针刺与康复训练不同干预次序对颅脑损伤患者TNFα、IL1β表达的影响(1)
摘要目的：探究针刺与康复训练不同干预次序对颅脑损伤(TBI)患者肿瘤坏死因子α(TNFα)、白介素1β(IL1β)表达的影响。方法：选取2015年6月至2016年10月我院收治的TBI患者74例，随机分为对照组和实验组，每组37例，对照组采用先针刺后康复训练治疗，实验组采用先康复训练后针刺治疗，比较2组治疗效果，采用FuglMeyer量表(FMA)评价2组患者上、下肢运动功能，检测并分析TNFα、IL1β水平变化。结果：治疗后2组Barthel指数、MMSE评分显著高于治疗前，NIHSS评分显著低于治疗前(P<001)，实验组NIHSS评分显著高于对照组(P<005)，其他评分组间比较，差异无统计学意义(P>005)；治疗后2组上、下肢运动功能FMA评分均显著高于治疗前(P<001)，且实验组高于对照组(P<001)；治疗后2组TNFα、IL1β水平显著低于治疗前(P<001)，2组间比较，差异无统计学意义(P>005)。结论：2种治疗方法均可改善患者的临床症状，降低TNFα、IL1β水平，减少炎性反应因子对脑组织的损伤，改善肢体运动功能，但采取先针刺后康复治疗的顺序，可更快的改善患者的神经功能。
关键词颅脑损伤；针刺；康复训练；肿瘤坏死因子α；白介素1β
AbstractObjective：To observe the effects of different intervention orders of electroacupuncture and rehabilitation on the expression of tumor necrosis factorα (TNFα) and interleukin1β (IL1β) in patients with traumatic brain injury (TBI). Methods：A total of 74 cases of TBI patients(admitted from June 2015 to October 2016 in our hospital) were selected and randomly divided into control group and experimental group， with 37 cases in each. The control group was treated with electroacupuncture and rehabilitation successively， and the experimental group was treated with rehabilitation and electroacupuncture successively. The curative effect and the level of TNFα， IL1β in the two groups were compared using the FuglMeyer scale (FMA). Besides， the upper and lower limb motor function of the two groups were evaluated. Results：After treatment， Barthel index， MMSE scores of two groups were significantly higher， and the NIHSS score was significantly lower (P<001). After treatment， NIHSS score of experimental group was significantly higher than that of the control group (P<005)， but there is no significant difference in other scores of the two groups (P>005). After treatment， upper and lower limb motor function (FMA score) of the two groups were significantly higher (P<001)， and that of the experimental group was higher than that of the control group (P<001). Moreover， levels of TNFα， IL1β in the two groups were significantly lower (P<001)， there is no significant difference between the two groups (P>005). Conclusion：Both treatment can improve the clinical symptoms of TBI patients， reduce the level of TNFα， IL1β， reduce the damage of brain tissue， and improve the function of limb motor. However， TBI patients treated with electroacupuncturerehabilitation order can recover more quickly.
Key WordsTraumatic brain injury； Electroacupuncture； Rehabilitation； Tumor necrosis factorα； Interleukin1β
中圖分类号：R2453文献标识码：Adoi：10.3969/j.issn.1673-7202.2017.04.046, 百拇医药(李眺 曾小香 蒋兆荣)
关键词颅脑损伤；针刺；康复训练；肿瘤坏死因子α；白介素1β
AbstractObjective：To observe the effects of different intervention orders of electroacupuncture and rehabilitation on the expression of tumor necrosis factorα (TNFα) and interleukin1β (IL1β) in patients with traumatic brain injury (TBI). Methods：A total of 74 cases of TBI patients(admitted from June 2015 to October 2016 in our hospital) were selected and randomly divided into control group and experimental group， with 37 cases in each. The control group was treated with electroacupuncture and rehabilitation successively， and the experimental group was treated with rehabilitation and electroacupuncture successively. The curative effect and the level of TNFα， IL1β in the two groups were compared using the FuglMeyer scale (FMA). Besides， the upper and lower limb motor function of the two groups were evaluated. Results：After treatment， Barthel index， MMSE scores of two groups were significantly higher， and the NIHSS score was significantly lower (P<001). After treatment， NIHSS score of experimental group was significantly higher than that of the control group (P<005)， but there is no significant difference in other scores of the two groups (P>005). After treatment， upper and lower limb motor function (FMA score) of the two groups were significantly higher (P<001)， and that of the experimental group was higher than that of the control group (P<001). Moreover， levels of TNFα， IL1β in the two groups were significantly lower (P<001)， there is no significant difference between the two groups (P>005). Conclusion：Both treatment can improve the clinical symptoms of TBI patients， reduce the level of TNFα， IL1β， reduce the damage of brain tissue， and improve the function of limb motor. However， TBI patients treated with electroacupuncturerehabilitation order can recover more quickly.
Key WordsTraumatic brain injury； Electroacupuncture； Rehabilitation； Tumor necrosis factorα； Interleukin1β
中圖分类号：R2453文献标识码：Adoi：10.3969/j.issn.1673-7202.2017.04.046, 百拇医药(李眺 曾小香 蒋兆荣)
参见：首页 > 医疗版 > 疾病专题 > 神经外科 > 颅脑损伤