CAJ | 학술논문

目的：观察醒脑开窍针刺法对重度颅脑损伤（ STBI）患者血浆髓鞘碱性蛋白（ MBP）、胶质纤维酸性蛋白（ GFAP）含量的影响。方法将60例STBI患者随机分成针刺组和对照组，对照组予西医常规治疗，针刺组在此基础上加用醒脑开窍针刺法治疗。分别于治疗前及治疗后3，7，14 d检测2组患者血浆MBP、GFAP含量，评估2组患者格拉斯哥昏迷评分（GCS）；观察2组治疗7，14 d苏醒例数、苏醒时间；于治疗14 d后根据格拉斯哥预后评分（ GOS）评定预后。结果2组治疗后血浆MBP、GFAP含量均较治疗前逐渐下降，针刺组治疗后7，14 d血浆MBP和GFAP含量均明显低于对照组（P均＜0．05），其中针刺组治疗后3 d血浆GFAP含量也明显低于对照组（P＜0．05）。针刺组治疗后3，7，14 d GCS评分均明显高于对照组（P均＜0．05）；治疗后7，14 d苏醒率均高于对照组（P＜0．05），苏醒时间均较对照组明显缩短（P均＜0．05）；治疗后14 d总有效率明显高于对照组（P＜0．05）。结论醒脑开窍针刺法可有效降低STBI患者血浆MBP、GFAP含量，促进STBI受损神经修复，有效抑制继发性脑损伤的发生，提高苏醒率，缩短苏醒时间，改善患者预后。
목적：관찰성뇌개규침자법대중도로뇌손상（ STBI）환자혈장수초감성단백（ MBP）、효질섬유산성단백（ GFAP）함량적영향。방법장60례STBI환자수궤분성침자조화대조조，대조조여서의상규치료，침자조재차기출상가용성뇌개규침자법치료。분별우치료전급치료후3，7，14 d검측2조환자혈장MBP、GFAP함량，평고2조환자격랍사가혼미평분（GCS）；관찰2조치료7，14 d소성례수、소성시간；우치료14 d후근거격랍사가예후평분（ GOS）평정예후。결과2조치료후혈장MBP、GFAP함량균교치료전축점하강，침자조치료후7，14 d혈장MBP화GFAP함량균명현저우대조조（P균＜0．05），기중침자조치료후3 d혈장GFAP함량야명현저우대조조（P＜0．05）。침자조치료후3，7，14 d GCS평분균명현고우대조조（P균＜0．05）；치료후7，14 d소성솔균고우대조조（P＜0．05），소성시간균교대조조명현축단（P균＜0．05）；치료후14 d총유효솔명현고우대조조（P＜0．05）。결론성뇌개규침자법가유효강저STBI환자혈장MBP、GFAP함량，촉진STBI수손신경수복，유효억제계발성뇌손상적발생，제고소성솔，축단소성시간，개선환자예후。
Objective It is to observe the effect of Xingnao-kaiqiao acupuncture on the plasma levels of MBP and GFAP in patients with severe traumatic brain injury.Methods Sixty cases of patients with severe traumatic brain injury were random-ly divided into an acupuncture group and a control group.The control group were treated with routine western medicine.The acupuncture group were additionally treated with Xingnao-kaiqiao acupuncture.The serum levels of MBP and GFAP in the patients in both groups were detected at the time of admission, 3days,7 days and 14 days after therapy, and their Glasgow Co-ma Scale (GCS) was evaluated.Arousal time and rate after 7days and 14 days of two groups were observed and compared. The prognosis was evaluated according to Glasgow Outcome Score ( GOS) in 14 days after treatment.Results The differences of MBP level in the acupuncture group at the time of 3days after therapy have no statistically significant compared with the con-trol group.The serum level of MBP of the acupuncture group was significantly lower than the control group at the time of 7days and 14 days after therapy(P<0.05).The serum level of GFAP of the acupuncture group was significantly lower than the con-trol group(P<0.05).The GCS of the acupuncture group was significantly higher than the control group(P<0.05).The a-rousal time of the acupuncture group was significantly shorter while the arousal rate was significantly higher than the control group(P<0.05).The total effective rate of the acupuncture group was significantly higher than the control group(P<0.05). Conclusion Therapy with Xingnao-kaiqiao acupuncture can decrease the plasma levels of MBP, GFAP, promote restoration of the injured nerve and effectively restrain the occurrence of secondary brain injury, increase arousal rate, and decrease a-rousal time, and improve the patients'prognosis.