"通督调神"针法联合眼针对缺血性脑卒中患者肢体运动功能和血清BDNF及BDNF甲基化水平的影响OA
Effects of Tongdu Tiaoshen Needling Combined with Eye Acupuncture on Limb Motor Function,Serum BDNF Level,and BDNF Methylation in Patients with IS
目的:观察"通督调神"针法联合眼针治疗气虚血瘀型缺血性脑卒中(IS)恢复期患者肢体运动功能障碍的临床疗效.方法:随机将50例符合纳入标准的患者分为观察组和对照组,各25例.对照组根据IS相关指南予以药物对症治疗,并行"通督调神"针法针刺治疗,观察组在此基础上联合眼针.记录临床疗效、简易智能精神状态筛查量表(MMSE)、美国国立卫生研究院卒中量表(NIHSS)、Fugl-Meyer运动功能评定量表(FMA)、改良Barthel指数(MBI)评分及相关中医症候评分,采用酶联免疫吸附和亚硫酸氢盐测序法检测患者血清BDNF因子和BDNF甲基化的水平变化.结果:治疗后,观察组总有效率为90.00％(18/20),显著优于对照组的60.00％(12/20),差异具有统计学意义(P＜0.05);两组NIH-SS、FMA、MBI评分以及相关中医症候评分,均较治疗前改善,且观察组显著优于对照组,差异具有统计学意义(P＜0.05);血清BDNF则均较治疗前升高,观察组明显高于对照组,差异具有统计学意义(P＜0.05);BDNF甲基化均较治疗前降低,且观察组明显低于对照组,差异具有统计学意义(P＜0.05);而MMSE评分,两组治疗前后的差异均无统计学意义(P＞0.05).结论:"通督调神"针法联合眼针可显著提高气虚血瘀型IS恢复期患者的临床疗效,改善神经功能缺损和肢体运动功能及相关中医症候,提高生活质量,其作用机制可能与调节BDNF甲基化水平、促进体内BDNF的表达有关,临床值得推广.
Objective:To observe the clinical efficacy of Tongdu Tiaoshen needling combined with eye acupuncture in improving limb motor dysfunction in patients with ischemic stroke(IS)of Qi deficiency and blood stasis during convalescent phase.Methods:50 patients who met the inclusion criteria were randomly divided into the observation group and the control group,with 25 patients in each group.The control group received symptomatic medication according to IS treatment guidelines combined with Tongdu Tiaoshen needling;on which basis,the observation group was also treated with eye acupuncture.Clinical efficacy,scores of Mini-Mental State Examination(MMSE),National Institutes of Health Stroke Scale(NIHSS),Fugl-Meyer Assessment(FMA),Modified Barthel Index(MBI),and relevant TCM symptoms were compared between the two groups.Serum levels of BDNF and BDNF methylation status were measured using enzyme-linked immunosorbent assay(ELISA)and bisulfite sequencing.Results:The total effective rate was 90.00％(18/20)in the observation group,which was significantly higher than 60.00％(12/20)in the control group(P＜0.05).The scores of NIHSS,FMA,MBI,and related TCM symptoms improved significantly after the treatment compared with before the treatment in both groups,and the improvements were more significant in the observation group(P＜0.05).The serum level of BDNF increased significantly after the treatment in both groups,with the observation group showing a higher level than the control group(P＜0.05).BDNF methylation level decreased after the treatment in both groups,with the observation group showing a significantly lower level than the control group(P＜0.05).There were no statistical differences in MMSE scores between the two groups both before and after the treatment(P＞0.05).Conclusion:The combination of Tongdu Tiaoshen needling and eye acupuncture can significantly enhance clinical efficacy in patients with IS of Qi deficiency and blood stasis during convalescent phase.It effectively improves neurological deficits,limb motor function,and related TCM symptoms,thereby enhancing patients' quality of life.The underlying mechanism may be related to the regulation of BDNF methylation level and the promotion of BDNF expression.
浦延鹏;储浩然;王震;张静波;胡徽星;梁发俊;章显宝;尹苗苗;郑之俊
安徽中医药大学第二附属医院,安徽 合肥 230061安徽中医药大学第二附属医院,安徽 合肥 230061安徽中医药大学第二附属医院,安徽 合肥 230061安徽中医药大学第二附属医院,安徽 合肥 230061安徽中医药大学第二附属医院,安徽 合肥 230061安徽中医药大学第二附属医院,安徽 合肥 230061安徽中医药大学第二附属医院,安徽 合肥 230061安徽中医药大学第二附属医院,安徽 合肥 230061安徽中医药大学第二附属医院,安徽 合肥 230061
医药卫生
缺血性脑卒中肢体运动功能障碍通督调神针法眼针脑源性神经营养因子
Ischemic strokeLimb motor dysfunctionTongdu Tiaoshen needlingEye acupunctureBDNF
《针灸临床杂志》 2026 (2)
16-21,6
国家自然科学基金面上项目,编号:81774399储浩然全国名老中医药专家传承工作室项目,编号:国中医药人教函[2022]75号安徽省中医药领军人才项目,编号:中医药发展秘[2018]23号安徽省自然科学基金青年项目,编号:2308085QH293安徽省教育厅重点项目,编号:2023AH050829安徽省中医药管理局中医药传承创新科研项目,编号:2024CCCX118、2024CCCX116安徽中医药大学国家中医药管理局中医基础理论高水平重点学科开放课题,编号:ZYJCLLYB-03长三角名医工作室,编号:皖中医药发展秘[2023]16号.
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