高压氧联合井穴放血对脑卒中患者预后的影响

Effect of hyperbaric oxygen therapy combined with Jing acupoints bloodletting on prognosis and telomere length of hemorrhagic stroke patients

摘要:

目的 探讨井穴放血联合高压氧治疗对出血性脑卒中患者预后及端粒长度的影响。方法 将120 例 研究对象随机分为井穴放血组、联合组（井穴放血+ 高压氧）及对照组，每组40 例。其中，井穴放血组经血 肿清除术后，在常规内科治疗基础上给予井穴放血治疗；联合组在井穴放血治疗方案基础上同时给予高压氧 治疗；对照组进行常规内科治疗。比较3 组患者入院当日与治疗后36 d 美国国立卫生研究院卒中量表（NHISS）、 Fusl-Meyer 运动功能评定量表评分（FMA）、格拉斯哥昏迷量表评分（GCS）、认知功能评分（MMSE）、日 常生活能力评分（ADL）及临床疗效；实时荧光定量聚合酶链反应检测患者入院当日及治疗后36 d 时外周血 白细胞端粒长度变化。结果 3 组患者入院当日NHISS、FMA、GCS、MMSE 及ADL 评分比较，差异无统 计学意义（P >0.05）。3 组患者治疗后36 d 治疗总有效率比较，差异有统计学意义（P <0.05）。3 组患者治疗 前后NHISS、FMA、GCS、MMSE 及ADL 评分差值比较，差异有统计学意义（P <0.05），联合组FMA、GCS 及MMSE 高于井穴放血组（P <0.05）。3 组患者治疗前后端粒长度差值比较，差异有统计学意义（P <0.05），井 穴放血组和联合组端粒长度长于对照组（P <0.05）。结论 井穴放血疗法联合高压氧治疗能改善出血性脑卒 中患者的预后，促进受损端粒的修复。

Abstract:

Objective To explore the effect of Jing acupoints bloodletting combined with hyperbaric oxygen therapy on the nerve function and telomere length of patients with hemorrhagic stroke. Methods Totally 120 subjects were randomly divided into three groups: Jing acupoints bloodletting group, Jing acupoints bloodletting+hyperbaric oxygen group (combined group) and control group (40 cases for each group). After the evacuation of hematoma, the Jing acupoints bloodletting group was given bloodletting treatment on the basis of routine medical treatment; the combined group was given hyperbaric oxygen treatment on the basis of the Jing acupoints bloodletting group; the control group received routine medical treatment. Nerve function was evaluated on the day of admission and 36 days after treatment, which includes National Institute of Health stroke scale (NHISS) score, Fusl-Meyer motor function assessment scale (FMA), Glasgow Coma Scale (GCS), Mini-mental State Examination (MMSE) score, daily life ability score (ADL). Clinical efficacy was evaluated as well. Real-time PCR was used to detect telomere length in peripheral blood of patients on the day of admission and 36 days after treatment. Results There were no significant differences in NHISS, FMA, GCS, MMSE and ADL scores among the three groups on the day of admission (P > 0.05). 36 days after treatment, the difference of the total effective rate of treatment among the control group, the bloodletting group and the combined group was statistically significant (P < 0.05); the differences in NHISS, FMA, GCS, MMSE and ADL scores changes among the control group, the bloodletting group and the combined group were statistically significant (P < 0.05), and FMA, GCS, MMSE in combined group were higher than those in Jing acupoints bloodletting group; the differences in telomere length changes among the control group, the bloodletting group and the combined group were statistically significant (P < 0.05), and telomere length increased in Jing acupoints bloodletting group and combined group compared to control group. Conclusions Jing acupoints bloodletting combined with hyperbaric oxygen therapy has a significant effect on the prognosis of patients with hemorrhagic stroke and promoting repair of damaged telomere.