基于多模态MRI技术研究针刺早期干预立体定向脑血肿抽吸术后患者的疗效机制

来源:用户上传      作者:王波　王天磊　韩媛媛

　　 〔摘要〕 目的 基于多模B磁共振成像（magnetic resonance imaging， MRI）技术研究针刺早期干预立体定向脑血肿抽吸术后患者的疗效机制。方法 以本院2019年8月至2021年8月治疗的120例脑出血患者作为研究对象，按照随机分组原则分为观察组和对照组，每组60例。两组患者均采取立体定向脑血肿抽吸术进行治疗，观察组患者在此基础上联合采用针刺早期干预治疗，比较两组患者的治疗效果、美国国立卫生研究院卒中量表（national institutes of health stroke scale， NIHSS）评分、神经功能之间的差异。结果 观察组患者的总有效率（88.33%）显著高于对照组（71.67%），差异有统计学意义（P<0.05）。治疗后，两组患者的NIHSS评分较治疗前显著下降（P<0.05），且观察组患者治疗6、8、12周后NIHSS评分均显著低于对照组（P<0.05）。术后6个月，观察组格拉斯哥结局量表（Glasgow outcome scale， GOS）分级显著高于对照组（P<0.05）。治疗后，两组患者的白介素-1β（interleukin 1β， IL-1β）、白介素-6（interleukin 6， IL-6）以及肿瘤坏死因子-α（tumor necrosis factor-α， TNF-α）均较治疗前显著下降（P<0.05），且观察组患者的IL-1β、IL-6及TNF-α显著低于对照组（P<0.05）。治疗后，两组患者的各向异性分数（fraction anisotrophy， FA） 较治疗前显著降低（P<0.05），且观察组患者的FA显著低于对照组（P<0.05）。结论 脑血肿抽吸术后采用基于多模态MRI技术以及针刺早期干预，使患者的神经功能显著恢复，治疗效果显著，值得临床推广。
　　 〔关键词〕 脑血肿;多模态MRI;抽吸术;针刺;神经功能;NIHSS评分;白介素;肿瘤坏死因子
　　 〔中图分类号〕R246 〔文献标志码〕B 〔文章编号〕doi：10.3969/j.issn.1674-070X.2022.07.018
　　Therapeutic mechanism of early acupuncture intervention on patients after stereotactic
　　aspiration of intracerebral hematoma based on multimodal MRI
　　WANG Bo， WANG Tianlei， HAN Yuanyuan
　　（Sanya Hospital of Traditional Chinese Medicine， Sanya， Hainan 572000， China）
　　〔Abstract〕 Objective To study the therapeutic mechanism of early acupuncture intervention on patients after stereotactic aspiration of intracerebral hematoma based on multimodal MRI. Methods A total of 120 patients with intracerebral hemorrhage treated in our hospital from August 2019 to August 2021 were taken as the research objects. According to the principle of random grouping， the above patients were randomly divided into observation group and control group， with 60 cases in each group. The patients in both groups were treated with stereotactic aspiration of intracerebral hematoma. On this basis， the patients in the observation group were combined with acupuncture early intervention treatment. The treatment effect， national institutes of health stroke scale （NIHSS） score and differences in neurological function of the two groups were compared. Results The total effective rate of the observation group （88.33%） was significantly higher than that of the control group （71.67%）， and the difference was statistically significant （P<0.05）. After treatment， the NIHSS score of the two groups was significantly lower than that before treatment （P<0.05）， and the NIHSS score of the observation group was significantly lower than that of the control group after 6， 8 and 12 weeks of treatment （P<0.05）. Six months after operation， the Glasgow outcome scale （GOS） of the observation group was significantly higher than that of the control group （P<0.05）. After treatment， the level of interleukin 1β （IL-1β）， interleukin 6 （IL-6） and tumor necrosis factor-α （TNF-α） in two groups were significantly decreased compared with those before treatment （P<0.05）， and the levels of IL-1β， IL-6 and TNF-α in the observation group was significantly lower than those in control group （P<0.05）. After treatment， the fraction anisotropy （FA） of the two groups was significantly lower than that before treatment （P<0.05）， and the FA of the observation group was significantly lower than that of the control group （P<0.05）. Conclusion After cerebral hematoma aspiration， multimodal MRI technology and early acupuncture intervention can significantly recover the neurological function of patients， and the treatment effect is significant， which is worthy of clinical promotion.

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