摘要
目的观察天麻钩藤饮联合抗血小板治疗对阴虚风动型缺血性中风患者疗效、血清HCY与CRP的影响。方法将84例缺血性中风患者随机分为两组,均给予常规治疗,对照组(n=42)在其基础上予以双抗血小板治疗,观察组(n=42)在对照组基础上联合天麻钩藤饮治疗。比较两组治疗前、治疗4周后的中医证候积分,评估其临床疗效,并记录其治疗前后神经损伤修复及运动功能[美国国立卫生院神经功能缺损评分(NIHSS)量表、简化Fugl-Meyer运动功能评分法(FMA)、Berg平衡量表(BBS)]、脑血流灌注指标[脑血流量(CBV)、脑血流速度(CBF)]、血清学因子[白细胞介素-6(IL-6)、正五聚蛋白3(PTX-3)、肿瘤坏死因子(TNF-α)、同型半胱氨酸(Hcy)、C-反应蛋白(CRP)]、生活质量[Spitzer生活质量指数(SQLI)]变化。结果治疗4周后,两组主症舌强语謇、肢体麻木、半身不遂及次症眩晕、口干舌燥、手足心热、耳鸣的中医症候积分、NIHSS量表评分、IL-6、PTX-3、TNF-α、Hcy、CRP水平较治疗前存在下降趋势(均P<0.05),而简化FMA量表评分、BSS量表、CBV、CBF水平及SQLI量表(健康感受、精神面貌、支持帮助、心理状态、活动能力)各维度评分及总分较治疗前存在上升趋势(均P<0.05),且观察组变化幅度更大(P<0.05);观察组总有效率为95.24%明显高于对照组80.95%(P<0.05)。结论天麻钩藤饮联合抗血小板可有效改善缺血性中风患者脑血流灌注,促进神经及运动功能的恢复,提高其临床疗效,且还可进一步降低其炎症反应及Hcy水平,从而综合提高其生活质量,于其病情转归有利。
Objective To observe the effects of Tianma Gouteng Decoction(天麻钩藤饮)combined with antiplatelet therapy on efficacy,serum HCY and CRP of patients with ischemic stroke of wind formation from Yin deficiency type.Methods A total of 84 patients with ischemic stroke who were treated in our hospital were randomly divided into two groups.Both groups were given conventional treatment,and control group(n=42)was given double antiplatelet therapy on this basis,and observation group(n=42)was given Tianma Gouteng Decoction on the basis of control group.The scores of TCM syndromes were compared between the two groups before treatment and after 4 weeks of treatment,and the clinical efficacy was evaluated,and the nerve injury repair and motor function[National Institute of Health Stroke Scale(NIHSS),simplified Fugl-Meyer assessment(FMA),Berg balance scale(BBS)],cerebral blood perfusion indexes[cerebral blood volume(CBV),cerebral blood flow velocity(CBF)],serological factors[interleukin-6(IL-6),pentraxins 3(PTX-3),tumor necrosis factor(TNF-α),homocysteine(Hcy),C-reactive protein(CRP)]and quality of life[Spitzer quality of life inventory(SQLI)]were recorded before and after treatment.Results After 4 weeks of treatment,the scores of TCM syndromes of main symptoms of stiff tongue and impeded speech,limb numbness and hemiplegia and secondary symptoms of dizziness,dry mouth,feverishness in palms and soles and tinnitus,NIHSS scale score,and levels of IL-6,PTX-3,TNF-α,Hcy and CRP in the two groups showed decreasing trends compared with those before treatment(all P<0.05),while the simplified FMA scale score,BSS scale,CBV and CBF and scores of dimensions(health feeling,mental outlook,support and help,mental state,activity ability)and total score of SQLI scale showed increasing trends compared with those before treatment(all P<0.05),and the changes were greater in observation group(P<0.05).The total effective rate in observation group was significantly higher than that in control group(95.24%vs 80.95%)(P<0.05).Conclusion Tianma Gouteng Decoction combined with antiplatelet therapy can effectively improve cerebral blood perfusion in patients with ischemic stroke,promote the recovery of neurological function and motor function,improve the clinical efficacy,and can further reduce inflammatory response and Hcy level,and then comprehensively enhance the quality of life and it is beneficial to the disease outcomes.
作者
鲍勇
项尚
朱莎
洪亮
杨言府
BAO Yong;XIANG Shang;ZHU Sha;HONG Liang;YANG Yanfu(Traditional Chinese Hospital of Luan,Luan 237006,Anhui,China)
出处
《辽宁中医药大学学报》
CAS
2021年第8期175-178,共4页
Journal of Liaoning University of Traditional Chinese Medicine
基金
安徽省卫生厅中医药科研计划(2014zy48)
关键词
天麻钩藤饮
抗血小板
缺血性中风
疗效
阴虚风动型
同型半胱氨酸
Tianma Gouteng Decoction(天麻钩藤饮)
antiplatelet
ischemic stroke
efficacy
wind formation from Yin deficiency type
homocysteine
作者简介
鲍勇(1981-),男,安徽肥东人,主治医师,硕士,研究方向:中西医结合脑病专业。
