实用医学杂志 ›› 2022, Vol. 38 ›› Issue (23): 3002-3006.doi: 10.3969/j.issn.1006⁃5725.2022.23.020

• 中医药现代化 • 上一篇    下一篇

通督调神针刺辅助治疗结核性脑膜炎的疗效观察

潘静洁 黄晋 刘堂营 黎仁彬 刘文雯   

  1. 广州市胸科医院中医科(广州 510095)
  • 出版日期:2022-12-10 发布日期:2022-12-10
  • 基金资助:
    广东省中医药科技项目(编号:20211304);广州市中医药和中西医结合科技项目(编号:20212A011016)

Therapeutic effect of Tongdu Tiaoshen acupuncture on tuberculous meningitis

PAN Jingjie,HUANG Jin LIU Tangying,LI Renbin,LIU Wenwen.   

  1. Department of Traditional Chinese medicine,Guangzhou Chest Hospital Guangzhou 510095,China

  • Online:2022-12-10 Published:2022-12-10

摘要:

目的 探讨通督调神针刺疗法在治疗结核性脑膜炎(tuberculous meningitis,TBM)中的辅助治疗作用。方法以 50 例 TBM 系统治疗联合通督调神针刺结核性脑膜炎患者为观察组,以 50 例单纯抗结核药物治疗患者为对照组,应用中医症候积分、肢体功能 FMA 评分、神经功能 NIHSS 评分、昏迷程度 GCS 评分和脑脊液压力及其神经生长因子(NGF)、白细胞计数(WBC)、蛋白定量(PRO)、葡萄糖(GLU)、氯化物(Cl- )等生化检测为观察指标,以治愈、显效、有效和无效程度分级考察治疗效果。结果 观察组和对照组患者治疗的治愈、显效、有效和无效率分别为 22%、36%、32%、10%和 10%、20%、56%、14%,总有效率分别为 90%、86%,两组间差异有统计学意义(χ2 = 8.142,P = 0.043);治疗前两组间中医症候积分和 FMA、NIHSS、GCS 评分差异均无统计学意义(P > 0.05),两组治疗前后以及治疗后观察组与对照组之间则差异有统计学意义(P < 0.05);治疗前对照组脑脊液细胞计数显著高于观察组(P = 0.004),治疗后二者间差异无统计学意义(P = 0.593);治疗前两组间脑脊液压力、NGF、蛋白质、葡萄糖和氯化物均差异无统计学意义(P > 0.05),治疗后观察组的 NGF、氯化物则显著高于对照组(P < 0.05);两组患者治疗前后 6 项脑脊液指标均差异有统计学意义(P < 0.05)。结论 通督调神针刺疗法对结核性脑膜炎具有辅助治疗作用,通过改善脑脊液生化成份而促进神经系统功能恢复为其可能机制。

关键词: 结核性脑膜炎, 通督调神针刺法, 抗结核药物治疗

Abstract:

Objective To explore the auxiliary therapeutic effect of the acupuncture therapy of“Tongdu Tiaoshen”in the treatment of tuberculous meningitis(TBM). Methods Fifty cases with TBM treated with anti⁃ tuberculous chemotherapy plus Tongdu Tiaoshen acupuncture were assigned into the observation group and another fifty cases with TBM treated only with anti⁃tuberculous chemotherapy into control group. The two groups were com⁃ pared in terms of the scores of Traditional Chinese medicine(TCM)syndromes,limb function by FMA,neural function by NIHSS,coma degree by GCS,and the levels of nerve growth factor(NGF),white blood cell count (WBC),protein,glucose and chloride of their cerebrospinal fluid. The therapeutic effect was classified as cure obvious effect,effectiveness and ineffectiveness. Results The rates of cure,obvious effect,effectiveness and ineffectiveness in the observation group were 22%,36%,32% and 10%,respectively,while the rates in the con⁃ trol group were 10%,20%,56% and 14% respectively. There was significant difference between the group(90% vs. 86%,χ2 = 8.142,P = 0.043).Before the treatment,there were no significant differences in the scores of TCM FMA,NIHSS and GCS between the two groups(P > 0.05). but the differences in the scores were significant in each group between pre⁃treatment and post⁃treatment as well as between the two group after the treatment(P < 0.05). The CSF cell count in the control group was significantly higher than that in the observation group before the treat⁃ ment(P = 0.004),but the counts of the two group showed no significant difference after the treatment(P = 0.593). There were no significant differences in CSF pressure,NGF,protein,glucose and chloride between the two groups before the treatment(P > 0.05),while the levels of NGF and chloride in the observation group were significantly higher than those in the control group(P < 0.05)after the treatment. There were significant differences in the levels of cerebrospinal fluids between the two groups both before the treatment and after the treatment(P < 0.05). Conclusion Tongdu Tiaoshen acupuncture has an auxiliary therapeutic effect on tuberculous meningitis,possiblydue to its promoting the recovery of nervous system function by improving the biochemical composition of cerebro⁃ spinal fluid. 

Key words:

tuberculous meningitis, Tongdu Tiaoshen acupuncture, anti?tuberculous chemotherapy