开窍醒神补虚通络针刺治疗对脑卒中后偏瘫患者血液流变学和Notch信号通路的影响

摘要 目的：探讨开窍醒神补虚通络针刺治疗对脑卒中后偏瘫患者血液流变学和Notch信号通路的影响。方法：选取东莞市中医院2020年12月至2022年7月期间收治的110例脑卒中后偏瘫患者，按照随机数字表法分为观察组（55例，脑卒中常规康复治疗结合开窍醒神补虚通络针刺治疗）和对照组（55例，脑卒中常规康复治疗）。对比两组各项量表评分日常生活能力量表（ADL）、美国国立卫生研究院卒中量表（NIHSS）、Fugl-Meyer量表（FMA）]、平衡功能前后倾斜角（F-BIA）、左右倾斜角（L-RIA）、Berg平衡量表（BBS）]、血液流变学和Notch信号通路相关指标。结果：与对照组相比，观察组干预4周后ADL、FMA评分更高，NIHSS评分更低（P<0.05）。与对照组相比，观察组干预4周后BBS、F-BIA、L-RIA更高（P<0.05）。与对照组相比，观察组干预4周后全血高切黏度、纤维蛋白原、血浆黏度、全血低切黏度更低（P<0.05）。与对照组相比，观察组干预4周后Notch1信使核糖核酸（mRNA）、Notch2 mRNA、Jagged1 mRNA、Jagged2 mRNA更低（P<0.05）。结论：开窍醒神补虚通络针刺治疗可有效改善脑卒中后偏瘫患者的日常活动能力、神经功能、运动功能和平衡功能，改善血液流变学和Notch信号通路。

Effect of Kaiqiao Xingshen Buxu Tongluo Acupuncture Treatment on Hemorheology and Notch Signal Pathway in Patients with Hemiplegia after Stroke

ABSTRACT Objective: To explore the effect of Kaiqiao Xingshen Buxu Tongluo acupuncture treatment on hemorheology and Notch signal pathway in patients with hemiplegia after stroke. Methods: 110 patients with hemiplegia after stroke who were admitted to Dongguan Traditional Chinese Medicine Hospital from December 2020 to July 2022 were selected, and they were divided into observation group (55 cases, treated with routine rehabilitation for stroke combined with Kaiqiao Xingshen Buxu Tongluo acupuncture) and control group (55 cases, treated with routine rehabilitation for stroke) according to the random number table method. The scores of various scales activity of daily life (ADL), the national institutes of health stroke scale (NIHSS), Fugl-Meyer assessment (FMA)], balance function front and back inclination angle (F-BIA), left and right inclination angle (L-RIA), Berg balance scale (BBS)], hemorheology and Notch signaling pathway related indexes were compared between the two groups. Results: Compared with the control group, the observation group had higher ADL and FMA scores, and lower NIHSS scores at 4 weeks after intervention(P<0.05). Compared with the control group, the observation group had higher BBS, F-BIA, and L-RIA at 4 weeks after intervention(P<0.05). Compared with the control group, the observation group had lower whole blood high shear viscosity, fibrinogen, plasma viscosity, and whole blood low shear viscosity at 4 weeks after intervention(P<0.05). Compared with the control group, the observation group had lower Notch1 messenger ribonucleic acid (mRNA), Notch2 mRNA, Jagged1 mRNA, Jagged2 mRNA at 4 weeks after intervention(P<0.05). Conclusion: Kaiqiao Xingshen Buxu Tongluo acupuncture treatment can effectively improve the daily activity ability, nerve function, motor function and balance functionin patients with hemiplegia after stroke, and improve hemorheology and Notch signal pathway.