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火针疗法对改善脑梗死患者神经功能的疗效及其对肠道菌群代谢产物的影响

Efficacy of Fire-Needle Therapy in Improving Neurological Function Following Cerebral Infarction and Its Effect on Intestinal Flora Metabolites.

作者信息

Feng Yi-Jun, Wang Bing-Quan, Cao Lu-Lu, Dong Li-Ying, Zhang Chu-Yi, Hu Dong-Jian, Zhou Zhen, Cao Jin-Xiu

机构信息

Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, People's Republic of China.

Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, People's Republic of China.

出版信息

Int J Gen Med. 2024 Feb 2;17:387-399. doi: 10.2147/IJGM.S450027. eCollection 2024.

Abstract

OBJECTIVE

This study was to investigate the mechanism of action and clinical efficacy of fire-needle therapy in improving neurological function in patients with acute cerebral infarction (identified as a wind-phlegm-blood stasis syndrome in traditional Chinese medicine).

METHODS

We included patients diagnosed with acute cerebral infarction (wind-phlegm-blood stasis syndrome) admitted to the Encephalopathy and Acupuncture Center of the Second Affiliated Hospital of Tianjin University of Chinese Medicine. We randomly allocated them into the treatment and control groups, with 45 cases in each group. Acupuncture treatments that focused on regulating the mind and dredging the collaterals were used in the control group, while the treatment group additionally received fire-needle therapy. Our indicators included the National Institutes of Health Stroke Scale (NIHSS) scores, the Fugl-Meyer Assessment (FMA) scale, peripheral blood tumor necrosis factor-α (TNF-α), interleukin-17 (IL-17), hypersensitivity C-reactive protein (hs-CRP), and intestinal metabolites short-chain fatty acids (SCFAs). We measured these indicators before treatment and 14 days after treatment.

RESULTS

The post-treatment NIHSS scores of the two groups were significantly reduced ( < 0.05), and the treatment group showed a more significant decline in the score when compared to the control group ( < 0.05). The treatment group showing significant improvement in the domains of reflex activity, mobility, cooperative movement, and finger movement ( < 0.05). Both groups showed a significant decrease in the IL-17 and hs-CRP levels ( < 0.05), with the treatment group demonstrating a significant declining trend when compared to the control group ( < 0.05). The levels of acetic acid, propionic acid, butyric acid, and valeric acid all increased significantly in the two groups ( < 0.05), with acetic acid and butyric acid increasing significantly in the treatment group when compared to the control group ( < 0.05). Clinical efficacy rate: 78.6% of patients in the treatment group had an excellent rate, whereas it was 30.0% in the control group, and the difference was statistically significant ( < 0.001).

CONCLUSION

Fire-needle therapy was effective in upregulating the SCFA content in patients with acute cerebral infarction (wind-phlegm-blood stasis syndrome), inhibiting the level of the inflammatory response, and improving the recovery of neurological functions.

CLINICAL REGISTRATION NUMBER

Registration website link: https://www.chictr.org.cn. Registration date: 2022/9/27. Registration number: ChiCTR2200064122.

摘要

目的

本研究旨在探讨火针疗法改善急性脑梗死(中医辨证为风痰瘀阻证)患者神经功能的作用机制及临床疗效。

方法

选取天津中医药大学第二附属医院脑病针灸中心收治的急性脑梗死(风痰瘀阻证)患者。将其随机分为治疗组和对照组,每组45例。对照组采用以调神通络为主的针刺治疗,治疗组在此基础上加用火针疗法。观察指标包括美国国立卫生研究院卒中量表(NIHSS)评分、Fugl-Meyer评估量表(FMA)、外周血肿瘤坏死因子-α(TNF-α)、白细胞介素-17(IL-17)、超敏C反应蛋白(hs-CRP)以及肠道代谢产物短链脂肪酸(SCFAs)。于治疗前及治疗14天后测量上述指标。

结果

两组治疗后NIHSS评分均显著降低(<0.05),且治疗组评分下降幅度较对照组更显著(<0.05)。治疗组在反射活动、运动能力、协同运动及手指运动等方面有显著改善(<0.05)。两组IL-17及hs-CRP水平均显著降低(<0.05),且治疗组下降趋势较对照组更显著(<0.05)。两组乙酸、丙酸、丁酸及戊酸水平均显著升高(<0.05),且治疗组乙酸及丁酸升高幅度较对照组更显著(<0.05)。临床有效率:治疗组患者的优良率为78.6%,对照组为30.0%,差异有统计学意义(<0.001)。

结论

火针疗法可有效上调急性脑梗死(风痰瘀阻证)患者的SCFA含量,抑制炎症反应水平,促进神经功能恢复。

临床注册号

注册网站链接:https://www.chictr.org.cn。注册日期:2022/9/27。注册号:ChiCTR2200064122。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/72eb/10850761/3177a9eb7ec3/IJGM-17-387-g0001.jpg

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