摘要
目的通过应用解痉方壮灸神阙穴治疗痰热内阻型抗N-甲基-D-天冬氨酸(NMDA)受体脑炎,观察其疗效及对相关机制进行探讨。方法选取2019年1月1日至2020年6月30日广东三九脑科医院住院明确诊断为抗NMDA受体脑炎患者60例,随机数字表法分为两组,各30例。对照组男10例,女20例,年龄(22.1±9.4)岁;观察组男12例,女18例,年龄(26.8±11.9)岁。对照组采用常规西药治疗,观察组在此基础上添加解痉方壮灸神阙穴疗法,每日1次,共治疗3周。记录两组治疗前及治疗开始后1周、2周、3周、4周不自主运动评定量表(AIMS)、简易精神状态评价量表(MMSE)、日常生活能力评定(ADL)评分。记录治疗中及治疗后与壮灸相关的烫伤、烧伤或其他过敏等不良反应。结果两组患者性别分布、年龄、病程、脑脊液抗体滴度及入组时MMSE、AIMS、ADL评分比较,差异均无统计学意义(均P>0.05)。治疗后2周、3周、4周,观察组MMSE评分分别为(19.8±2.4)分、(20.8±2.3)分、(22.1±1.9)分,均高于对照组(18.3±2.9)分、(19.3±2.0)分、(20.8±2.1)分,差异均有统计学意义(均P<0.05)。两组抗NMDA受体脑炎患者治疗后1周AIMS评分比较,差异有统计学意义(P<0.05)。治疗后2周、4周,观察组ADL评分分别为(58.1±7.9)分、(69.2±9.9)分,均高于对照组(54.0±7.6)分、(62.3±7.7)分,差异均有统计学意义(均P<0.05)。治疗过程中观察组无一例与壮灸相关的烫伤、烧伤或其他过敏等不良反应。结论应用解痉方壮灸神阙穴治疗痰热内阻型抗NMDA受体脑炎疗效确切,值得临床推广应用。
Objective To evaluate the efficacy of Zhuang moxibustion on Shenque acupoint with spasmolysis prescription in the treatment of phlegm-heat and internal resistance type anti-N-methyl-D-aspartate(NMDA)receptor encephalitis and its related mechanism.Methods Sixty patients with anti-NMDA receptor encephalitis in Guangdong 999 Brain Hospital from January 1,2019 to June 30,2020 were included in this study,and were divided into a control group and an observation group with the random number table,30 cases in each group.There were 10 males and 20 females in the control group,with an age of(22.1±9.4)years old.There were 12 males and 18 females in the observation group,with an age of(26.8±11.9)years old.Both groups were given conventional western medicine treatment,and the observation group was given Zhuang moxibustion on Shenque acupoint with spasmolysis prescription on the basis,once daily for 3 weeks.The scores of Abnormal Involuntary Movement Scale(AIMS),Mini-Mental State Examination(MMSE),and Ability of Daily Living(ADL)were recorded before the treatment and 1,2,3,and 4 weeks after the treatment.Adverse reactions related to scald,burn,or other allergies during and after the treatment were recorded.Results There were no statistically significant differences in gender distribution,age,course of disease,cerebrospinal fluid antibody titer,and MMSE,AIMS,and ADL scores between the 2 groups(all P>0.05).The MMSE scores of the observation group 2,3,and 4 weeks after the treatment were(19.8±2.4)points,(20.8±2.3)points,and(22.1±1.9)points,respectively,which were higher than those of the control group[(18.3±2.9)points,(19.3±2.0)points,and(20.8±2.1)points],with statistically significant differences(all P<0.05).There was a statistically significant difference in the AIMS score between the 2 groups 1 week after the treatment(P<0.05).The ADL scores of the observation group 2 and 4 weeks after the treatment were(58.1±7.9)points and(69.2±9.9)points,respectively,which were higher than those of the control group[(54.0±7.6)points and(62.3±7.7)points],with statistically significant differences(both P<0.05).During the treatment,there was no case of scald,burn,or other allergic reactions related to Zhuang moxibustion in the observation group.Conclusion It is safe and effective to treat phlegm-heat and internal resistance type anti-NMDA receptor encephalitis with Zhuang moxibustion on Shenque acupoint with spasmolysis prescription,worthy of further clinical application.
作者
徐炎
胡运新
孙永奇
潘梦秋
刘初容
王玉周
Xu Yan;Hu Yunxin;Sun Yongqi;Pan Mengqiu;Liu Churong;Wang Yuzhou(Department of Neurology,Guangdong 999 Brain Hospital,Guangzhou 510089,China;Rehabilitation Training Centre,Guangdong 999 Brain Hospital,Guangzhou 510089,China;Department of Neurology,The Sixth Affiliated Hospital of Sun Yat-sen University,Guangzhou 510655,China)
出处
《国际医药卫生导报》
2021年第16期2530-2533,共4页
International Medicine and Health Guidance News
基金
广东省中医药局科研项目(20192066)。
关键词
抗N-甲基-D-天冬氨酸受体脑炎
痰热内阻
解痉方
神阙穴
壮灸
Anti-N-methyl-D-aspartate receptor encephalitis
Phlegm-heat and internal resistance
Spasmolysis prescription
Shenque acupoint
Zhuang moxibustion
