培元还五汤联合针灸治疗缺血性脑卒中恢复期患者的疗效及对血清细胞因子和睡眠质量的影响

目的:探讨培元还五汤联合针灸治疗缺血性脑卒中恢复期患者的疗效及对血清细胞因子和睡眠质量的影响。方法:选取北京王府中西医结合医院于2017年1月～2018年12月间接收的99例缺血性脑卒中恢复期患者,根据数表法将患者随机分为对照组(n=49,给予基础治疗和常规康复训练)和研究组(n=50,在对照组基础上给予培元还五汤联合针灸治疗),比较两组患者临床疗效、神经功能缺损情况、上肢运动功能、睡眠质量以及血清超敏C-反应蛋白(hs-CRP)、妊娠相关蛋白A(PAPP-A)、神经生长因子(NGF)、脑源性神经营养因子(BDNF)水平变化,记录两组治疗期间不良反应发生情况。结果:研究组治疗后临床总有效率为92.00%(46/50),显著高于对照组患者的71.43%(35/49)(P0.05)。两组患者治疗2个月后神经功能缺损(NIHSS)评分、睡眠质量评分降低,且研究组低于对照组(P0.05),Fugl-Meyer运动(FMA)评分则升高,且研究组高于对照组(P0.05)。两组患者治疗2个月后血清hs-CRP、PAPP-A水平降低,且研究组低于对照组(P0.05),血清NGF、BDNF水平则升高,且研究组高于对照组(P0.05)。两组不良反应发生率比较无差异(P0.05)。结论:培元还五汤联合针灸治疗缺血性脑卒中恢复期患者,疗效确切,可有效改善患者神经功能、上肢运动功能、睡眠质量,改善相关细胞因子水平,且不增加不良反应发生率,具有一定的临床应用价值。

Effect of Peiyuan Huanwu Decoction Combined with Acupuncture and Moxibustion on Serum Cytokines and Sleep Quality in Patients with Recovery Stage of Ischemic Stroke

ABSTRACT Objective: To explore the curative effect of Peiyuan Huanwu decoction combined with acupuncture and moxibustion on serum cytokines and sleep quality in patients with recovery stage of ischemic stroke. Methods: 99 patients with recovery stage of ischemic stroke received indirectly in Beijing Royal Integrative Medicine Hospital from January 2017 to December 2018 were selected, and they were randomly divided into control group (n=49, given basic treatment and routine rehabilitation training) and study group (n=50, given Peiyuan Huanwu decoction combined with acupuncture and moxibustion treatment on the basis of the control group). The clinical efficacy, neurological deficit, motor function of upper limbs, sleep quality and serum levels of high sensitivity C-reactive Prot (hs-CRP), pregnancy-associated protein A (PAPP-A), nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF) were compared between the two groups. The occurrence of adverse reactions during the treatment of the two groups were recorded. Results: The total effective rate of the study group was 92.00% (46/50) after treatment, which was significantly higher than 71.43% (35/49) of the control group (P<0.05). 2 months after treatment, the national-institute of health stroke scale (NIHSS) score and sleep quality score of the two groups decreased, and the study group was lower than the control group (P<0.05), while the FMA score increased, and the study group was higher than the control group (P<0.05). The levels of serum hs-CRP and PAPP-A decreased in two groups at 2 months after treatment, and the study group was lower than the control group (P<0.05). The levels of serum NGF and BDNF increased, and the study group was higher than the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: Peiyuan Huanwu decoction combined with acupuncture and moxibustion in the treatment of patients with recovery stage of ischemic stroke has definite curative effect. It can effectively improve the neurological function, upper limb motor function, sleep quality, improve the level of related cytokines, and do not increase the incidence of adverse reactions. It has certain clinical application value.