阿托伐他汀联合针刺治疗脑卒中后轻度认知障碍的效果观察
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摘要
目的观察阿托伐他汀钙片联合针刺治疗对脑卒中后轻度认知障碍患者应激氧化反应及脑血流动力学的影响。方法选取医院2015年1月-2017年1月收治的脑卒中后轻度认知障碍患者300例,根据不同治疗方法分为观察组和对照组各150例。对照组给予阿托伐他汀钙片治疗,观察组在对照组基础上给予针刺治疗。对比2组患者临床疗效、治疗前后应激氧化反应指标及脑循环动力学指标变化情况。结果观察组患者总有效率为80.67%高于对照组的54.67%,差异有统计学意义(χ~2=15.4495,P<0.05)。治疗前2组OX-LDL及8-iso-PGF2α水平比较差异均无统计学意义(P>0.05);治疗前后观察组OX-LDL及8-iso-PGF2α水平比较差异均无统计学意义(P>0.05);治疗后对照组患者OX-LDL、8-iso-PGF2α水平均高于治疗前及观察组,差异均有统计学意义(P<0.05)。治疗前2组R、Qmean、Vmean比较差异均无统计学意义(P>0.05);治疗后观察组患者R水平低于治疗前及对照组,Qmean、Vmean水平均高于治疗前及对照组,差异均有统计学意义(P<0.05)。结论阿托伐他汀钙片联合针刺方案可有效改善脑卒中后轻度认知障碍。
Objective To observe the effects of atorvastatin combined with acupuncture on stress oxidative response and cerebral hemodynamics in patients with mild cognitive impairment after stroke.Methods 300 patients with mild cognitive impairment after stroke from January 2015 to January 2017 were selected.According to different treatment methods,they were divided into observation group and control group,each of 150 cases.Control group was treated with atorvastatin,and observation group was given acupuncture treatment on the basis of control group.The clinical efficacy,stress oxidation index and cerebral circulation dynamics index changes before and after treatment of two groups were compared.Results The total effective rate in observation group was 80.67% higher than 54.67% in control group,the difference was statistically significant(χ~2=15.4495,P<0.05).There were no significant differences in the levels of OX-LDL and 8-iso-PGF2α between two groups before treatment(P>0.05).There was no significant difference in the levels of OX-LDL and 8-iso-PGF2α before and after treatment in observation group(P>0.05);After treatment,the levels of OX-LDL and 8-iso-PGF2α in control group were higher than those before treatment and observation group,and the difference was statistically significant(P<0.05).There were no significant differences in R,Qmean and Vmean between two groups before treatment(P>0.05).After treatment,the R level of observation group was lower than that before treatment and control group,the Qmean and Vmean levels were higher than before treatment and control group,and the difference was statistically significant(P<0.05).Conclusion Atorvastatin combined with acupuncture can effectively improve mild cognitive impairment after stroke.
Objective To observe the effects of atorvastatin combined with acupuncture on stress oxidative response and cerebral hemodynamics in patients with mild cognitive impairment after stroke.Methods 300 patients with mild cognitive impairment after stroke from January 2015 to January 2017 were selected.According to different treatment methods,they were divided into observation group and control group,each of 150 cases.Control group was treated with atorvastatin,and observation group was given acupuncture treatment on the basis of control group.The clinical efficacy,stress oxidation index and cerebral circulation dynamics index changes before and after treatment of two groups were compared.Results The total effective rate in observation group was 80.67% higher than 54.67% in control group,the difference was statistically significant(χ~2=15.4495,P<0.05).There were no significant differences in the levels of OX-LDL and 8-iso-PGF2α between two groups before treatment(P>0.05).There was no significant difference in the levels of OX-LDL and 8-iso-PGF2α before and after treatment in observation group(P>0.05);After treatment,the levels of OX-LDL and 8-iso-PGF2α in control group were higher than those before treatment and observation group,and the difference was statistically significant(P<0.05).There were no significant differences in R,Qmean and Vmean between two groups before treatment(P>0.05).After treatment,the R level of observation group was lower than that before treatment and control group,the Qmean and Vmean levels were higher than before treatment and control group,and the difference was statistically significant(P<0.05).Conclusion Atorvastatin combined with acupuncture can effectively improve mild cognitive impairment after stroke.
引文
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[2] 钟昌宝,梁振达,李南.阿托伐他汀与洛伐他汀治疗2型糖尿病合并缺血性脑卒中的随机对照临床研究[J].中国临床药理学杂志,2018,34(13):1497-1500.DOI:10.13699/j.cnki.1001-6821.2018.13.003.
[3] 张士杰.阿托伐他汀联合拜阿司匹林对缺血性脑卒中患者血脂水平变化及日常生活能力的影响[J].北方药学,2018,15(4):44-45.DOI:10.3969/j.issn.1004-4337.2018.04.040.
[4] 吴智成.探讨阿托伐他汀联合阿司匹林治疗急性缺血性脑卒中的效果[J].数理医药学杂志,2018,31(4):557-558.DOI:10.3969/j.issn.1672-8351.2018.04.033.
[5] 路延丽,乔向东,叶芳.通心络胶囊联合阿司匹林和阿托伐他汀对缺血性脑卒中二级预防的疗效分析[J].贵州医药,2018,42(3):318-320.DOI:10.3969/j.issn.1000-744X.2018.03.024.
[6] 李慧伟,夏小敬.阿托伐他汀钙片治疗脑卒中合并脑微出血的临床效果分析[J].河南医学研究,2018,27(3):461.DOI:10.3969/j.issn.1004-437X.2018.03.042.
[7] 石蕊.阿托伐他汀联合氯吡格雷+阿司匹林双抗治疗对缺血性急性脑卒中患者再发血管事件的获益及风险分析[J].湖南师范大学学报(医学版),2018,15(1):104-107.DOI:10.3969/j.issn.1673-016X.2018.01.034.
[8] 张小健,周媛,郭泽春,等.针刺颈夹脊穴和督脉穴联合阿托伐他汀对脑卒中后轻度认知障碍患者血流动学的影响[J].湖南师范大学学报(医学版),2017,14(2):131-134.DOI:10.3969/j.issn.1673-016X.2017.02.041.
[9] 李家炎.电针对ApoE-/-小鼠主动脉窦IL-6表达的影响[D].南京:南京中医药大学,2016.
[10] 林志诚,陈立典,陶静,等.电针百会穴对脑梗死后认知障碍患者听觉P300的影响[J].上海针灸杂志,2014,33(1):14-17.DOI:10.13460/j.issn.1005-0957.2014.01.0014.