【作者】 桑鹏；

【导师】 孙申田；

【作者基本信息】 黑龙江中医药大学 ， 针灸推拿学， 2009， 博士

【摘要】 目的：通过头穴透刺与普通针刺组、药物对照组治疗急性脑梗死临床疗效的神经功能缺损评分对比研究，从神经生化和免疫方面进行脑保护机理探讨，以用于指导头穴透刺对急性脑梗死的脑保护治疗。方法：全部病例采用随机分配的方法，分为三组：头穴透刺组40例（头穴透刺+药物），普通针刺组40例（普通针刺+药物），对照组40例（单纯药物组）。1临床研究：治疗14天后，进行神经功能缺损评分（NDS）测定。2实验研究：（1）全部病例均于治疗前、治疗后第7天、第14天清晨空腹采血，进行ELISA酶联免疫检测SOD、MDA、TNF-α、IL-6、NO、ET（2）全部病例均于治疗前、治疗后第7天、第14天清晨空腹采血，进行全自动氨基酸分析仪检测GLU，ASP（3）全部病例均于治疗前、治疗后第7天、第14天清晨空腹采血，利用全自动生化分析仪测定血清Mg²⁺，Ca²⁺结果：1．治疗14天后，头穴透刺组病人的神经功能缺损程度的改善以及临床疗效评定均明显优于两对照组（P＜0．05及P＜0．01），说明了头穴透刺对急性脑梗死肯定的临床疗效。2．治疗后14天，血清Mg²⁺的含量明显降低，Ca²⁺含量明显升高。且头穴透刺组和对照组比较（P＜0．01）；IL-6，TDNF-α的含量下降，头穴透刺组与对照组比较皆有显著性差异（P＜0．0 1）；NO，ET的含量下降，头穴透刺组与对照组比较皆有显著性差异（P＜0．01）；GLU，ASP的含量下降，头穴透刺组与对照组比较皆有显著性差异（P＜0．01）SOD的含量明显升高，MDA含量明显降低，头穴透刺组与两对照组比较有显著性差异（P＜0．01）。说明头穴透刺有助于减轻急性脑梗死后脑组织损伤，从而发挥脑保护作用。结论：1头穴透刺可显著改善急性脑梗死患者的神经功能缺损评分，疗效明显优于普通针刺组与药物对照组。2头穴透刺可综合调整急性脑梗死后自由基、内皮素及一氧化氮、兴奋性氨基酸、钙超载、炎性细胞因子含量，从而发挥全面、系统性的脑保护作用。更多还原

【Abstract】 Objective:penetration through the scalp acupuncture group and thegeneral,drug control group,the treatment of acute cerebral infarctionneurological deficit scores of the comparative study,from the nervous andimmune aspects of chemical and biological protection mechanism of thebrain to the first hole to guide through gill treatment of acute cerebralinfarction.Methods:All patients randomly assigned to adopt the methods,divided into three groups:the first penetration hole group of 40 patients (thefirst hole through barbed + drug),40 cases of ordinary acupuncture group(general acupuncture + drug),40 cases of the control group (simple druggroup).1.Clinical Research:14 days after treatment,the neurological deficit scoresmeasured.2.Experimental Study:(1) All patients were treated before the 7th day after treatment,the first 14days of fasting blood collection,ELISA enzyme-linked immunosorbent assayfor detection of SOD,MDA,TNF-α,IL-6,NO,ET(2) All patients were treated before the 7th day after treatment,the first 14days of fasting blood for automaticamino acid analyzer GLU,ASP(3) in the treatment of all patients before the 7th day after treatment,thefirst 14 days of fasting blood collection,the use of automatic biochemicalanalyzer for determination of serum Mg2 +,Ca2 +Results:1.14 days after treatment,scalp penetration acupuncturegroup of patients the degree of neurological deficit and improving theassessment of clinical efficacy was significantly better than the two controlgroups (P＜0.05 and P＜0.01),describes the scalp penetration acupuncture onacute cerebral infarction sure clinical efficacy. 2.14 days after treatment,serum Mg2 + levels decreased significantly,Ca2+ content was significantly increased.Penetration point and the first groupand the control group (P＜0.0 1);IL-6,TDNF-αdecreased in the first holegroup penetration compared with the control group had significant difference(P＜0.01);NO,ET content decreased scalp penetration acupuncture groupcompared with the control group had significant difference (P＜0.01);GLU,ASP decreased the content of the first hole group penetration compared withthe control group had significant difference (P＜0.01) SOD significantlyincreased the content,MDA content was lower scalp penetration acupuncturegroup compared with the two control groups were significantly different (P＜0.01).Note scalp penetration acupuncture help to reduce brain tissuedamage in acute cerebral infarction,which play a role in brain protection.Conclusion:Hole through a barbed significantly in patients with acutecerebral infarction to improve the neurological deficit score,more effectivethan ordinary acupuncture group and the drug control group.Point 2 can be integrated through barbed adjusted free radicals after acutecerebral infarction,endothelin and nitric oxide,excitatory amino acids,calcium overload,inflammatory cytokines,which play a comprehensive andsystematicrole in cerebral protection.更多还原