摘要
目的:探讨醒脑开窍汤联合阿替普酶对急性脑梗死(AIS)患者血清炎症因子与神经功能缺损的影响。方法:选择2018年5月~2020年5月邯郸市第一医院收治的AIS患者122例,根据随机数字表法分成对照组与观察组,各61例。对照组采用阿替普酶治疗,观察组采用醒脑开窍汤联合阿替普酶治疗。比较两组治疗疗效以及治疗前后的中医证候积分。两组均观察2周,分别在治疗前后检测两组血清炎症因子的变化,包括血清白介素-6(IL-6)、白介素-12(IL-12)、白介素-16(IL-16)、肿瘤坏死因子-α(TNF-α)水平,经美国国立卫生研究院卒中量表(NIHSS)、Barthel指数评估两组神经功能缺损改善情况,并比较两组不良反应发生率。结果:观察组(90.16%)总有效率高于对照组(75.41%)(P<0.05)。两组治疗后口舌歪斜、偏瘫、言语蹇涩、神识昏蒙评分及总分低于治疗前,且观察组低于对照组(P<0.05)。两组治疗后血清IL-6、IL-12、IL-16、TNF-α水平及NIHSS评分低于治疗前,Barthel指数评分高于治疗前,且观察组血清IL-6、IL-16、TNF-α水平及NIHSS评分低于对照组,Barthel指数评分高于对照组(P<0.05)。观察组(8.20%)不良反应率与对照组(4.92%)比较无差异(P>0.05)。结论:与单纯阿替普酶治疗相比,醒脑开窍汤联合阿替普酶能更有效缓解AIS患者的中医症状与机体炎症,减轻神经功能缺损症状,从而提高总体疗效,且安全性高。
Objective:To explore the effect of Xingnao Kaiqiao Decoction combined with Alteplase on serum inflammatory factors and neurological deficits for patients with acute cerebral infarction(AIS).Methods:A total of 122 AIS patients admitted to our hospital from May 2018 to May 2020 were included.According to the random number table,they were divided into a western medicine group and a combination group with 61 cases each.The western medicine group was treated with Alteplase,and the combination group was treated with Xingnao Kaiqiao Decoction combined with Alteplase.Both groups were observed for 2 weeks.The efficacy of Chinese medicine and the scores of TCM syndromes before and after treatment were compared between the two groups.The changes of serum inflammatory factors in the two groups were detected before and after treatment,including serum interleukin-6(IL-6),interleukin-12(IL-12),interleukin-16(IL-16),tumor necrosis factor-α(TNF-α)level.The improvement of neurological deficits in the two groups was evaluated by the National Institutes of Health Stroke Scale(NIHSS)and Barthel Index,and the incidence of adverse reactions between the two groups was compared.Results:The total effective rate of the combination group(90.16%)was higher than that of the controlled group(75.41%)(P<0.05).After treatment,the scores of crooked tongue,hemiplegia,slurred speech,faintness,and total score were lower in the two groups than before treatment,and the combined group was lower than the western medicine group(P<0.05).Serum levels of IL-6,IL-12,IL-16,TNF-αand NIHSS scores after treatment in the two groups were lower than before treatment,and Barthel index scores were higher than before treatment,and the serum IL-6,IL-16,TNF-αlevel in the combination group and NIHSS score were lower than the western medicine group,Barthel index score was higher than the western medicine group(P<0.05).There was no difference in the adverse reaction rate between the combined group(8.20%)and the western medicine group(4.92%)(P>0.05).Conclusion:Compared with Alteplase treatment alone,Xingnao Kaiqiao Decoction combined with Alteplase can more effectively relieve the TCM symptoms and body inflammation in patients with AIS,reduce the symptoms of neurological deficits,thereby improving the overall efficacy and high safety.
作者
王廉昌
刘超
刘志军
王英杰
WANG Lianchang;LIU Chao;LIU Zhijun(Department of Three Neurology,the First Hospital of Handan City,Handan Hebei 056002,China;Department of Integrated Traditional and Western Medicine,the First Hospital of Handan City,Handan Hebei 056002,China)
出处
《四川中医》
2022年第3期159-163,共5页
Journal of Sichuan of Traditional Chinese Medicine
基金
邯郸市科学技术研究与发展计划项目(编号:182310-5)
关键词
急性脑梗死
醒脑开窍汤
阿替普酶
炎症因子
神经功能缺损
Acute cerebral infarction
Xingnao Kaiqiao Decoction
Alteplase
Inflammatory factors
Neurological deficit
作者简介
王廉昌,本科,副主任医师,主要从事脑血管病研究,E-mail:luck2014_88@163.com。
