【摘要】：目的:觀察針刺對急性腦梗死患者血清IL-10、IL-18水平變化以及神經(jīng)功能缺損情況的影響,探討針刺對急性腦梗死的治療作用及其機制。方法:本課題采用隨機對照試驗,對福建醫(yī)科大學附屬協(xié)和醫(yī)院神經(jīng)內(nèi)科的69例合格的急性腦梗死住院患者,隨機分成對照組和試驗組。兩組均接受神經(jīng)內(nèi)科常規(guī)藥物治療,試驗組加上針刺治療,針刺穴位選擇頭針的頂顳前斜線和體針的肩前、尺澤、內(nèi)關、合谷,髀關、伏兔、足三里、三陰交。干預時間為每天1次,每次60分鐘,連續(xù)觀察14天。療效評價主要指標為血清白細胞介素10、白細胞介素18的濃度,次要指標為神經(jīng)功能缺損評分(NIHSS),于治療前后分別對兩組進行觀察、評定。結果數(shù)據(jù)采用SPSS軟件統(tǒng)計處理。結果:1.治療后,試驗組和對照組血清IL-10濃度的均較治療前有所提高,與治療前相比,均具有顯著性統(tǒng)計學差異(P0.01);且試驗組優(yōu)于對照組(P0.05)。2.治療后,試驗組和對照組血清IL-18濃度的均較治療前有所降低,與治療前相比,均具有顯著性統(tǒng)計學差異(P0.01);且試驗組優(yōu)于對照組(P0.05)。3.治療后,試驗組和對照組NIHSS評分均較治療前有所降低,與治療前相比,均具有顯著性統(tǒng)計學差異(P0.01);但治療后兩組評分無明顯統(tǒng)計學差異(P0.05)。結論:1.兩種治療方案均能不同程度地影響腦梗死后血清IL-10、IL-18水平。2.在腦梗死急性期,相比內(nèi)科藥物治療,針刺結合內(nèi)科藥物治療對炎癥方面具有更明顯改善,而在神經(jīng)功能恢復方面無明顯差異。
[Abstract]:Objective: to observe the effect of acupuncture on the changes of serum IL-10 IL-18 level and neurological deficit in patients with acute cerebral infarction, and to explore the therapeutic effect and mechanism of acupuncture on acute cerebral infarction. Methods: a randomized controlled trial was conducted in 69 inpatients with acute cerebral infarction in Department of Neurology, Union Hospital, Fujian Medical University, and were randomly divided into two groups: control group and experimental group. Both groups were treated with routine medicine in neurology. The experimental group was treated with acupuncture. Acupuncture points were selected for scalp acupuncture in front of the parietal and temporal oblique lines and in front of the shoulders of body acupuncture, ulnazawa, Neiguan, Hegu, Biguan, Fu rabbit, Zusanli, Sanyinjiao. The intervention time was 1 time per day, 60 minutes each time, continuously observed for 14 days. The main outcome measures were the concentration of serum interleukin 10 and interleukin 18. The secondary index was nerve function defect score (NIHSS),). The two groups were observed and evaluated before and after treatment. Results the data were processed by SPSS software. The result is 1: 1. After treatment, the concentration of serum IL-10 in the experimental group and control group were higher than before treatment, compared with before treatment, there was significant statistical difference (P0.01), and the test group was better than the control group (P0.05). 2. After treatment, the concentration of serum IL-18 in the experimental group and control group were lower than before treatment, compared with before treatment, there was significant statistical difference (P0.01), and the test group was better than the control group (P0.05). 3. After treatment, the NIHSS scores of the experimental group and the control group were lower than those before treatment, and there was significant statistical difference between the two groups (P0.01), but there was no significant difference between the two groups after treatment (P0.05). Conclusion 1. The two treatment regimens can affect the level of IL-10 and IL-18 in different degree after cerebral infarction. In the acute phase of cerebral infarction, acupuncture combined with internal medicine had more obvious improvement on inflammation than that of internal medicine, but there was no significant difference in the recovery of nerve function.
【學位授予單位】：福建中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R246.6

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