CAJ | 학술논문

目的：观察比较针灸通督、常规针刺、药物3种治疗方法对缺血性脑卒中患者骨髓干细胞动员标记物CD34+、CD133+细胞水平及神经功能缺损评分的影响。方法将符合纳入标准的120例缺血性脑卒中患者随机分为针灸通督组(A组)、常规针刺组(B组)、药物组(C组),每组40例。3组在基础病常规药物治疗的前提下,A组患者采用艾灸百会、大椎刺络放血,同时结合针刺的治疗方法,取穴为风池、曲池、合谷、足三里、三阴交；B组针刺风池、曲池、合谷、足三里、三阴交；C组采用中成药通心络胶囊进行对照。3组均治疗14 d。3组患者在治疗前后均进行CD34+、CD133+、神经功能缺损的检测及评分,进行对比分析。结果3种疗法均能不同程度升高患者外周血CD34+、CD133+细胞水平,组内比较有显著性差异(P＜0.05,P＜0.01)；3组组间比较有显著性差异(P＜0.05),A组与B、C组相比有显著性差异(P＜0.05)。B组与C组比较差异无统计学意义(P＞0.05)；3种疗法均能不同程度地改善患者神经功能缺损评分,A组与B、C组相比差异有统计学意义(P＜0.05,P＜0.01)。B组与C组比较差异有统计学意义(P＜0.05)。结论针灸通督组、常规针刺组、药物组对缺血性脑卒中患者骨髓干细胞动员、神经功能缺损均具有不同程度的干预作用；针灸通督组对患者骨髓干细胞动员、神经功能缺损的干预作用优于常规针刺组和药物组,提示针灸通督疗法在治疗脑梗死方面可能具有更好的优势。
목적：관찰비교침구통독、상규침자、약물3충치료방법대결혈성뇌졸중환자골수간세포동원표기물CD34+、CD133+세포수평급신경공능결손평분적영향。방법장부합납입표준적120례결혈성뇌졸중환자수궤분위침구통독조(A조)、상규침자조(B조)、약물조(C조),매조40례。3조재기출병상규약물치료적전제하,A조환자채용애구백회、대추자락방혈,동시결합침자적치료방법,취혈위풍지、곡지、합곡、족삼리、삼음교；B조침자풍지、곡지、합곡、족삼리、삼음교；C조채용중성약통심락효낭진행대조。3조균치료14 d。3조환자재치료전후균진행CD34+、CD133+、신경공능결손적검측급평분,진행대비분석。결과3충요법균능불동정도승고환자외주혈CD34+、CD133+세포수평,조내비교유현저성차이(P＜0.05,P＜0.01)；3조조간비교유현저성차이(P＜0.05),A조여B、C조상비유현저성차이(P＜0.05)。B조여C조비교차이무통계학의의(P＞0.05)；3충요법균능불동정도지개선환자신경공능결손평분,A조여B、C조상비차이유통계학의의(P＜0.05,P＜0.01)。B조여C조비교차이유통계학의의(P＜0.05)。결론침구통독조、상규침자조、약물조대결혈성뇌졸중환자골수간세포동원、신경공능결손균구유불동정도적간예작용；침구통독조대환자골수간세포동원、신경공능결손적간예작용우우상규침자조화약물조,제시침구통독요법재치료뇌경사방면가능구유경호적우세。
ObjectiveTo observe the effect ofTong Du acupuncture-moxibustion, conventional acupuncture, and medication on the bone marrow stem cells (BMSCs) mobilization markers CD34+and CD133+, neurological deficit score in patients with ischemic stroke.Method Totally 120 eligible subjects with ischemic stroke were randomized into aTong Du acupuncture-moxibustion group (group A), a conventional acupuncture group (group B), and a medication group (group C), 40 in each group. In addition to the conventional medication given to all three groups, patients in group A also received moxibustion at Baihui (GV20), bloodletting at Dazhui (GV14), and acupuncture at Fengchi (GB20), Quchi (LI11), Hegu (LI4), Zusanli (ST36), and Sanyinjiao (SP6); patients in group B also received acupuncture at Fengchi, Quchi, Hegu, Zusanli, and Sanyinjiao; group C received patent Chinese medicine Tong Xin Luo capsules. The intervention lasted 14 d in all three groups. The CD34+and CD133+and neurological deficit score were evaluated and compared before and after intervention.Result The three treatment methods all significantly increased the level of CD34 + and CD133+in peripheral blood (P<0.05,P<0.01); the intergroup comparisons showed significant differences among the three groups (P<0.05), and the level in group A was significantly different from that in group B and C (P<0.05), while there was no significant difference between group B and C (P>0.05); the three treatment methods all improved the neurological deficit score to various extent, and the result in group A was significantly different from that in group B and C (P<0.05,P<0.01), and there was also a significant difference between group B and C (P<0.05).ConclusionsTong Du acupuncture-moxibustion, conventional acupuncture, and medication can influence the BMSCs and neurological deficit to different extent; the effect ofTong Du acupuncture-moxibustion on the BMSCs and neurological deficit is more significant than that of the conventional acupuncture and medication, suggesting thatTong Du acupuncture-moxibustion method should have advantage in treating cerebral infarction.