开窍醒神针法联合加味补阳还五汤对脑出血恢复期患者(气虚血瘀证)IL-2、MMP-9、BDNF及脑血流量的影响
收稿日期: 2024-09-18
网络出版日期: 2025-02-19
基金资助
江西省中医药中青年骨干人才培养项目(赣中医药科教字(2020)5号);江西省卫生计生委科技计划(20187062)
Effect of Kaiqiao Xingshen acupuncture combined with Buyang Huanwu decoction on IL⁃2, MMP⁃9, BDNF, and cerebral blood flow in patients with cerebral hemorrhage during recovery period (Qi deficiency and blood stasis syndrome)
Received date: 2024-09-18
Online published: 2025-02-19
目的 探讨开窍醒神针法联合补阳还五汤在脑出血恢复期患者(气虚血瘀证)治疗中的应用价值,观察其对炎性指标、神经因子的影响。 方法 166例脑出血恢复期患者(气虚血瘀证)患者均于2021年9月至2023年10月在南昌市洪都中医院就诊,纳入研究前均随机分组。对照组83例采用常规西医治疗,观察组83例联合开窍醒神针法及补阳还五汤治疗,治疗8周后比较疗效。 结果 治疗后两组血清基质金属蛋白酶-9(MMP-9)、内皮素-1(endothelin,ET-1)、白细胞介素-2(interleukin-2,IL-2)、同型半胱氨酸(homocysteine,Hcy)、Bcl-2相关X蛋白(the Bcl-2-associated X protein,bax)降低,脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)升高,观察组改善更显著,差异有统计学意义(P < 0.05);治疗后观察组脑血管平均流量、脑血管平均流速升高,血管外周阻力降低,观察组改善更显著(P < 0.05);治疗后观察组中医总症状积分降低,Fuel-Meyer功能评分(FMA评分)升高,观察组改善更显著(P < 0.05);观察组总有效率93.98%(78/83),高于对照组的80.72%(67/83),差异有统计学意义(P < 0.05)。 结论 对于脑出血恢复期患者(气虚血瘀证)而言应用开窍醒神针法及加味补阳还五汤有助于减轻炎症反应,促进血脑屏障恢复,改善脑血流量,促进神经功能恢复,提高临床疗效。
彭天忠 , 黄学娣 , 林星镇 , 袁娟 , 周峰 , 刘浪辉 , 占琦楠 , 朱满华 . 开窍醒神针法联合加味补阳还五汤对脑出血恢复期患者(气虚血瘀证)IL-2、MMP-9、BDNF及脑血流量的影响[J]. 实用医学杂志, 2025 , 41(3) : 428 -433 . DOI: 10.3969/j.issn.1006-5725.2025.03.019
Objective To explore the application value of Kaiqiao Xingshen acupuncture combined with Buyang Huanwu decoction in the treatment of patients with cerebral hemorrhage in the recovery period (Qi deficiency and blood stasis syndrome), and to observe its impact on inflammatory indicators and neurokines. Method A total of 166 patients with cerebral hemorrhage in the recovery period (Qi deficiency and blood stasis syndrome) treated in Hongdu Traditional Chinese Medicine Hospital from September 2021 to October 2023, were randomly divided into control group (83 cases treated with conventional western medicine), and observation group (83 cases treated with a combination of Kaiqiao Xingshen acupuncture and Buyang Huanwu decoction). The therapeutic effect in the two groups was compared after 8 weeks of treatment. Results After treatment, the serum levels of matrix metalloproteinase-9 (MMP-9), endothelin-1 (ET-1), interleukin-2 (IL-2), homocysteine (Hcy), and Bcl-2-associated X protein (bax) decreased in both groups, while brain-derived neurotrophic factor (BDNF) increased, and the improvement was more significant in the observation group, showing statistical significance (P < 0.05); the average cerebral vascular flow and flow velocity in the observation group increased, while peripheral vascular resistance decreased, and the improvement in the observation group was more significant (P < 0.05); the total symptom score of traditional Chinese medicine in the observation group decreased, while the Fuel Meyer functional score (FMA score) increased, and the improvement in the observation group was more significant (P < 0.05); The total effective rate of the observation group was 93.98% (78/83), which was higher than that of the control group (80.72%, 67/83) (P < 0.05). Conclusion For patients with cerebral hemorrhage in the recovery period (Qi deficiency and blood stasis syndrome), Kaiqiao Xingshen acupuncture and Buyang Huanwu decoction help alleviate inflammatory reactions, promote the recovery of the blood-brain barrier, improve cerebral blood flow, promote neurological function recovery, and enhance clinical efficacy.
| 1 | SUN J, SONG F H, WU J Y, et al. Sestrin2 overexpression attenuates osteoarthritis pain via induction of AMPK/PGC-1α-mediated mitochondrial biogenesis and suppression of neuroinflammation[J]. Brain Behav Immun, 2022, 102: 53-70. doi:10.1016/j.bbi.2022.02.015 |
| 2 | HERWEH C, NORDLOHNE S, SYKORA M,et al.Climatic and Seasonal Circumstances of Hypertensive Intracerebral Hemorrhage in a Worldwide Cohort[J]. Stroke, 2020,48(12):3384-3386. |
| 3 | GU L, SUN M, LI R,et al.Activation of RKIP Binding ASC Attenuates Neuronal Pyroptosis and Brain Injury via Caspase-1/GSDMD Signaling Pathway After Intracerebral Hemorrhage in Mice[J].Transl Stroke Res,2022,13(6):1037-1054. doi:10.1007/s12975-022-01009-4 |
| 4 | 张海沙,罗琳,原小军,等. 中老年脑微出血灶发生危险因素分析[J]. 包头医学院学报,2023,39(2):20-25. |
| 5 | PAPALE M, NETTI G S, STALLONE G,et al.Understanding Mechanisms of RKIP Regulation to Improve the Development of New Diagnostic Tools[J].Cancers,2022,14(20):5070. doi:10.3390/cancers14205070 |
| 6 | 魏华,黄金秀,蔡海荣,等. 急性脑出血患者中医证型与炎症因子的相关性研究[J]. 中医药信息,2018,35(4):91-94. |
| 7 | 中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组.中国脑出血诊治指南(2019)[J].中华神经科杂志,2019, 52(12):994-1005. doi:10.3760/cma.j.issn.1006-7876.2019.12.003 |
| 8 | 郑筱萸. 中药新药临床指导原则 [S]. 北京:中国医药科技出版社,2002:162-167. |
| 9 | HUANG T, JIA Z, FANG L,et al. Extracellular vesicle-derived miR-511-3p from hypoxia preconditioned adipose mesenchymal stem cells ameliorates spinal cord injury through the TRAF6/S1P axis[J]. Brain Res Bull,2022,180:73-85. doi:10.1016/j.brainresbull.2021.12.015 |
| 10 | 雷彪,于蓬勃,屈香,等. 脑出血早期血肿扩大的相关因素研究新进展[J]. 中国临床神经外科杂志,2023,28(6):411-413. |
| 11 | HUA Y, HUANG Q, CHEN G, et al. Comparison of modified anterior and traditional posterior accesses for ultrasound-guided superior laryngeal nerve block in awake endotracheal intubation:Study protocol for a randomised non-inferiority clinical trial[J].BMJ Open,2023,13(2):e068779. doi:10.1136/bmjopen-2022-068779 |
| 12 | RAMKUMAR R, ARORA S, BHATIA N,et al. Ultrasound guided superior laryngeal nerve block as an adjuvant to generalanesthesia during endoscopic laryngeal surgery:A prospective,randomized,double-blind trial[J]. Am J Otolaryngol,2019,40(1):30-35. doi:10.1016/j.amjoto.2018.09.004 |
| 13 | 林晓伟,顾勇,王能,等. 熄风化瘀通络方治疗脑出血急性期风痰瘀阻型患者的疗效及其对相关炎性因子、神经因子和血脑屏障的影响[J]. 广州中医药大学学报,2022,39 (4):756-763. |
| 14 | 殷志锋,蒋宝华,许国峰,等. 补阳还五汤治疗恢复期气虚血瘀型高血压脑出血的临床疗效观察[J]. 中西医结合心脑血管病杂志,2021,19(17):3020-3022. |
| 15 | 李改,胡兵,张会敏. 瘦素、IL-18、NLRP3与高血压性脑出血严重程度、预后的关系及其在预后评估中的价值[J]. 实用医学杂志,2020,36(5):628-633. |
| 16 | CHEN F, ZHANG S, LI B,et al. A review of invasive intracranial pressure monitoring following surgery for hypertensive cerebral hemorrhage[J]. Front Neurol,2023,14:1108722. doi:10.3389/fneur.2023.1108722 |
| 17 | 黄艳丽,张海垠. 局部亚低温治疗对高血压性脑出血患者血清hs-CRP及Hcy水平的影响研究[J]. 中国实验诊断学,2020,24(1):11-14. |
| 18 | LIAO Y C, WU W C, HSIEH M H,et al. Ultrasound-guided superior laryngeal nerve block assists in anesthesia for bronchoscopic surgical procedure:A case report of anesthesia for rigid bronchoscopy[J].Medicine (Baltimore),2020,99(27):e20916. doi:10.1097/md.0000000000020916 |
| 19 | 毕红东,江思瑜,李宝群,等. 补阳还五汤对脑出血大鼠脑组织HIF-1α、SDF-1、CXCR-4表达的影响[J]. 中国老年学杂志,2021,41(17):3755-3758. |
| 20 | 马雪,周世辉. 脑苷肌肽联合甲氯芬酯治疗急性脑出血的疗效及对血清MMP-2/9、TSP-1/2、神经相关因子的影响[J]. 实用医学杂志,2021,37(4):507-512. |
| 21 | 吴林,张光彩,周晓晖,等. 温针灸对高血压脑出血恢复期气虚血瘀患者S100B、MMP-9、Hcy及炎性因子水平的影响[J]. 上海针灸杂志,2021,40(8):907-912. |
| 22 | HEYBATI K, ZHOU F,ALI S,et al.Outcomes of dexmedetomidine versus propofol sedation in critically ill adults requiring mechanical ventilation: A systematic review and meta-analysis of randomised controlled trials[J].Br J Anaesth,2022,129(4):515-526. doi:10.1016/j.bja.2022.06.020 |
| 23 | QU W, CHENG Y, PENG W,et al. Targeting iNOS alleviates early brain injury after experimental subarachnoid hemorrhage via promoting ferroptosis of M1 microglia and reducing neuroinflammation[J]. Mol Neurobiol,2022,59(5):3124-3139. doi:10.1007/s12035-022-02788-5 |
| 24 | 郭思佳. 清脑通脉汤配合针灸治疗脑出血后偏瘫的疗效及对血清S100β蛋白、NSE水平及运动功能的影响[J]. 四川中医,2022,40(2):149-152. |
| 25 | DOS SANTOS I R C, DIAS M N C, GOMES-LEAL W. Microglial activation and adult neurogenesis after brain stroke[J]. Neural Regen Res,2022,16(3):456-459. doi:10.4103/1673-5374.291383 |
| 26 | 吴晓光,仇志富,孟杰,等. 补阳还五汤对脑出血模型大鼠脑组织PI3K、Akt、Bcl-2、BAX蛋白表达的影响[J]. 中国组织工程研究,2020,20(40):5933-5938. |
| 27 | 阎立安,谢耀君,胡艳文,等. 针灸辅助康复训练对重症脑出血患者神经缺损功能和脑血管功能的影响[J]. 四川中医,2022,40(2):196-199. |
/
| 〈 |
|
〉 |