摘要
目的:基于^(1)H-MRS探究针刺治疗颅脑损伤(TBI)昏迷患者意识状态相关脑区代谢物水平的改变,探讨针刺促苏醒的作用机制。方法:选取2022年8月~2023年12月期间广东省第二中医院针灸康复科收治的32例颅脑损伤昏迷患者,采用随机数字表法将其分为对照组和针刺组各16例。两组患者均给予常规治疗,针刺组在此基础上加用醒脑开窍针刺治疗。比较两组患者治疗前后格拉斯哥昏迷量表评分(GCS)、治疗后GCS疗效,并采用头颅质子核磁共振波谱(^(1)H-MRS)检查,比较两组患者治疗前后NAA/Cr、Cho/Cr、NAA/Cho水平。结果:治疗后,两组患者GCS评分均较治疗前显著提高(P<0.05),且针刺组GCS评分高于对照组(P<0.05),针刺组GCS总有效率高于对照组(P<0.05);治疗后,两组患者感兴趣区NAA/Cr、NAA/Cho比值均较治疗前升高(P<0.05),Cho/Cr比值均较治疗前降低(P<0.05),且针刺组NAA/Cr、NAA/Cho、Cho/Cr比值均优于对照组(P<0.05)。结论:针刺对促进脑外伤昏迷患者苏醒具有显著疗效,其作用机制可能与改善意识状态相关脑区代谢有关。
Objective:To explore the changes in metabolite levels related to consciousness status in comatose patients with traumatic brain injury(TBI)treated with acupuncture based on proton magnetic resonance spectroscopy(^(1)H-MRS),and to investigate the mechanism of acupuncture in promoting awakening.Methods:From August 2022 to December 2023,32 comatose patients with craniocerebral injury admitted to the Acupuncture and Moxibustion Rehabilitation Department of Guangdong Provincial Second Hospital of Traditional Chinese Medicine were selected.They were divided into a control group and an acupuncture group with 16 cases each by random number table method.Both groups received routine treatment,while the acupuncture group was additionally given Xingnao Kaiqiao Acupuncture Therapy on this basis.The Glasgow Coma Scale(GCS)scores before and after treatment,and the GCS efficacy after treatment were compared between the two groups.Proton magnetic resonance spectroscopy(^(1)H-MRS)was used to detect the ratios of N-acetylaspartate/creatine(NAA/Cr),choline/creatine(Cho/Cr),and N-acetylaspartate/choline(NAA/Cho)in the region of interest(ROI)of patients in both groups before and after treatment.Results:After treatment,the GCS scores of both groups were significantly higher than those before treatment(P<0.05),and the GCS score of the acupuncture group was higher than that of the control group(P<0.05).The total effective rate of GCS in the acupuncture group was higher than that in the control group(P<0.05).After treatment,the ratios of NAA/Cr and NAA/Cho in the ROI of both groups increased compared with those before treatment(P<0.05),while the Cho/Cr ratio decreased compared with that before treatment(P<0.05).In addition,the ratios of NAA/Cr,NAA/Cho,and Cho/Cr in the acupuncture group were more significantly improved than those in the control group(P<0.05).Conclusion:Acupuncture has a significant effect on awakening comatose patients with TBI,and its mechanism may be related to improving the metabolism of brain regions associated with consciousness.
作者
陈对梅
陆彦青
胡青松
CHEN Duimei;LU Yanqing;HU Qingsong(Guangdong Provincial Second Hospital of Traditional Chinese Medicine(Guangdong Provincial Engineering Technology Research Institute of Traditional Chinese Medicine),Guangzhou,Guangdong 510095)
出处
《中医康复》
2026年第2期60-64,共5页
Traditional Chinese Medicine Rehabilitation
基金
广东省中医药局科研项目(20221037)。
关键词
磁共振波谱
颅脑损伤
昏迷
针刺
促醒
格拉斯哥昏迷量表评分
脑代谢
N-乙酰天门冬氨酸
胆碱
magnetic resonance spectroscopy
traumatic brain injury
coma
acupuncture
wake-promoting
Glasgow Coma Scale
cerebral metabolism
N-acetylaspartate
choline
