摘要
目的观察针刺联合纳洛酮治疗高血压脑出血术后昏迷的临床疗效。方法将68例高血压脑出血术后昏迷患者随机分为对照组和观察组,每组34例。两组均进行常规治疗,对照组另予纳洛酮静脉滴注,观察组在对照组治疗基础上联合针刺治疗。比较两组患者的苏醒率及苏醒时间、格拉斯哥昏迷量表(Glasgow coma scale,GCS)评分、脑电图分级、基底动脉及大脑中动脉平均血流速度(mean velocity, Vm)、脑脊液白介素(interleukin,IL)-1β与乳酸(lactic acid, LA)水平。结果治疗后,观察组苏醒率高于对照组(P<0.05),苏醒时间短于对照组(P<0.05)。两组治疗后GCS评分均较治疗前升高(P<0.05),且观察组GCS评分明显高于对照组(P<0.05)。两组治疗后脑电图分级较治疗前明显改善(P<0.05),且观察组脑电图分级优于对照组(P<0.05)。两组治疗后基底动脉、大脑中动脉Vm均升高(P<0.05),且观察组基底动脉、大脑中动脉Vm高于对照组(P<0.05)。两组治疗后脑脊液IL-1β、LA水平均降低(P<0.05),且观察组脑脊液IL-1β、LA水平低于对照组(P<0.05)。结论针刺联合纳洛酮治疗高血压脑出血术后昏迷可提高苏醒率,缩短苏醒时间,改善意识障碍及脑电活动,提升脑血流速度,降低脑脊液IL-1β、LA水平。
Objective To observe the clinical efficacy of acupuncture plus Naloxone in treating coma after surgery for hypertensive cerebral hemorrhage. Method Sixty-eight patients with coma after surgery for hypertensive cerebral hemorrhage were randomized into a control group and an observation group, with 34 cases in each group. The two groups both received conventional treatment. In addition, the control group was given intravenous drip of Naloxone,while the observation group was given intravenous drip of Naloxone plus acupuncture. The resuscitation rate and time,Glasgow coma scale(GCS) score, electroencephalogram grading, mean velocity(Vm) of basilar artery and middle cerebral artery, and the levels of interleukin(IL)-1β and lactic acid(LA) in cerebrospinal fluid were compared between the two groups. Result After treatment, the resuscitation rate was higher in the observation group than in the control group(P<0.05) and the time taken for resuscitation was shorter in the observation group than in the control group(P<0.05). The GCS score increased after treatment in both groups(P<0.05), and was higher in the observation group than in the control group(P<0.05). The electroencephalogram grading was markedly improved after intervention in both groups(P<0.05), and was better in the observation group than in the control group(P<0.05). The Vm of basilar artery and middle cerebral artery increased after treatment in both groups(P<0.05) and the values were higher in the observation group than in the control group(P<0.05). After treatment, the levels of IL-1β and LA in cerebrospinal fluid declined in the two groups(P<0.05), and were lower in the observation group than in the control group(P<0.05).Conclusion In the treatment of coma after surgery for hypertensive cerebral hemorrhage, acupuncture plus Naloxone can enhance the resuscitation rate, shorten the time taken for resuscitation, improve the disturbance of consciousness and electrical activity of the brain, accelerate the cerebral blood flow and down-regulate the levels of IL-1β and LA in cerebral spinal fluid.
作者
刘丽瑾
汤新颜
黄丁
李奉奇
LIU Li-jin;TANG Xin-yan;HUANG Ding;LI Feng-qi(The First Affiliated Hospital of Hunan Traditional Chinese Medical College,Zhuzhou 412000,China)
出处
《上海针灸杂志》
2021年第10期1167-1171,共5页
Shanghai Journal of Acupuncture and Moxibustion
关键词
针刺疗法
针药并用
高血压
脑出血
昏迷
苏醒
Acupuncture therapy
Acupuncture medication combined
Hypertension
Cerebral hemorrhage
Coma
Resuscitation
