针灸改善急性缺血性脑卒中患者的神经功能和抗炎作用:双盲随机对照试验。

IF 4.3 3区 材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC ACS Applied Electronic Materials Pub Date : 2024-05-08 DOI:10.1016/j.ctim.2024.103049
Chueh-Yi Tsai , Wen-Ling Liao , Hung-Ming Wu , Chia-Wei Chang , Wei-Liang Chen , Ching-Liang Hsieh
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引用次数: 0

摘要

背景和目的:针灸具有抗炎作用,是世界卫生组织推荐的脑卒中辅助治疗方法。本研究探讨了急性缺血性脑卒中(AIS)急性期干预对神经功能结果的改善,以及早期针灸的抗炎作用:50名AIS患者被随机分配到对照组(CG,25名患者,接受假针灸治疗)或治疗组(TG,25名患者,接受针灸治疗)。针灸干预每周两次,连续 4 周共 8 次。主要结果是美国国立卫生研究院卒中量表(NIHSS)、改良Rankin量表(mRS)和Barthel指数(BI)评分的变化。次要结果是血清炎症相关生物标志物水平的变化:共有 35 名患者(18 名 CG 患者和 17 名 TG 患者)完成了试验。在 V2(针灸干预后进行的第二次评估)和 V1(针灸干预前进行的第一次评估;4.33 ± 1.91 vs. 2.68 ± 1.42,p = 0.005)之间,以及 V3(最后一次针灸干预后 28 天进行的第三次评估)和 V1(6.00 ± 2.53 vs. 3.83 ± 2.31,p = 0.012)之间,TG 的 NIHSS 评分降低幅度大于 CG。在 V2 和 V1 之间(28.89 ± 15.39 vs. 14.21 ± 19.38,p = 0.016)以及 V3 和 V1 之间(39.41 ± 20.98 vs. 25.00 ± 18.47,p = 0.038),TG 比 CG 的 BI 分数增加得更多。在高炎症参与者中,TG 组血清 IL-12p70 水平在 V2 和 V1 之间的升高幅度大于 CG 组(0.20 ± 0.19 vs. -0.14 ± 0.30,pg/ml,p = 0.006):针灸改善了 AIS 患者的神经功能,针灸改善神经功能与抗炎作用之间的关系有待进一步研究。此外,未来有望开展样本量更大、随访时间更长的研究以及多中心临床试验。
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Acupuncture improves neurological function and anti-inflammatory effect in patients with acute ischemic stroke: A double-blinded randomized controlled trial

Background and purpose

Acupuncture exerts an anti-inflammatory effect and is recommended by the World Health Organization as a complementary therapy for stroke. This study investigated the improvement in neurological function outcome in acute-stage intervention of acute ischemic stroke (AIS), and the anti-inflammatory effect of early acupuncture.

Methods

Fifty patients with AIS were randomly assigned to either a control group (CG, 25 patients, received sham acupuncture) or treatment group (TG, 25 patients, received acupuncture treatment). Acupuncture intervention was administered twice a week for a total of 8 sessions over 4 consecutive weeks. The primary outcome was the changes in the National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), and Barthel Index (BI) scores. The secondary outcome was the changes in serum inflammation-related biomarker levels.(ANAIS trial)

Results

A total of 35 patients (18 patients in the CG and 17 patients in the TG) completed the trial. The reduction in NIHSS scores was greater in the TG than in the CG between V2 (second assessment administered after acupuncture intervention) and V1 (first assessment administered before acupuncture intervention; 4.33 ± 1.91 vs. 2.68 ± 1.42, p = 0.005) and between V3 (third assessment administered 28 days after last acupuncture intervention) and V1 (6.00 ± 2.53 vs. 3.83 ± 2.31, p = 0.012). The increase in BI scores was greater in the TG than in the CG between V2 and V1 (28.89 ± 15.39 vs. 14.21 ± 19.38, p = 0.016) and between V3 and V1 (39.41 ± 20.98 vs. 25.00 ± 18.47, p = 0.038). Among participants with high inflammation, the increase in serum IL-12p70 level between V2 and V1 was greater in the TG than in the CG (0.20 ± 0.19 vs. −0.14 ± 0.30, pg/mL p = 0.006).

Conclusions

Acupuncture improved the neurological function of patients with AIS, and the relationship between acupuncture improving neurological function and anti-inflammatory effect needs further study. In addition, studies with larger sample sizes and longer follow-ups as well as multicenter clinical trials are expected in the future.

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