGF)、神经元特异性烯醇化酶(NSE)]水平。比较两组治疗前后血流动力学[波动指数(PI)、平均血流速度(Vm)、动脉收缩期峰值流速(Vs)]情况。比较两组治疗前后凝血指标[活化部分凝血活酶时间(APTT)、国际标准化比值(INR)、纤维蛋白原(FIB)水平、D-二聚体(D-D)水平]。记录并比较两组治疗过程中不良反应发生情况。结果联合组治疗总有效率高于对照组(P<0.05)。两组治疗后BDNF、NGF水平均高于同组治疗前,且联合组治疗后均高于对照组(P<0.05);两组治疗后NSE水平均低于同组治疗前,且联合组治疗后低于对照组(P<0.05)。两组治疗后D-D、FIB水平均低于同组治疗前,且联合组治疗后均低于对照组(P<0.05);两组治疗后INR高于同组治疗前,APTT长于同组治疗前,且联合组治疗后INR高于对照组,APTT短于对照组(P<0.05)。两组治疗后Vm、Vs均快于治疗前,且联合组治疗后均快于对照组(P<0.05);两组治疗后PI水平均低于治疗前,且联合组治疗后低于对照组(P<0.05)。两组不良反应总发生率比较,联合组低于对照组,但差异无统计学意义(P>0.05)。结论针刺联合通窍涤痰汤对缺血性脑卒中急性期患者有较好的治疗效果,其对患者神经因子、凝血指标及血流动力学指标均具有较好的改善作用,且不增加不良反应发生风险。
Objective To explore the effect of acupuncture combined with Tongqiao Ditan decoction on nerve factors,coagulation indexes and hemodynamics in patients with acute ischemic stroke.Methods A total of 82 patients with acute ischemic stroke admitted to the hospital from January 2022 to August 2023 were selected as the research objects.According to the random number table method,they were divided into the combined group and the control group,with 41 cases in each group.The total effective rate was compared between the two groups before and after treatment.The levels of nerve factors[brain-derived neurotrophic factor(BDNF),nerve growth factor(NGF),neuron-specific enolase(NSE)]were compared between the two groups before and after treatment.The hemodynamics[fluctuation index(PI),mean blood flow velocity(Vm),peak systolic arterial flow velocity(Vs)]were compared between the two groups before and after treatment.The coagulation indexes[activated partial thromboplastin time(APTT),international normalized ratio(INR),fibrinogen(FIB)level,D-dimer(D-D)level]were compared between the two groups before and after treatment.The incidence of adverse reactions during treatment was recorded and compared between the two groups.Results The total effective rate of the combined group was higher than that of the control group(P<0.05).The levels of BDNF and NGF in the two groups after treatment were higher than those before treatment,and those in the combined group after treatment were higher than those in the control group(P<0.05).The NSE levels of the two groups after treatment were lower than those before treatment,and the NSE levels of the combined group after treatment were lower than those of the control group(P<0.05).The levels of D-D and FIB in the two groups after treatment were lower than those before treatment,and those in the combined group after treatment were lower than those in the control group(P<0.05).After treatment,the INR of the two groups was higher than that before treatment,and APTT was longer than that before treatment,and the INR of the combined group after treatment were higher than those of the control group,and APTT was shorter than that of the control group(P<0.05).After treatment,Vm and Vs of the two groups were faster than those before treatment,and those of the combined group were faster than those of the control group(P<0.05).The PI of the two groups after treatment were lower than those before treatment,and the PI of the combined group after treatment was lower than that of the control group(P<0.05).The total incidence of adverse reactions in the combined group was lower than that in the control group,but the difference was not statistically significant(P>0.05).Conclusion Acupuncture combined with Tongqiao Ditan decoction has a good therapeutic effect on patients with acute ischemic stroke,which has a good improvement in nerve factors,coagulation indexes and hemodynamic indexes,and does not increase the risk of adverse reactions.
作者
李婵
吉向丽
LI Chan;JI Xiangli(Department of Encephalopathy,Weinan Huazhou istrict Hospital of Traditional Chinese Medicine,Weinan,Shaanxi 714100,China;the Second Department of internal Medicine,Weinan Huazhou istrict Hospital of Traditional Chinese Medicine,Weinan,Shaanxi 714100,China)
出处
《检验医学与临床》
CAS
2024年第13期1846-1850,共5页
Laboratory Medicine and Clinic
基金
陕西省重点研发计划项目(2020SF-150)。
关键词
针刺
通窍涤痰汤
缺血性脑卒中
神经因子
凝血指标
血流动力学
acupuncture
Tongqiao Ditan decoction
ischemic stroke
nerve factor
coagulation index
hemodynamic
作者简介
李婵,女,副主任医师,主要从事针灸结合中医药治疗心脑血管疾病方面的研究;通信作者:吉向丽,E-mail:jl0429l@163.com。
