特定模式电针刺激联合 NGF 对缺血性中风的影响:随机对照试验研究方案

IF 2.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Clinics Pub Date : 2024-01-01 DOI:10.1016/j.clinsp.2024.100451
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引用次数: 0

摘要

背景神经生长因子(NGF)的出现促进了神经保护疗法的发展,但由于其血脑屏障(BBB)通透性较差,对脑缺血影响甚微。特定模式电针刺激(SMES)能安全有效地打开 BBB,但其临床效果尚无定论,在恢复期也有间接临床证据。因此,作者开展了一项多中心、随机、安慰剂对照、评估者盲法临床试验,以评估缺血性中风恢复期SMES联合NGF治疗的有效性和安全性。方法:从三家医院共招募288名中风患者,按1:1:1:1的比例随机分配到四组:针灸+安慰剂组、针灸+NGF组、SMES+安慰剂组和SMES+NGF组。将在治疗期间的基线、2 周和 4 周,以及治疗结束后的 4 周和 8 周随访时收集评估数据。主要结果指标为基本治愈率。次要结果指标包括简化的改良巴特尔指数、定时起床和走动测试、Fugl-Meyer 运动功能评估评分、Tinetti 以表现为导向的活动能力评估、蒙特利尔认知评估和 Loewenstein 职业治疗认知评估。此外,静息态功能磁共振成像和功能近红外光谱可检测脑血流和脑功能的变化,并研究临床疗效与处方干预机制之间的关系。
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Effect of Specific mode electroacupuncture stimulation combined with NGF during the ischaemic stroke: Study protocol for a randomized controlled trial

Background

The emergence of the Nerve Growth Factor (NGF) has promoted the development of neuroprotective therapy; however, it has little effect on cerebral ischemia because of its poor Blood-Brain Barrier (BBB) permeability. Specific Mode Electroacupuncture Stimulation (SMES) can open BBB safely and effectively; however, it has shown inconclusive clinical effects and indirect clinical evidence in the recovery phase. Hence, the authors conducted a multicentre, randomized, placebo-controlled, assessor-blinded clinical trial to assess the effectiveness and safety of SMES combined with NGF treatment used during ischaemic stroke recovery.

Methods

A total of 288 stroke patients from three hospitals will be recruited and randomly allocated to four groups: acupuncture + placebo, acupuncture + NGF, SMES + placebo, and SMES + NGF, in a 1:1:1:1 ratio. Assessment data will be collected at baseline, 2-weeks, and 4-weeks during the treatment period, as well as at the 4-week and 8-week follow-up after treatment completion. The primary outcome measure will be the basic cure rate. The secondary outcome measures include the simplified Modified Barthel Index, Timed Up and Go Test, Fugl-Meyer Assessment of Motor Function Score, Tinetti Performance Oriented Mobility Assessment, Montreal Cognitive Assessment, and Loewenstein Occupational Therapy Cognitive Assessment. Moreover, resting-state functional magnetic resonance imaging and Functional near-infrared spectroscopy can detect changes in cerebral blood flow and brain function and investigate the relationship between the clinical efficacy and mechanism of the prescribed interventions.

Conclusion

This study will provide clinical evidence for the efficacy and safety of SMES combined with NGF in the treatment of stroke patients.

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来源期刊
Clinics
Clinics 医学-医学:内科
CiteScore
4.10
自引率
3.70%
发文量
129
审稿时长
52 days
期刊介绍: CLINICS is an electronic journal that publishes peer-reviewed articles in continuous flow, of interest to clinicians and researchers in the medical sciences. CLINICS complies with the policies of funding agencies which request or require deposition of the published articles that they fund into publicly available databases. CLINICS supports the position of the International Committee of Medical Journal Editors (ICMJE) on trial registration.
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