目的 探究活血化瘀通络方联合火针刺法对急性脑梗死患者脑血流动力学及血清D-二聚体、白介素-6(in-terleakin-6，IL-6)、肿瘤坏死子-α(tumor necrosis factor-α，TNF-α)的影响。方法 收集 2021 年 2 月--2022 年 2 月惠州市中心人民医院神经内科及中医康复科就诊的急性脑梗死患者100例，随机分为试验组和对照组，各50例，两组患者均根据病情给予常规药物治疗，对照组予以常规药物治疗(包含阿司匹林肠溶片、依达拉奉、复方甘露醇、胞二磷胆碱注射液)，试验组在对照组的基础上予以活血化瘀通络方联合火针刺法，对比两组临床疗效、神经功能缺损程度、脑血流动力学指标、D-二聚体、IL-6、TNF-α、认知功能、生活质量及不良反应发生情况。结果 治疗后与对照组相比，试验组临床总有效率较高，差异具有统计学意义(P＜0。05)。治疗后两组患者最大峰值流速(spectral atlas systolic peak velocity，Vs)、舒张末流速(end diastolic velocity，Vd)、平均流速(mean velocity，Vm)、血管搏动指数(pulsatile index，PI)、血管阻力指数(resistant index，RI)等水平升高(P＜0。05);与对照组相比，试验组Vs、Vd、Vm、PI、RI等水平较高(P＜0。05)。治疗后两组神经功能缺损评分(neural function defect score，NFDS)、生活质量量表(quality of life scale，SS-QOL)评分降低，简易精神状态量表(mini-mental state examination，MMSE)评分增高(P＜0。05);治疗后与对照组相比，试验组NFDS评分、SS-QOL评分降低，MMSE评分较高(P＜0。05)。治疗后两组血清D-二聚体、IL-6、TNF-α水平降低(P＜0。05);治疗后与对照组相比，试验组血清D-二聚体、IL-6、TNF-α水平较低(P＜0。05)。两组不良反应相比差异无统计学意义(P＞0。05)。结论 活血化瘀通络方联合火针刺法能显著改善急性脑梗死患者脑血流动力学指标，促进认知功能的恢复，其作用机制与抑制血清D-二聚体、TNF-α和IL-6的合成与释放具有密切相关性，适宜临床应用推广。
Effect of Huoxue Huayu Tongluo Recipe(活血化瘀通络方)Combined with Fire Needle Needling on Cerebral Hemodynamics and Serum D-dimer,IL-6 and TNF-α in Patients with Acute Cerebral Infarction
Objective To investigate the effects of Self-made Huoxue Huayu Tongluo Formula(活血化瘀通络方)combined with fire needle needling on cerebral hemodynamics and serum levels of D-dimer,interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in patients with acute cerebral infarction.Methods A total of 100 patients with acute cerebral infarction who were treated in the Department of Neurology and Department of Neurorehabilitation of Huizhou Hospital of Traditional Chinese Medicine from February 2021 to February 2022 were collected and randomly divided into the experiment group and the control group,with 50 patients in each group.The control group was given conventional drug treatment(including aspirin enteric-coated tablets,edaravone,compound mannitol and citicoline injection),and the experimental group was given Self-made Huoxue Huayu Tongluo Formula combined with fire-acupuncture method on the basis of the control group.The clinical efficacy,degree of neu-rological impairment hemodynamic indexes,D-dimer,IL-6,TNF-α,cognitive function,quality of life and adverse reactions of were compared.Results After treatment,compared with those of the control group,the total clinical effective rate of the experi-ment group was higher,and the difference was statistically significant(P＜0.05).After treatment,the maximum peak velocity(Vs),end diastolic velocity(Vd),mean velocity(Vm),Vascular pulse index(PI),vascular resistance index(RI)and other lev-els of patients in the two groups increased(P＜0.05).Compared with those of the control group,the levels of Vs,Vd,Vm,PI and RI in the experiment group were higher(P＜0.05).After treatment,the scores of neurological deficit score(NFDS)and stroke specific quality of life scale(SS-QOL)decreased,while the scores of mini-mental state examination(MMSE)increased(P＜0.05).After treatment,compared with those of the control group,the NFDS score and SS-QOL score of the experiment group decreased,while the MMSE score was higher(P＜0.05).Serum levels of D-dimer,IL-6 and TNF-α in the two groups after treatment decreased(P＜0.05).After treatment,compared with those of the control group,the serum levels of D-dimer,IL-6 and TNF-α in the experiment group were lower(P＜0.05).There was no significant difference in adverse reactions between the two groups(P＞0.05).Conclusion The self-made formula of activating blood circulation,removing blood stasis and dredging collaterals combined with fire needle needling can significantly improve the indexes of cerebral hemodynamics in patients with a-cute cerebral infarction,promote the recovery of cognitive function,and its mechanism is to inhibit serum D-dimer and TNF-αThe synthesis and release of IL-6 and IL-6 are closely related,which is suitable for clinical application and promotion.
万方数据
维普
