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目的探讨针灸对重度脑外伤急性期患者凝血功能影响及促醒作用的研究。方法选取武汉市协和医院神经外科收治的重度脑外伤急性期患者92例,按随机数字表法分为两组:对照组(n=46),予手术治疗、降低颅内压、纠正低氧血症、营养治疗、高压氧舱等常规治疗;观察组(n=46),在常规治疗的基础上加针灸治疗,每次留针40 min,连续治疗1周。治疗结束后,对比治疗前后患者凝血功能中凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血时间(TT)、纤维蛋白降解产物(PDF)、血浆D-聚体(DD)、血小板(PLT)水平变化;血中内皮素(ET)、一氧化氮(NO)水平变化以及两组患者治疗苏醒时间。结果治疗后两组患者凝血功能均有所改善,且观察组PT、APTT、TT、DD、PLT较对照组改善明显,差异有统计学意义(P<0.05);治疗后两组患者ET、NO水平均改善,且观察组ET、NO较对照组明显下降,差异有统计学意义(P<0.01);治疗后观察组患者平均苏醒时间为(3.56±1.25)d,明显短于对照组的(7.64±1.92)d,差异有统计学意义(P<0.05)。结论针灸能够明显改善重度脑外伤急性期患者凝血功能,降低内皮素和一氧化氮含量,促进患者苏醒,提高临床疗效,值得临床推广。
Objective To investigate the effect of acupuncture and moxibustion on the coagulation function and its awakening effect in patients with acute traumatic brain injury. Methods Ninety-two patients with acute traumatic brain injury were enrolled in Department of Neurosurgery, Union Hospital, Wuhan. The patients were divided into two groups according to the random number table: control group (n = 46). The patients underwent surgery to reduce intracranial pressure and correct hypoxemia The patients in the observation group (n = 46) received acupuncture treatment on the basis of routine treatment for 40 min each time and were treated continuously for 1 week. Thromboplastin time (PT), activated partial thromboplastin time (APTT), clotting time (TT), fibrin degradation product (PDF), plasma D-dimer ), Platelet (PLT) levels; blood levels of endothelin (ET), nitric oxide (NO) levels and treatment recovery time in both groups. Results After treatment, the coagulation function of both groups was improved. The PT, APTT, TT, DD, PLT in the observation group were significantly improved compared with the control group (P <0.05). After treatment, the levels of ET, NO (P <0.01). After treatment, the mean recovery time of the observation group was (3.56 ± 1.25) d, which was significantly shorter than that of the control group (P <0.01) 7.64 ± 1.92) d, the difference was statistically significant (P <0.05). Conclusion Acupuncture can significantly improve the coagulation function, reduce the content of ET and NO in patients with acute traumatic brain injury, promote the patients to wake up and improve the clinical curative effect, which is worthy of clinical promotion.