Gou Li-Kun, Li Chun
Department of Critical Care Medicine, Lanzhou Second People's Hospital, Lanzhou 730046, Gansu Province, China.
World J Clin Cases. 2023 Jan 26;11(3):556-565. doi: 10.12998/wjcc.v11.i3.556.
Stroke is a common and frequently occurring disease of the nervous system and one of the three major diseases leading to human death. The incidence and mortality of stroke in China increase with age. Overall, 70 % of patients with stroke have serious disability, which results in heavy burden to their families and the society.
To analyze the effects of Qixue Shuangbu decoction and acupuncture combined with Western medicine on immune indexes and digestive tract function in patients with acute severe stroke.
A total of 68 patients with acute severe stroke admitted to Lanzhou Second People's Hospital between March 2018 and September 2021 were selected and divided into the control and observation groups according to a random number table method. The control group was administered routine Western medicine treatment, such as dehydration, lowering intracranial pressure, anticoagulation, improving cerebral blood circulation and cerebral nerve protection according to the "Guidelines for the Diagnosis and Treatment of Acute Ischemic Stroke in China." The observation group was administered Qixue Shuangbu decoction nasal feeding tube on the basis of the routine Western medicine treatment with simultaneous acupuncture. The two groups were compared.
The acute physiology and chronic health evaluation II, organ dysfunction syndrome score, National Institutes of Health Stroke Scale, and traditional Chinese medicine syndrome scores of the two groups were significantly decreased compared with those measured before treatment, and the complements C3 and C4, and immunoglobulins (Ig) M and G were significantly increased compared with those observed before treatment ( < 0.05). After treatment, the scores of the observation group were lower than those of the control group, and the complement and Ig levels were higher than those of the control group ( < 0.05). The levels of diamine oxidase (DAO), D-lactic acid (D-LA), and calcitonin gene-related peptide (CGRP) in the two groups were significantly higher than those before treatment, while the levels of lipopolysaccharide, ubiquitin carboxyl-terminal hydrolase 1 (UCH-L1), tumor necrosis factor-α (TNF-α), interleukin (IL) -2, and IL-8 were significantly lower than those before treatment ( < 0.05). After treatment, DAO, D-LA, and CGRP were higher in the observation group than in the control group, while lipopolysaccharide, UCH-L1, TNF-α, IL-2, and IL-8 were lower than in the control group ( < 0.05). The hospitalization time of individuals in the observation group was shorter than that of the control group ( < 0.05).
Qixue Shuangbu decoction and acupuncture combined with Western medicine for the treatment of acute severe stroke can regulate intestinal flora, reduce inflammation, improve intestinal mucosal barrier function and immune function related indicators, and promote recovery.
中风是一种常见且多发的神经系统疾病,是导致人类死亡的三大主要疾病之一。中国中风的发病率和死亡率随年龄增长而增加。总体而言,70%的中风患者有严重残疾,给其家庭和社会带来沉重负担。
分析气血双补汤联合针刺及西药对急性重症中风患者免疫指标及消化道功能的影响。
选取2018年3月至2021年9月在兰州市第二人民医院收治的68例急性重症中风患者,按随机数字表法分为对照组和观察组。对照组按照《中国急性缺血性脑卒中诊治指南》给予常规西药治疗,如脱水、降颅内压、抗凝、改善脑血液循环及脑保护等。观察组在常规西药治疗基础上给予气血双补汤鼻饲管给药并同时针刺,比较两组疗效。
两组治疗后的急性生理与慢性健康状况评分系统II、器官功能障碍综合征评分、美国国立卫生研究院卒中量表评分及中医证候评分均较治疗前显著降低,补体C3、C4及免疫球蛋白M、G均较治疗前显著升高(P<0.05)。治疗后,观察组上述评分低于对照组,补体及免疫球蛋白水平高于对照组(P<0.05)。两组治疗后二胺氧化酶(DAO)、D-乳酸(D-LA)及降钙素基因相关肽(CGRP)水平均较治疗前显著升高,而脂多糖、泛素羧基末端水解酶1(UCH-L1)、肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-2及IL-8水平均较治疗前显著降低(P<0.05)。治疗后,观察组DAO、D-LA及CGRP水平高于对照组,脂多糖、UCH-L1、TNF-α、IL-2及IL-8水平低于对照组(P<0.05)。观察组患者住院时间短于对照组(P<0.05)。
气血双补汤联合针刺及西药治疗急性重症中风能调节肠道菌群,减轻炎症反应,改善肠黏膜屏障功能及免疫功能相关指标,促进康复。