针刺对中风性假性球麻痹患者血浆内皮素及一氧化氮的影响

目的:探讨针刺治疗中风性假性球麻痹的可能机理。方法:将75例中风性假性球麻痹患者随机分为针刺组、西药组、针刺加西药组。针刺选穴以脑三针、舌三针、百会、通里、三阴交为主,并配以电针。西药以脑活素静脉点滴,并口服尼莫通、阿司匹林。分别于治疗前及治疗后检测患者血浆内皮素(ET)及一氧化氮(NO)。结果:在中风性假性球麻痹患者中存在ET、NO异常增高的情况,三组患者治疗前后ET、NO的比较,经统计学处理均有非常显著性差异(P<0.01),三种疗法均可使患者血中的ET含量和NO值显著降低。治疗后三组间的比较则显示,针刺组和针刺加西药组使ET含量和NO值降低的作用均优于西药组,而以针刺加西药组的作用最为明显。结论:针刺使患者血中ET含量和NO值降低可能是其治疗中风性假性球麻痹的机理之一。

Effect of Acupuncture on Plasma Endothelin and NO Levels in Apoplectic Pseudobulbar Paralysis Patients

Objective: To explore the underlying mechanism of acupuncture in the treatment of apoplectic pseudobulbar paralysis.Methods: Seventy-five apoplectic pseudobulbar paralysis patients were evenly randomized into acupuncture,medication and acupuncture+medication groups.Plasma endothelin(ET) and nitric oxide(NO) contents were assayed before and after treatment by using radioimmunoassay and high performance liquid chromatography technique respectively.Main acupoints used were "Naosanzhen" Naohu(GV 17) and bilateral Naokong(GB 19)],"Shesanzhen" Lianquan (CV 23),and two points 1 cun bilateral to CV-23],etc.supplemented with other acupoints according to syndrome-differentiation.Electroacupuncture(EA,frequency 10-50 Hz,strength 5-10 mA,continuous waves) was applied to these acupoints 30 min every time,once daily,with one month being a therapeutic course.Patients were treated with Cerebrolysin(20 mL+5% glucose saline 250 mL,i.v.),Nimodipine(30 mg,t.i.d.) and Aspirin(0.3 g,b.i.d.),continuously for one month.Results: Of the three 25 cases in acupuncture,medication and acupuncture+medication groups,3(12.0%),2(8.0%) and 9(36.0%) were cured,13(52.0%),7(28.0%) and 12(48.0%) had marked improvement,8(32.0%),12(48.0%) and 3(12.0%) had improvement,and 1((4.0%),) 4(16.0%) and 1((4.0%)) failed,with the effective rates being 96.0%,84.0% and 96.0% separately.The therapeutic effect of acupuncture+medication group was significantly superior to that of medication group(P<(0.05).) Before acupuncture treatment,no significant differences were found among the 3 groups in plasma ET and NO contents;and after treatment,both ET and NO levels lowered apparently.Comparison among the 3 groups showed that plasma NO and ET contents of acupuncture group and acupuncture+medication group were significantly lower than those of medication group(P<(0.05,)(0.01).) Conclusion: The therapeutic effects of acupuncture and acupuncture+medication in improving clinical symptoms and lowering plasma ET and NO are significantly superior to those of simple medication.