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头针联合高压氧治疗高血压脑出血临床疗效及对患者脑水肿、认知功能的影响
引用本文:冯宝静,宋国亮,张天麟,刘健,石小平,田广平. 头针联合高压氧治疗高血压脑出血临床疗效及对患者脑水肿、认知功能的影响[J]. 河北中医, 2020, 42(2): 264-269. DOI: 10.3969/j.issn.1002-2619.2020.02.023
作者姓名:冯宝静  宋国亮  张天麟  刘健  石小平  田广平
作者单位:河北省秦皇岛市第二医院神经外科,河北 秦皇岛 066600,河北省秦皇岛市第二医院中医科,河北 秦皇岛 066600,河北省秦皇岛市第二医院神经外科,河北 秦皇岛 066600,河北省秦皇岛市第二医院高压氧科,河北 秦皇岛066600,河北省秦皇岛市第二医院康复理疗科,河北 秦皇岛066600,北省秦皇岛市第二医院神经内科,河北 秦皇岛066600
基金项目:河北省秦皇岛市科学技术研究与发展计划
摘    要:目的观察头针联合高压氧治疗高血压脑出血临床疗效及对患者脑水肿、认知功能的影响。方法将134例高血压脑出血患者按照随机数字表法分为2组。对照组69例予常规药物联合高压氧治疗;观察组65例在对照组治疗基础上加头针治疗。2组均治疗2个月后统计临床疗效,并观察2组治疗第1、7、14、21 d血清神经元特异性烯醇化酶(NSE),第7、14、21 d脑水肿体积,治疗前后神经行为认知状态检查表(NCSE)评分及简易精神状态评价量表(MMSE)评分,以及并发症发生率。结果观察组总有效率90.77%(59/65),对照组总有效率69.57%(48/69),观察组总有效率优于对照组(P<0.05)。2组治疗第1、7 d血清NSE水平比较差异无统计学意义(P>0.05),观察组第14、21 d血清NSE水平均低于对照组同期(P<0.05);2组第21 d血清NSE水平均低于本组第14 d(P<0.05),观察组第14 d血清NSE水平低于本组第7 d(P<0.05)。2组治疗第7 d脑水肿体积比较差异无统计学意义(P>0.05),第14、21 d观察组脑水肿体积均低于对照组同期(P<0.05);对照组治疗第21 d脑水肿体积低于本组治疗第7 d(P<0.05),观察组治疗第14、21 d脑水肿体积均低于本组治疗第7 d(P<0.05)。治疗后2组NCSE、MMSE评分均较本组治疗前升高(P<0.05),且观察组高于对照组(P<0.05)。2组并发症发生率比较差异无统计学意义(P>0.05)。结论头针联合高压氧能更快地消除高血压脑出血患者脑水肿,改善认知功能,提高疗效。

关 键 词:头针  高压氧  高血压  脑出血  针刺疗法

Effect of scalp acupuncture combined with hyperbaric oxygen on cerebral edema and cognitive function in patients with hypertensive cerebral hemorrhage
FENG Baojing,SONG Guoliang,ZHANG Tianlin. Effect of scalp acupuncture combined with hyperbaric oxygen on cerebral edema and cognitive function in patients with hypertensive cerebral hemorrhage[J]. Hebei Journal of Traditional Chinese Medicine, 2020, 42(2): 264-269. DOI: 10.3969/j.issn.1002-2619.2020.02.023
Authors:FENG Baojing  SONG Guoliang  ZHANG Tianlin
Affiliation:(Department of Neurosurgery,The Second Hospital of Qinhuangdao,Qinhuangdao,Hebei 066600;不详)
Abstract:Objective To observe the effect of scalp acupuncture combined with hyperbaric oxygen on cerebral edema and cognitive function in patients with hypertensive cerebral hemorrhage.Methods 134 patients with hypertensive cerebral hemorrhage were divided into two groups according to the random number table method.69 cases in control group were treated by conventional medicine combined with hyperbaric oxygen.65 cases in observation group were treated by scalp acupuncture on the basis of the control group.After 2 months of treatment,the clinical effects of the two groups were statistically analyzed.On the 1st,7th,14th and 21st day after treatment,neuron specific enolase(NSE)was observed.On the 7th,14th and 21st day after treatment,brain edema volumewas observed.The neurobehavioral cognitive state checklist(NCSE)and simple mental assessment scale(MMSE)before and after treatment,and the incidence of complications were observed.Results The total effective rate was 90.77%(59/65)in treatment group and 69.57%(48/69)in control group.The clinical curative effect of the treatment group was better than that of the control group(P<0.05).There was no significant difference in serum NSE level between the two groups on the 1st and 7th day(P<0.05).The serum NSE level of the observation group on the 14th and 21st day was lower than that of the control group at the same time(P<0.05).The serum NSE level of the two groups on the 21st day was lower than that of the group on the 14th day(P<0.05),and the serum NSE level of the observation group on the 14th day was lower than that of the group on the 7th day(P<0.05).There was no significant difference in the volume of brain edema between the two groups on the 7th day(P>0.05).On the 14th and 21st day,the volume of brain edema in the observation group was lower than that in the control group(P<0.05).The volume of brain edema in the control group on the 21st day was lower than that in the group on the 7th day(P<0.05).The volume of brain edema in the observation group on the 14th and 21st day was lower than that in the group on the 7th day(P<0.05).After treatment,the scores of NCSE and MMSE in the two groups were increased(P<0.05),and the scores in the observation group were higher than those in the control group(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion Scalp acupuncture combined with hyperbaric oxygen can eliminate brain edema,improve cognitive function and improve curative effect in patients with hypertensive cerebral hemorrhage.
Keywords:Scalp acupuncture  Hyperbaric oxygen  Hypertension  Cerebral hemorrhage  Acupuncture therapy
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