调神醒脑针刺法对脑卒中后认知障碍患者氧化应激及miR-34a、SIRT1的影响

高珺; 边哲; 张赛雪

doi:10.16766/j.cnki.issn.1674-4152.004448

调神醒脑针刺法对脑卒中后认知障碍患者氧化应激及miR-34a、SIRT1的影响

doi: 10.16766/j.cnki.issn.1674-4152.004448

高珺¹,
边哲^2, ,,
张赛雪¹

1.
华北理工大学附属医院康复科，河北唐山 063000
2.
华北理工大学附属医院神经内科

基金项目:

河北省中医药管理局科研项目 2023334

详细信息

通讯作者:
边哲，E-mail：bianzheshow@163.com

中图分类号: R743.3 R749.29
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出版历程
- 收稿日期: 2025-01-08

Effects of Tiaoshen Xingnao acupuncture on oxidative stress, miR-34a and SIRT1 in patients with cognitive impairment after stroke

GAO Jun¹,
BIAN Zhe^{2
, ,},
ZHANG Saixue¹

1.
Rehabilitation Department of North China University of Science and Technology Affiliated Hospital, Tangshan, Hebei 063000, China

摘要

摘要: 目的探究调神醒脑针刺法对脑卒中后认知障碍患者炎症反应、应激反应、认知功能及miR-34a、SIRTI等指标的影响，为临床治疗提供新思路。方法选取2023年3—9月在华北理工大学附属医院治疗的90例脑卒中后认知障碍患者作为研究对象，根据区组随机法按2:1比例随机分为观察组(60例，调神醒脑针刺法+认知功能训练)和对照组(30例，认知功能训练)。比较2组患者炎症反应[白介素-6(IL-6)、C反应蛋白(CRP)]、应激反应[超氧化物歧化酶(SOD)、丙二醛(MDA)]、认知影响(MESSS)及微小核糖核酸-34a(miR-34a)、血清沉默信息调节因子2相关酶1(SIRT1)的变化。结果治疗4周后，观察组MDA [(5.68±0.86) μmol/mL vs. (8.37±1.68) μmol/mL]、MESSS[(14.00±3.00)分vs.(18.00±4.00)分]低于对照组，差异有统计学意义(P < 0.05)，而SOD[(126.35±12.37) U/mL vs.(82.38±10.49) U/mL]高于对照组，差异有统计学意义(P < 0.05)。治疗4周后，观察组IL-6[(148.59±29.67) pg/L vs.(209.59±26.37) pg/L]、CRP[(6.19±1.86) mg/Lvs.(10.68±3.67)mg/L]低于对照组，差异具有统计学意义(P < 0.05)；观察组miR-34a[(1.16±0.19) vs.(1.46±0.16)]、SIRT1[(1.16±0.22) vs.(0.93±0.18)]低于对照组，差异具有统计学意义(P < 0.05)。结论调神醒脑针刺法可改善脑卒中后认知障碍患者的应激反应，减轻炎症反应，降低miR-34a、SIRT1的水平，促进患者认知功能恢复。
- 调神醒脑针刺法 /
- 脑卒中后认知障碍 /
- 氧化应激 /
- 微小核糖核酸-34a /
- 血清沉默信息调节因子2相关酶1
Abstract: Objective This study investigated the effects of Tiaoshen Xingnao acupuncture on patients with post-stroke cognitive impairment by observing and comparing the changes in inflammatory response, stress response, cognitive function, and the expression levels of miR-34a and SIRT1, with the aim of providing new ideas and approaches for clinical treatment. Methods Ninety patients with post-stroke cognitive impairment treated in the Affiliated Hospital of North China University of Science and Technology from March 2023 to September 2023 were enrolled. Using a block randomization method, they were randomly assigned at a 2:1 ratio to an observation group (60 cases, Tiaoshen Xingnao acupuncture + cognitive function training) and a control group (30 cases, cognitive function training) according to the treatment modalities. The inflammatory response indicators (IL-6, CRP), oxidative stress response (SOD, MDA), cognitive effects (MESSS), and effects on miR-34a, SIRT1 were compared between the two groups. Results After 4 weeks of treatment, MDA [(5.68±0.86) μmol/mL vs. (8.37±1.68) μmol/mL] and MESSS [(14.00±3.00) points vs. (18.00±4.00) points] in the observation group were lower than those in the control group, and the differences were statistically significant (P < 0.05), whereas SOD [(126.35±12.37) U/mL vs. (82.38±10.49) U/mL] was higher than that in the control group, with a statistically significant difference (P < 0.05). After 4 weeks of treatment, IL-6 [(148.59±29.67) pg/L vs. (209.59±26.37) pg/L] and CRP [(6.19±1.86) mg/L vs. (10.68±3.67) mg/L] in the observation group were lower than those in the control group, and the difference was statistically significant (P < 0.05). After 4 weeks of treatment, miR-34a [(1.16±0.19)] was lower than that in the control group [(1.46±0.16)], while SIRT1 [(1.16±0.22) vs. (0.93±0.18)] was higher than that in the control group, and the difference was statistically significant (P < 0.05). Conclusion Tiaoshen Xingnao acupuncture can improve oxidative stress responses, reduce inflammatory reactions, decrease the expression of miR-34a and SIRT1, and promote the recovery of cognitive function in patients with cognitive impairment after stroke.
- Tiaoshen Xingnao acupuncture /
- Cognitive impairment after stroke /
- Oxidative stress /
- MicroRNA-34a /
- Silent mating type information regulation 2 homolog-1
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表 1 2组脑卒中后认知障碍患者基线资料比较

Table 1. Comparison of baseline characteristics between two groups of patients with post-stroke cognitive impairment

指标	观察组 (n=60)	对照组 (n=30)	统计量	P值
性别[例(%)]			0.374^a	0.541
女性	22(36.67)	13(43.33)
男性	38(63.33)	17(56.67)
类型[例(%)]			1.628^a	0.202
缺血性	38(63.33)	23(76.67)
出血性	22(36.67)	7(23.33)
饮酒史[例(%)]			0.360^a	0.549
有	32(53.33)	18(60.00)
无	28(46.67)	12(40.00)
糖尿病[例(%)]			<0.001^a	0.999
有	34(56.67)	17(56.67)
无	26(43.33)	13(43.33)
高血压[例(%)]			0.204^a	0.652
有	35(58.33)	16(53.33)
无	25(41.67)	14(46.67)
吸烟史[例(%)]			<0.001^a	0.999
有	26(43.33)	13(43.33)
无	34(56.67)	17(56.67)
文化程度[例(%)]			1.021^c	0.307
初中及以下	15(25.00)	10(33.33)
高中及大专	28(46.67)	14(46.67)
本科及以上	17(28.33)	6(20.00)
高脂血症[例(%)]			0.023^a	0.878
有	37(61.67)	18(60.00)
无	23(38.33)	12(40.00)
BMI(x±s)	23.00±2.00	23.00±3.13	<0.001^b	0.999
病程(x±s，月)	6.00±2.00	6.00±2.00	0.299^b	0.765
年龄(x±s，岁)	55.00±11.00	54.00±10.00	0.419^b	0.676
注：^a为χ²值，^b为t值, ^c为Z值。

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表 2 2组脑卒中后认知障碍患者应激反应及认知情况比较(x ±s)

Table 2. Comparison of stress responses and cognitive status between two groups of patients with post-stroke cognitive impairment (x ±s)

组别	例数	SOD(U/mL)		MDA(μmol/mL)		MESSS(分)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	60	66.27±7.89	126.35±12.37	10.74±1.63	5.68±0.86	23.85±4.92	13.92±2.87
对照组	30	65.35±7.23	82.38±10.49	10.68±1.59	8.37±1.68	24.10±5.86	17.96±3.91
统计量		0.536^a	1.224^b	0.166^a	20.224^b	0.184^a	4.026^b
P值		0.594	<0.001	0.869	<0.001	0.854	<0.001
注：^a为t值，^b为F值。

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表 3 2组脑卒中后认知障碍患者炎症反应指标(x ±s)

Table 3. Inflammatory response indicators in two groups of patients with post-stroke cognitive impairment (x ±s)

组别	例数	IL-6(pg/L)		CRP(mg/L)
组别	例数	治疗前	治疗后	治疗前	治疗后
观察组	60	238.59±29.68	148.59±29.67	15.17±4.69	6.19±1.86
对照组	30	243.68±28.39	209.59±26.37	14.68±4.29	10.68±3.67
统计量		0.778^a	0.093^b	0.480^a	19.570^b
P值		0.439	<0.001	0.623	<0.001
注：^a为t值，^b为F值。

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表 4 2组脑卒中后认知障碍患者miR-34a、SIRT1比较(x ±s)

Table 4. Comparison of miR-34a and SIRT1 between two groups of patients with post-stroke cognitive impairment (x ±s)

组别	例数	miR-34a		SIRT1
组别	例数	治疗前	治疗后	治疗前	治疗后
观察组	60	2.03±0.32	1.16±0.19	0.58±0.14	1.16±0.22
对照组	30	1.98±0.29	1.46±0.16	0.56±0.12	0.93±0.18
统计量		0.727^a	1.779^b	0.702^a	1.997^b
P值		0.469	<0.001	0.484	<0.001
注：^a为t值，^b为F值。

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