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Article(id=1322923575098876241, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923490592043032, articleNumber=null, orderNo=null, doi=10.13193/j.issn.1673-7717.2025.05.009, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=null, receivedDateStr=null, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793339159035, onlineDateStr=2026-10-30, pubDate=1746806400000, pubDateStr=2025-05-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793339159035, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793339159035, creator=13701087609, updateTime=1793339159035, updator=13701087609, issue=Issue{id=1322923490592043032, tenantId=1146029695717560320, journalId=1255847919539208197, year='2025', volume='43', issue='5', pageStart='1', pageEnd='258', issueExtLink='null', onlineDate='null', pubDate='1746806400000', pubDateStr='2025-05-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793339138887, creator='13701087609', updateTime=1793340572227, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322929502539612595, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923490592043032, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322929502539612596, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923490592043032, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=40, endPage=43, ext={EN=ArticleExt(id=1322923576931787090, articleId=1322923575098876241, tenantId=1146029695717560320, journalId=1255847919539208197, language=EN, title=Effect of Early Electroacupuncture Therapy on Recovery of Nerve Function after Craniocerebral Injury, columnId=1256183361521967297, journalTitle=Chinese Archives of Traditional Chinese Medicine, columnName=Target on National Project, runingTitle=null, highlight=null, articleAbstract=
Objective

To study the effectof early electroacupuncture therapy on the recovery of nerve function after craniocerebral injury.

Methods

A total of270 patients diagnosed as craniocerebral injury were divided into two groups according to the random number table，135 patients in the control group received conventional Western medicine treatment，and 135 patients in the study group received electroacupuncture treatment based on the control group. The clinical efficacy，lower limb function，neurological function defect and walking ability of the two groupswere observed and compared.

Results

The total effective rate of the study group was 97.78%（132/135），higher than that（73.33%，99/135）of the control group，and the difference was statistically significant（P<0.05）. After treatment，compared with thatof the control group，the TCM syndrome score of the study group was lower，and the difference was statistically significant（P<0.05）. Compared with those of the control group，the National Institute of Health Stroke Scale（NIHSS）score，Fugl-Meyer score，Berg score and Barthel index in the study group were higher，and the differences were statistically significant（P<0.05）. Compared with those of the control group，the levels of VILIP-1，NSE and S100βin the study group were lower，and the difference was statistically significant（P<0.05）.

Conclusion

Electroacupuncture can improve themotor function and nerve function of patients with craniocerebral injury and promote the recovery of patients as soon as possibly，which has high clinical application value.

, authors=Jun LI, Lili YU, Jianguo XIA, Bowen LI, authorsList=Jun LI, Lili YU, Jianguo XIA, Bowen LI, authorCompany=null, correspAuthors=null, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322923578810835289, articleId=1322923575098876241, tenantId=1146029695717560320, journalId=1255847919539208197, language=CN, title=早期电针治疗对颅脑损伤神经功能恢复的影响研究, columnId=1256183362172142382, journalTitle=中华中医药学刊, columnName=国家项目点击, runingTitle=null, highlight=null, articleAbstract=
目的

研究早期电针治疗对颅脑损伤神经功能恢复的影响研究。

方法

270例被确诊为颅脑损伤的患者按随机数字表分为两组，对照组135例采取常规西医治疗，研究组135例在对照组基础上实施电针治疗。观察比较两组患者的临床疗效、下肢功能、神经功能缺损情况以及步行能力。

结果

研究组总有效率为97.78%（132/135），高于对照组的73.33%（99/135），差异有统计学意义（P<0.05）。治疗后，与对照组相比，研究组中医证候积分更低，差异有统计学意义（P<0.05）。与对照组相比，研究组美国国立卫生院卒中量表（National institute of health stroke scale，NIHSS）评分、运动功能评定量表（Fugl-meyer assessment，FMA）评分、Berg平衡量表（Berg balance scale，BBS）评分、日常生活活动能力评定指数（Barthel index，BI）更高，差异有统计学意义（P<0.05）。与对照组相对比，研究组视锥蛋白样蛋白-1（Visininlike protein 1，VILIP-1）、神经元特异性烯醇化酶（Neuron-specific enolase，NSE）、S100β蛋白（S100β）水平更低，差异有统计学意义（P<0.05）。

结论

颅脑损伤患者早期施以电针治疗后，治疗效果显著，可改善患者运动功能、神经功能，促进患者尽快恢复，临床应用价值较高。

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李军（1976-）男，辽宁锦州人，副主任医师，学士，研究方向：神经外科。

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李军（1976-）男，辽宁锦州人，副主任医师，学士，研究方向：神经外科。

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组别例数显效有效无效总有效
对照组13540（29.63）59（43.70）36（26.67）99（73.33）
研究组13570（51.85）62（45.93）3（2.22）132（97.78）
χ2值---32.637 4
P值---0.000 0
), ArticleFig(id=1322923582870921594, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923575098876241, language=CN, label=表1, caption=

两组颅脑损伤患者临床疗效比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数显效有效无效总有效
对照组13540（29.63）59（43.70）36（26.67）99（73.33）
研究组13570（51.85）62（45.93）3（2.22）132（97.78）
χ2值---32.637 4
P值---0.000 0
), ArticleFig(id=1322923582938030459, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923575098876241, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间神昏谵语肢体麻木肢体软瘫头痛呕吐
对照组135治疗前4.25±1.554.14±1.563.23±1.754.67±1.45
治疗后2.23±1.072.54±1.122.41±1.042.87±1.13
t值12.461 39.680 44.680 211.376 8
P值0.000 00.000 00.000 00.000 0
研究组135治疗前4.35±1.424.22±1.993.45±1.674.87±1.51
治疗后1.44±0.411.32±0.871.28±0.211.51±0.67
t值22.876 215.514 314.979 723.632 2
P值0.000 00.000 00.000 00.000 0
治疗前t值0.552 70.367 61.056 71.110 0
治疗前P值0.580 90.713 50.291 60.268 0
治疗后t值8.010 59.995 112.374 712.028 5
治疗后P值0.000 00.000 00.000 00.000 0
), ArticleFig(id=1322923583009333628, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923575098876241, language=CN, label=表2, caption=

两组颅脑损伤患者中医证候积分比较（±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间神昏谵语肢体麻木肢体软瘫头痛呕吐
对照组135治疗前4.25±1.554.14±1.563.23±1.754.67±1.45
治疗后2.23±1.072.54±1.122.41±1.042.87±1.13
t值12.461 39.680 44.680 211.376 8
P值0.000 00.000 00.000 00.000 0
研究组135治疗前4.35±1.424.22±1.993.45±1.674.87±1.51
治疗后1.44±0.411.32±0.871.28±0.211.51±0.67
t值22.876 215.514 314.979 723.632 2
P值0.000 00.000 00.000 00.000 0
治疗前t值0.552 70.367 61.056 71.110 0
治疗前P值0.580 90.713 50.291 60.268 0
治疗后t值8.010 59.995 112.374 712.028 5
治疗后P值0.000 00.000 00.000 00.000 0
), ArticleFig(id=1322923583076442493, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923575098876241, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间MMSEBBSBI 指数
对照组135治疗前17.23±2.4015.23±3.7544.67±5.45
治疗后21.51±3.2932.41±5.6474.87±7.43
t值12.211 429.472 438.080 4
P值0.000 00.000 00.000 0
研究组135治疗前17.27±2.3715.45±3.6744.87±5.51
治疗后25.64±3.5238.28±6.2188.51±8.67
t值22.917 536.773 449.358 9
P值0.000 00.000 00.000 0
治疗前t值0.137 80.487 20.299 8
治疗前P值0.890 50.626 50.764 5
治疗后t值9.959 58.130 213.879 9
治疗后P值0.000 00.000 00.000 0
), ArticleFig(id=1322923583139357054, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923575098876241, language=CN, label=表3, caption=

两组颅脑损伤患者临床情况比较（±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间MMSEBBSBI 指数
对照组135治疗前17.23±2.4015.23±3.7544.67±5.45
治疗后21.51±3.2932.41±5.6474.87±7.43
t值12.211 429.472 438.080 4
P值0.000 00.000 00.000 0
研究组135治疗前17.27±2.3715.45±3.6744.87±5.51
治疗后25.64±3.5238.28±6.2188.51±8.67
t值22.917 536.773 449.358 9
P值0.000 00.000 00.000 0
治疗前t值0.137 80.487 20.299 8
治疗前P值0.890 50.626 50.764 5
治疗后t值9.959 58.130 213.879 9
治疗后P值0.000 00.000 00.000 0
), ArticleFig(id=1322923583219048831, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923575098876241, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间VILIP-1/（pg/mL）NSE/（ng/mL）S100β/（ng/mL）
对照组135治疗前607.23±62.4013.23±1.753.67±0.45
治疗后371.51±30.298.41±1.342.34±0.33
t值39.485 225.408 627.692 3
P值0.000 00.000 00.000 0
研究组135治疗前607.07±60.3713.45±1.673.71±0.51
治疗后320.64±23.525.28±2.211.51±0.20
t值51.366 334.269 446.661 3
P值0.000 00.000 00.000 0
治疗前t值0.021 41.056 70.683 3
治疗前P值0.982 90.291 60.495 0
治疗后t值15.412 414.071 324.991 8
治疗后P值0.000 00.000 00.000 0
), ArticleFig(id=1322923583281963392, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923575098876241, language=CN, label=表4, caption=

两组颅脑损伤患者神经标志物比较（±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间VILIP-1/（pg/mL）NSE/（ng/mL）S100β/（ng/mL）
对照组135治疗前607.23±62.4013.23±1.753.67±0.45
治疗后371.51±30.298.41±1.342.34±0.33
t值39.485 225.408 627.692 3
P值0.000 00.000 00.000 0
研究组135治疗前607.07±60.3713.45±1.673.71±0.51
治疗后320.64±23.525.28±2.211.51±0.20
t值51.366 334.269 446.661 3
P值0.000 00.000 00.000 0
治疗前t值0.021 41.056 70.683 3
治疗前P值0.982 90.291 60.495 0
治疗后t值15.412 414.071 324.991 8
治疗后P值0.000 00.000 00.000 0
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早期电针治疗对颅脑损伤神经功能恢复的影响研究
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李军 , 俞莉莉 , 夏建国 , 李博文
中华中医药学刊 | 国家项目点击 2025,43(5): 40-43
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中华中医药学刊 |国家项目点击 2025 , 43 (5) : 40 -43
早期电针治疗对颅脑损伤神经功能恢复的影响研究
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李军, 俞莉莉, 夏建国, 李博文
作者信息
  • 浙江中医药大学滨江学院附属江南医院，浙江 杭州 310057
作者简介:

李军（1976-）男，辽宁锦州人，副主任医师，学士，研究方向：神经外科。

Effect of Early Electroacupuncture Therapy on Recovery of Nerve Function after Craniocerebral Injury
Jun LI, Lili YU, Jianguo XIA, Bowen LI
Affiliations
  • Jiangnan Hospital Affiliated to Binjiang College of Zhejiang Chinese Medical University，Hanghzou 310057，Zhejiang，China
出版时间: 2025-05-10 doi: 10.13193/j.issn.1673-7717.2025.05.009
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摘要
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目的

研究早期电针治疗对颅脑损伤神经功能恢复的影响研究。

方法

270例被确诊为颅脑损伤的患者按随机数字表分为两组，对照组135例采取常规西医治疗，研究组135例在对照组基础上实施电针治疗。观察比较两组患者的临床疗效、下肢功能、神经功能缺损情况以及步行能力。

结果

研究组总有效率为97.78%（132/135），高于对照组的73.33%（99/135），差异有统计学意义（P<0.05）。治疗后，与对照组相比，研究组中医证候积分更低，差异有统计学意义（P<0.05）。与对照组相比，研究组美国国立卫生院卒中量表（National institute of health stroke scale，NIHSS）评分、运动功能评定量表（Fugl-meyer assessment，FMA）评分、Berg平衡量表（Berg balance scale，BBS）评分、日常生活活动能力评定指数（Barthel index，BI）更高，差异有统计学意义（P<0.05）。与对照组相对比，研究组视锥蛋白样蛋白-1（Visininlike protein 1，VILIP-1）、神经元特异性烯醇化酶（Neuron-specific enolase，NSE）、S100β蛋白（S100β）水平更低，差异有统计学意义（P<0.05）。

结论

颅脑损伤患者早期施以电针治疗后，治疗效果显著，可改善患者运动功能、神经功能，促进患者尽快恢复，临床应用价值较高。

早期  /  电针  /  颅脑损伤  /  神经功能
Objective

To study the effectof early electroacupuncture therapy on the recovery of nerve function after craniocerebral injury.

Methods

A total of270 patients diagnosed as craniocerebral injury were divided into two groups according to the random number table，135 patients in the control group received conventional Western medicine treatment，and 135 patients in the study group received electroacupuncture treatment based on the control group. The clinical efficacy，lower limb function，neurological function defect and walking ability of the two groupswere observed and compared.

Results

The total effective rate of the study group was 97.78%（132/135），higher than that（73.33%，99/135）of the control group，and the difference was statistically significant（P<0.05）. After treatment，compared with thatof the control group，the TCM syndrome score of the study group was lower，and the difference was statistically significant（P<0.05）. Compared with those of the control group，the National Institute of Health Stroke Scale（NIHSS）score，Fugl-Meyer score，Berg score and Barthel index in the study group were higher，and the differences were statistically significant（P<0.05）. Compared with those of the control group，the levels of VILIP-1，NSE and S100βin the study group were lower，and the difference was statistically significant（P<0.05）.

Conclusion

Electroacupuncture can improve themotor function and nerve function of patients with craniocerebral injury and promote the recovery of patients as soon as possibly，which has high clinical application value.

early stage  /  electroacupuncture  /  craniocerebral injury  /  neural function
李军, 俞莉莉, 夏建国, 李博文. 早期电针治疗对颅脑损伤神经功能恢复的影响研究. 中华中医药学刊, 2025 , 43 (5) : 40 -43 . DOI: 10.13193/j.issn.1673-7717.2025.05.009
Jun LI, Lili YU, Jianguo XIA, Bowen LI. Effect of Early Electroacupuncture Therapy on Recovery of Nerve Function after Craniocerebral Injury[J]. Chinese Archives of Traditional Chinese Medicine, 2025 , 43 (5) : 40 -43 . DOI: 10.13193/j.issn.1673-7717.2025.05.009
正文
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颅脑损伤是临床上常见的一种外伤性疾病，主要是由于在外力的作用下导致的脑组织损伤，包括锐器打击、交通事故、灾害等。若颅脑损伤的程度较为严重，大脑皮质的高级活动中枢受损，伴随着疾病的发展而出现不同程度的神经功能损伤，影响患者的运动、言语、感觉功能，降低患者的生活质量[1-2]。从中医的角度上看，颅脑损伤属于“眩晕”“头痛”等范畴[3]。中医认为，脑部是元神之符，颅脑损伤主要是由于外伤导致脑内的血液淤积，经络被阻滞，不通则痛，气机不畅，神明皆蒙。因此，治疗时应以活血化瘀、疏经通络为主。针灸治疗颅脑创伤患者具有独特的治疗效果，尤其是促进患者苏醒，且在发病初期给予电针治疗，可明显改善患者意识及神经功能。电针是基于针刺疗法发展而成的一种现代中医药特色理疗法，通过毫针对人体的经络、穴位进行刺激，产生不同的脉冲电流，从而实现针刺效应[4-5]。基于此，为探讨早期电针治疗颅脑损伤患者的临床效果，选取我院被确诊为颅脑损伤的患者作为研究对象，对比其临床效果。现报道如下。
1　临床资料
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1.1　一般资料
选取2018年10月—2023年9月在浙江中医药大学滨江学院附属江南医院神经外科收入治疗的被确诊为颅脑损伤的270例患者作为研究对象，按随机数字表法分为两组，各135例。研究组男67例，女68例；年龄30～72岁，平均（56.72±10.24）岁；病程20～40 d，平均（30.64±3.13）d；疾病类型：脑挫伤35例，脑内血肿40例，硬膜下血肿40例，硬膜外血肿20例。对照组男65例，女70例；年龄32～71岁，平均（58.45±10.01）岁；病程21～42 d，平均（29.67±3.48）d；疾病类型：脑挫伤40例，脑内血肿43例，硬膜下血肿39例，硬膜外血肿13例。两组比较，差异无统计学意义（P>0.05）。
1.2　诊断标准
①符合《王忠诚神经外科学》[6]中对颅脑损伤的诊断标准；②经CT或MRI被确诊的患者；③发病时间在20～45 d。
1.3　中医辨证标准
符合瘀血阻络证，头痛如针刺，神昏谵语，言语迟缓，肢体软瘫无力，面黯肤青，舌质黯紫或有瘀点，脉弦缓无力。
1.4　纳入标准
①与上述中西医的诊断标准相符；②患者年龄在18岁以上；③患者病情稳定，简易精神状态检查量表（mini-mental state examination，MMSE）评分<24分；④患者家属了解该研究，知情并签署相关文件。
1.5　排除标准
①凝血功能障碍、严重出血倾向的患者；②重度颅脑损伤的患者；③存在电针相关禁忌的患者；④伴有晕针史的患者；⑤由于其余脑血管疾病导致神经功能损伤的患者。
2　治疗方法
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2.1　对照组
予以患者降低颅内压、改善脑血管循环、促进代谢、营养神经等内科对症治疗，并同步予以吞咽、运动、认知等康复治疗。
2.2　研究组
在对照组的基础上加以电针治疗，具体操作如下：患者仰卧位，取穴：头部（百会穴、神庭穴、四神聪），患侧上肢肩髃穴、曲池穴、手三里穴、内关穴、合谷穴，患侧下肢环跳穴、风市穴、足三里穴、阳陵泉穴、三阴交穴。所有穴位进行常规消毒后，使用一次性无菌毫针进行针刺。使用电针治疗仪（恒明经穴HM6805-Ⅱ型针灸仪，四川恒明科技开发有限公司）取穴百会穴、神庭穴一组，患肢肩髃穴和曲池穴一组，风市穴和足三里穴一组，使用连续波，频率2 Hz，以电针针刺点肌肉震颤为宜，不宜过大，调节时需询问患者是否能耐受，以患者能耐受的程度为宜，30 min/次，1次/d。对于肌张力较高的患者，不宜采取强刺激。两组均连续治疗1个月。
3　观察指标与统计学方法
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3.1　观察指标
（1）临床疗效[7]。显著：治疗后患者神经功能、日常生活能力明显改善，但未达到正常水平；有效：治疗后神经功能、日常生活能力较前改善；无效：治疗后神经功能、日常生活能力无改善，甚至痉挛加重。总有效率＝显著率＋有效率。（2）中医证候积分[8]。评定内容包括神昏谵语、肢体麻木、肢体软瘫、头痛呕吐，各项分值为0～6分。分值越高，患者症状越严重。（3）治疗前后临床情况，包括精神症状、平衡功能、日常生活能力。①采用MMSE[9]对患者进行评估，分值0～30分，分值越高，说明精神状态越好。②采用Berg平衡量表（Berg balance scale，BBS）[10]对患者进行评定，总分56分，分值越高，平衡能力越好。③采用日常生活活动能力评定指数（Barthel index，BI）[11]对日常生活能力进行评定，分值越高，日常生活能力越好。（4）神经标志物：治疗前后，抽取患者空腹静脉血，测定视锥蛋白样蛋白-1（Visinin-like Protein 1，VILIP-1）、神经元特异性烯醇化酶（Neuron-specific enolase，NSE）、S100β蛋白（S100β）。
3.2　统计学方法
数据采用SPSS 23.0软件进行统计分析。经SPSS图形工具检验，对符合正态分布的数据，进行组间差异性分析，采用单因素方差分析方法，两组数据间比较则通过事后比较LSD检验方法。同组内数据采用配对样本t检验。分类数据采用卡方（χ2）检验。并设定显著性水平阈值为α＝0.05，以P<0.05表示差异有统计学意义。
4　结果
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4.1　临床疗效
两组均连续治疗1个月后，研究组总有效率为97.78%，比对照组73.33%有效率高，经χ2检验后差异有统计学意义（P<0.05）。详见表1。
4.2　中医证候积分比较
治疗前，两组中医证候积分比较差异无统计学意义（P>0.05）；连续治疗1个月后，与对照组相对比，研究组中医证候积分（神昏谵语、肢体麻木、肢体软瘫、头痛呕吐）更低，差异有统计学意义（P<0.05）。详见表2。
4.3　临床情况比较
治疗前，两组MMSE评分、Berg评分、Barthel指数比较差异无统计学意义（P>0.05）；治疗后，两组临床症状评分指数均明显改善，但与对照组相对比，研究组美国国立卫生院卒中量表（National institute of health stroke scale，NIHSS）评分、运动功能评定量表（Fugl-meyer assessment，FMA）评分、BBS评分、BI指数更高，差异有统计学意义（P<0.05）。详见表3。
4.4　两组神经标志物比较
治疗前，两组VILIP-1、NSE、S100β水平比较差异无统计学意义（P>0.05）；治疗后，两组神经标志物水平均降低，但与对照组相对比，研究组VILIP-1、NSE、S100β水平更低，差异有统计学意义（P<0.05）。详见表4。
5　讨论
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颅脑损伤是临床常见的创伤性疾病，具有较高的发病率和致残率，且严重危及患者的生命安全。颅脑损伤后，会导致患者的神经功能出现损伤，从而导致患者出现意识障碍、运动障碍、感觉障碍、言语障碍等，严重影响患者的日常生活，降低患者的生活质量。目前，临床治疗颅脑损伤多以降低颅内压、颅内血肿清除术、改善脑血管循环、促进代谢等进行治疗，虽然可以通过西医治疗存活下来，但是神经功能的损伤难以通过药物治疗进行改善[12-14]。因此，采取科学、有效的治疗方式改善患者神经功能刻不容缓。
近年来，随着中医治疗的不断发展，采取中医治疗颅脑损伤已逐渐深入临床当中。中医认为颅脑损伤是一种非常复杂的疾病，因为颅脑损伤后，体内的气血运行紊乱，阴阳不能正常沟通，再加上受到外力攻击，血液会溢出血管，或者是血管中的血液淤积在血管里，就会形成瘀血，从而导致大脑的清窍被蒙[15]。因此，治疗时应以活血化瘀、疏经通络、醒脑开窍为主。针灸是中医治疗的传统技术，广泛运用于颅脑损伤的治疗当中。针灸具有疏通经络、调和气血、平衡阴阳的作用[16]。而针刺穴位取气后，通过电针把产生的微小电流，与机体产生类似的生物电，通过毫针对身体进行刺激，从而达到防病治病的目的。头针能够有效地调整大脑皮质运动区，使神经内分泌、血管舒张能力得到恢复，同时还能降低神经组织和内皮细胞VEGF的生成、释放，使大脑的血液流通得到更好的改善，降低了神经损伤的程度，促进了患侧肢体的功能恢复[17]。神庭和百会分别具有宁神、开窍、通阳、调阳等功能，通过电针对腧穴实施强力刺激，能够激发经气、开窍醒脑、疏通气血[18-19]。电针可以提高皮层的兴奋性，激活脑干网，激活下丘脑的下部投射系统，刺激上行的兴奋性中枢，加速损伤后的神经修复，提高脑功能[20]。颅脑损伤患者大多伴有肢体障碍，通过对患者上下肢进行电针治疗，改善患者肢体功能障碍情况，更好地促进患者恢复。肩髃穴除治疗肩颈部疼痛外，对治疗上肢的屈伸不利具有较好疗效，可达到疏通经络的目的[21]。内关属于八脉交会穴，通过针刺后可达到疏通气血、阴阳调和、开窍安神的功效[22]。风市穴可以祛风湿、通经络、止痹痛[23]。足三里穴属于保健穴位，具有补中益气、健脾和胃、理气降逆、通经活血的作用[24]。三阴交可以滋阴补肾、补脑醒神、开窍生髓，进而改善大脑中枢神经系统障碍[25]。电针仪是一种以普通“毫针针刺”为基本原理，通过施加不同强度、频率和振幅的电流，对穴位进行长期的有效刺激，以增强其治疗效果的仪器。通过针刺加以电流，可以有效提高临床效果。且电针介入时间的不同，会影响患者的神经功能恢复。电针介入的时间越早，导致残疾的可能性就越小，患者神经功能恢复就越好[26-27]。但是，在针灸治疗中，有必要避免因过度刺激而引起肌肉痉挛[28]。在本研究中，研究组总有效率更高，中医证候积分更低，NIHSS评分、Fugl-Meyer评分、BBS评分、BI指数更高，差异有统计学意义（P<0.05）。说明采取电针治疗颅脑损伤患者后，临床效果更好，可有效改善患者的一系列临床症状。与对照组相对比，研究组VILIP-1、NSE、S100Β水平更低，差异有统计学意义（P<0.05）。说明采取电针治疗可有效改善患者神经标志物水平。颅脑损伤后相关因子极易被活化，在受损部位及血液中高表达，促进损伤进程[29]。而在颅脑损伤的急性期，脑组织损伤导致血脑屏障受损，脑血流改变，细胞代谢改变，引起血清VILIP-1、S-100β、NSE的增高而进入血液[30-31]。S-100β能够调控神经元的功能，当该水平增高时，会加重损伤神经细胞，导致神经细胞凋亡[32]。NSE存在于大脑灰质细胞质当中，当颅脑损伤时会导致NSE的大量释放，影响神经功能[33]。VILIP-1的增高也会导致生理功能的损伤[34-35]。通过电针治疗刺激以上指标的改善，从而恢复神经功能，考虑电针治疗颅脑损伤促进预后的机制与此相关。
综上所述，颅脑损伤患者通过早期电针治疗后，治疗效果显著，可有效改善患者的一系列临床症状，修复神经功能，促进患者恢复，值得推广。
基金
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  • 国家自然科学基金青年科学基金项目(81904053)
  • 浙江省医药卫生科技计划项目(2020KY797)
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2025年第43卷第5期
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doi: 10.13193/j.issn.1673-7717.2025.05.009
  • 首发时间：2026-10-30
  • 出版时间：2025-05-10
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国家自然科学基金青年科学基金项目(81904053)
浙江省医药卫生科技计划项目(2020KY797)
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    浙江中医药大学滨江学院附属江南医院，浙江 杭州 310057
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2种不同金属材料的力学参数
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Number of
genus		 种数
Number of
species		 占总种数比例
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total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
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species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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