目的评价中医综合疗法治疗缺血性脑卒中后肢体功能障碍的临床疗效。方法将符合入选标准的2017年6月-2019年1月多中心联盟医院收治的160例缺血性脑卒中后肢体功能障碍患者采用随机数字表法分为2组,每组80例。对照组采用西医基础治疗与康...目的评价中医综合疗法治疗缺血性脑卒中后肢体功能障碍的临床疗效。方法将符合入选标准的2017年6月-2019年1月多中心联盟医院收治的160例缺血性脑卒中后肢体功能障碍患者采用随机数字表法分为2组,每组80例。对照组采用西医基础治疗与康复训练,观察组在对照组基础上联合中医综合疗法(中药内服+中药熏洗+耳穴贴压)治疗。2组均治疗4周,随访2个月。分别于治疗前后进行中医症状评分,采用Fugl-Meyer量表评估肢体功能障碍程度,采用美国国立卫生研究院卒中量表(national institudes of health stroke scale,NIHSS)评估神经功能受损程度,采用Barthel指数评估日常生活活动能力,依据Brunnstrom运动功能评定法进行临床疗效评价。结果治疗后,观察组肢体强痉拘急[(1.57±0.36)分比(1.98±0.53)分,t=5.724]、偏身麻木[(1.37±0.31)分比(1.80±0.36)分,t=8.096]、屈伸不利[(1.31±0.25)分比(1.84±0.46)分,t=9.055]评分均低于对照组(P<0.01);Fugl-Meyer活动和平衡评分均高于对照组(t值分别为2.739、4.705,P<0.05或P<0.01),NIHSS评分低于对照组(t=9.645,P<0.01),Barthel指数高于对照组(t=7.870,P<0.01)。观察组总有效率为97.5%(78/80)、对照组为88.8%(71/80),2组比较差异有统计学意义(χ^(2)=4.783,P=0.028)。结论中医综合疗法可有效改善缺血性脑卒中患者中医症状及肢体功能,促进神经功能恢复,提高日常生活能力及临床疗效。展开更多
BACKGROUND： Inhibitory signals, i.e. neurite growth inhibitors （NGIs）, presenting on central nervous system （CNS） myelin have been shown to play a crucial role in inhibiting lesioned axonal sprouting and leading ...BACKGROUND： Inhibitory signals, i.e. neurite growth inhibitors （NGIs）, presenting on central nervous system （CNS） myelin have been shown to play a crucial role in inhibiting lesioned axonal sprouting and leading to less functional recovery. Vaccines targeting NGIs may provide multifactorial protection against brain insults by overcoming the inhibitory effects of these NGIs and boosting the body＇s immune repair mechanisms. OBJECTIVE： To evaluate the effect of poststroke DNA immunization against NGIs on the rehabilitation for sensorimotor function of rat models of local cerebral ischemia. DESIGN： Completely randomized grouping design, and controlled experiment. SETTING： Brain Injury Research Laboratory, Department of Neurosurgery, National Neuroscience Institute, Singapore. MATERIALS： Sixty adult male Sprague-Dawley rats ranging in age from 45 to 120 days and in weight from 180 to 250 grams were provided by Animal Center of Department of Anatomy, Faculty of Medicine, National University of Singapore. pcDNA3.1（＋）-neurite growth inhibitors （pcDNA-NGIs） a gift was provided by Dr. Xiao from Department of Clinical Research, Singapore General Hospital, Singapore. METHODS： The experiment was carried out at Brain Injury Research Laboratory, Department of Neurosurgery, National Neuroscience Institute, Singapore from August 2003 to April 2005. （1）The involved rats were randomized into 3 groups： pcDNA-NGIs group （group A）, pcDNA3.1 （＋） group （group B） and model group （group C）, with 20 rats in each group. Left focal cerebral ischemia （FCI） was permanently induced through middle cerebral artery occlusion （MCAO） with the assistance of an operating microscope. Successful MCAO was determined by a 20% decrease to baseline in the ipsilateral cerebral blood flow. 100 μg of pcDNA-NGIs eluted in phosphate-buffered saline （PBS） was intramuscularly injected into the tibial muscle once a week after MCAO for 6 weeks in group A. As control, pcDNA3.1 （＋） was also adm展开更多
目的评价中风醒脑液联合依达拉奉注射液治疗急性缺血性脑卒中(acute ischemic stroke,AIS)的疗效。方法将符合入选标准的2020年5月-2021年3月本院AIS患者92例,按病历尾号分为2组,每组46例。2组均给予西医常规疗法治疗,对照组在此基础上...目的评价中风醒脑液联合依达拉奉注射液治疗急性缺血性脑卒中(acute ischemic stroke,AIS)的疗效。方法将符合入选标准的2020年5月-2021年3月本院AIS患者92例,按病历尾号分为2组,每组46例。2组均给予西医常规疗法治疗,对照组在此基础上静脉滴注依达拉奉注射液,研究组在对照组基础上联合加服中风醒脑液。2组均连续治疗2周。分别于治疗前后采用美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)评估患者神经功能缺损程度,改良Rankin量表(modified Ranking Scale,mRS)评估患者预后。采用全自动血液流变仪检测全血高切黏度、红细胞压积、全血低切黏度、纤维蛋白原,采用ELISA法检测超敏C反应蛋白(hs-CRP)、IL-6和内皮素-1(ET-1)水平。记录不良反应,评价疾病转归。结果治疗后,研究组mRS评分[(2.06±0.18)分比(2.73±0.23)分,t=15.56]、NIHSS评分[(5.25±2.36)分比(10.61±2.48)分,t=14.58]低于对照组(P<0.01)。治疗后,研究组血清hs-CRP[(9.04±1.98)mg/L比(14.36±2.09)mg/L,t=12.57]、IL-6[(23.14±1.46)ng/L比(39.37±2.51)ng/L,t=12.39]、ET-1[(67.18±13.22)ng/L比(98.14±22.29)ng/L,t=19.37]水平低于对照组(P<0.01);全血高切黏度[(7.53±1.37)mPa·s比(9.24±1.42)mPa·s,t=5.89]、红细胞压积[(0.27±0.06)%比(0.39±0.08)%,t=8.14]、全血低切黏度[(5.92±1.09)mPa·s比(8.35±1.24)mPa·s,t=9.98]、纤维蛋白原[(1.63±0.42)g/L比(2.47±0.58)g/L,t=7.96]低于对照组(P<0.01)。治疗期间,对照组不良反应发生率为8.70%(4/46)、研究组为15.22%(7/46),2组比较差异无统计学意义(χ^(2)=0.93,P=0.335)。治疗后,对照组转归良好率为73.9%(34/46)、研究组为93.5%(43/46),2组比较差异有统计学意义(χ^(2)=6.45,P=0.011)。结论中风醒脑液联合依达拉奉注射液可有效降低AIS患者炎性细胞因子水平,改善血液流变学指标,发挥脑保护作用。展开更多
文摘目的评价中医综合疗法治疗缺血性脑卒中后肢体功能障碍的临床疗效。方法将符合入选标准的2017年6月-2019年1月多中心联盟医院收治的160例缺血性脑卒中后肢体功能障碍患者采用随机数字表法分为2组,每组80例。对照组采用西医基础治疗与康复训练,观察组在对照组基础上联合中医综合疗法(中药内服+中药熏洗+耳穴贴压)治疗。2组均治疗4周,随访2个月。分别于治疗前后进行中医症状评分,采用Fugl-Meyer量表评估肢体功能障碍程度,采用美国国立卫生研究院卒中量表(national institudes of health stroke scale,NIHSS)评估神经功能受损程度,采用Barthel指数评估日常生活活动能力,依据Brunnstrom运动功能评定法进行临床疗效评价。结果治疗后,观察组肢体强痉拘急[(1.57±0.36)分比(1.98±0.53)分,t=5.724]、偏身麻木[(1.37±0.31)分比(1.80±0.36)分,t=8.096]、屈伸不利[(1.31±0.25)分比(1.84±0.46)分,t=9.055]评分均低于对照组(P<0.01);Fugl-Meyer活动和平衡评分均高于对照组(t值分别为2.739、4.705,P<0.05或P<0.01),NIHSS评分低于对照组(t=9.645,P<0.01),Barthel指数高于对照组(t=7.870,P<0.01)。观察组总有效率为97.5%(78/80)、对照组为88.8%(71/80),2组比较差异有统计学意义(χ^(2)=4.783,P=0.028)。结论中医综合疗法可有效改善缺血性脑卒中患者中医症状及肢体功能,促进神经功能恢复,提高日常生活能力及临床疗效。
基金the grants from the National Medical Research Council and Health Research of Singapore
文摘BACKGROUND： Inhibitory signals, i.e. neurite growth inhibitors （NGIs）, presenting on central nervous system （CNS） myelin have been shown to play a crucial role in inhibiting lesioned axonal sprouting and leading to less functional recovery. Vaccines targeting NGIs may provide multifactorial protection against brain insults by overcoming the inhibitory effects of these NGIs and boosting the body＇s immune repair mechanisms. OBJECTIVE： To evaluate the effect of poststroke DNA immunization against NGIs on the rehabilitation for sensorimotor function of rat models of local cerebral ischemia. DESIGN： Completely randomized grouping design, and controlled experiment. SETTING： Brain Injury Research Laboratory, Department of Neurosurgery, National Neuroscience Institute, Singapore. MATERIALS： Sixty adult male Sprague-Dawley rats ranging in age from 45 to 120 days and in weight from 180 to 250 grams were provided by Animal Center of Department of Anatomy, Faculty of Medicine, National University of Singapore. pcDNA3.1（＋）-neurite growth inhibitors （pcDNA-NGIs） a gift was provided by Dr. Xiao from Department of Clinical Research, Singapore General Hospital, Singapore. METHODS： The experiment was carried out at Brain Injury Research Laboratory, Department of Neurosurgery, National Neuroscience Institute, Singapore from August 2003 to April 2005. （1）The involved rats were randomized into 3 groups： pcDNA-NGIs group （group A）, pcDNA3.1 （＋） group （group B） and model group （group C）, with 20 rats in each group. Left focal cerebral ischemia （FCI） was permanently induced through middle cerebral artery occlusion （MCAO） with the assistance of an operating microscope. Successful MCAO was determined by a 20% decrease to baseline in the ipsilateral cerebral blood flow. 100 μg of pcDNA-NGIs eluted in phosphate-buffered saline （PBS） was intramuscularly injected into the tibial muscle once a week after MCAO for 6 weeks in group A. As control, pcDNA3.1 （＋） was also adm
文摘目的评价中风醒脑液联合依达拉奉注射液治疗急性缺血性脑卒中(acute ischemic stroke,AIS)的疗效。方法将符合入选标准的2020年5月-2021年3月本院AIS患者92例,按病历尾号分为2组,每组46例。2组均给予西医常规疗法治疗,对照组在此基础上静脉滴注依达拉奉注射液,研究组在对照组基础上联合加服中风醒脑液。2组均连续治疗2周。分别于治疗前后采用美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)评估患者神经功能缺损程度,改良Rankin量表(modified Ranking Scale,mRS)评估患者预后。采用全自动血液流变仪检测全血高切黏度、红细胞压积、全血低切黏度、纤维蛋白原,采用ELISA法检测超敏C反应蛋白(hs-CRP)、IL-6和内皮素-1(ET-1)水平。记录不良反应,评价疾病转归。结果治疗后,研究组mRS评分[(2.06±0.18)分比(2.73±0.23)分,t=15.56]、NIHSS评分[(5.25±2.36)分比(10.61±2.48)分,t=14.58]低于对照组(P<0.01)。治疗后,研究组血清hs-CRP[(9.04±1.98)mg/L比(14.36±2.09)mg/L,t=12.57]、IL-6[(23.14±1.46)ng/L比(39.37±2.51)ng/L,t=12.39]、ET-1[(67.18±13.22)ng/L比(98.14±22.29)ng/L,t=19.37]水平低于对照组(P<0.01);全血高切黏度[(7.53±1.37)mPa·s比(9.24±1.42)mPa·s,t=5.89]、红细胞压积[(0.27±0.06)%比(0.39±0.08)%,t=8.14]、全血低切黏度[(5.92±1.09)mPa·s比(8.35±1.24)mPa·s,t=9.98]、纤维蛋白原[(1.63±0.42)g/L比(2.47±0.58)g/L,t=7.96]低于对照组(P<0.01)。治疗期间,对照组不良反应发生率为8.70%(4/46)、研究组为15.22%(7/46),2组比较差异无统计学意义(χ^(2)=0.93,P=0.335)。治疗后,对照组转归良好率为73.9%(34/46)、研究组为93.5%(43/46),2组比较差异有统计学意义(χ^(2)=6.45,P=0.011)。结论中风醒脑液联合依达拉奉注射液可有效降低AIS患者炎性细胞因子水平,改善血液流变学指标,发挥脑保护作用。
