Chen Yong, Du Zhong-Heng, Chen Hai-Yan, Pan Yan
Department of Acupuncture, Tuina and Physical Therapy, First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325100, Zhejiang Province, China.
School of Nursing, Wenzhou Medical University, Wenzhou 325005, Zhejiang Province.
Zhongguo Zhen Jiu. 2022 Aug 12;42(8):857-62. doi: 10.13703/j.0255-2930.20210823-k0006.
To observe the effect of staged acupuncture on serum irisin level, neurological deficit, balance ability and spasticity in patients with ischemic stroke.
Sixty patients with ischemic stroke were randomly divided into a staged acupuncture group and a routine acupuncture group, 30 cases in each group; another 30 healthy subjects were selected as a normal group. The patients with ischemic stroke were treated with aspirin (100 mg each time, once a day, changing to 50 mg for prophylactic dose after 4 weeks). The patients in the staged acupuncture group were treated with staged acupuncture (acupoints were selected according to the soft paralysis period, spasticity period and recovery period, sequelae period) and rehabilitation treatment, while the patients in the routine acupuncture group were treated with acupuncture of soft paralysis-period as the staged acupuncture group and rehabilitation treatment. All the treatment was given once a day, 5 times a week, 2 weeks as a course of treatment, and 4 consecutive courses of treatment were provided. Before treatment and at 2 weeks, 4 weeks, 6 weeks and 8 weeks into treatment, the serum irisin level was measured, and the scores of National Institutes of Health stroke scale (NIHSS), Fugl-Meyer assessment scale-balance (FM-B) and comprehensive spasticity scale (CSS) were compared, and the correlation between the serum irisin level and NIHSS and FM-B scores in the two groups was analyzed.
Before treatment, the serum irisin levels in the two groups were lower than those in the normal group (<0.01). Compared before treatment, the serum irisin levels and FM-B scores were increased (<0.01), and the NIHSS scores were decreased at 2, 4, 6 and 8 weeks into treatment in the two groups (<0.01). At 4, 6 and 8 weeks into treatment, in the staged acupuncture group, the serum irisin levels and FM-B scores were higher than those in the routine acupuncture group (<0.01, <0.05), and the NIHSS scores were lower than those in the routine acupuncture group (<0.01). After treatment, the CSS scores in the two groups were increased first and then decreased. Compared before treatment, the CSS scores were increased at 2, 4, 6 and 8 weeks into treatment in the two groups (<0.01). At 4, 6 and 8 weeks into treatment, the CSS scores in the staged acupuncture group were lower than those in the routine acupuncture group (<0.01). The serum irisin level was negatively correlated with NIHSS score ( =-0.772, =0.000), and positively correlated with FM-B score ( =0.675, =0.000).
The severity of neurological deficit and balance ability are related to serum irisin level in patients with ischemic stroke. The staged acupuncture could increase the serum irisin level, improve the neurological function, balance ability and spasticity in patients with ischemic stroke.
观察分期针刺对缺血性脑卒中患者血清鸢尾素水平、神经功能缺损、平衡能力及痉挛状态的影响。
将60例缺血性脑卒中患者随机分为分期针刺组和常规针刺组，每组30例；另选取30例健康受试者作为正常组。缺血性脑卒中患者给予阿司匹林治疗（每次100mg，每日1次，4周后改为预防剂量50mg）。分期针刺组采用分期针刺（根据软瘫期、痉挛期、恢复期、后遗症期选取穴位）结合康复治疗，常规针刺组采用与分期针刺组软瘫期相同的针刺方法结合康复治疗。所有治疗均每日1次，每周5次，2周为1个疗程，连续治疗4个疗程。于治疗前及治疗2周、4周、6周、8周时检测血清鸢尾素水平，比较美国国立卫生研究院卒中量表（NIHSS）评分、Fugl-Meyer平衡评定量表（FM-B）评分及综合痉挛量表（CSS）评分，并分析两组血清鸢尾素水平与NIHSS、FM-B评分之间的相关性。
治疗前，两组患者血清鸢尾素水平均低于正常组（<0.01）。与治疗前比较，两组患者治疗2周、4周、6周、8周时血清鸢尾素水平及FM-B评分均升高（<0.01），NIHSS评分降低（<0.01）。治疗4周、6周、8周时，分期针刺组患者血清鸢尾素水平及FM-B评分高于常规针刺组（<0.01，<0.05），NIHSS评分低于常规针刺组（<0.01）。治疗后，两组CSS评分均先升高后降低。与治疗前比较，两组患者治疗2周、4周、6周、8周时CSS评分均升高（<0.01）。治疗4周、6周、8周时，分期针刺组CSS评分低于常规针刺组（<0.01）。血清鸢尾素水平与NIHSS评分呈负相关（r=-0.772，P=0.000），与FM-B评分呈正相关（r=0.675，P=0.000）。
缺血性脑卒中患者神经功能缺损严重程度及平衡能力与血清鸢尾素水平有关。分期针刺可提高缺血性脑卒中患者血清鸢尾素水平，改善其神经功能、平衡能力及痉挛状态。
