化瘀通腑开窍方对急性脑梗死患者血清同型半胱氨酸的影响及疗效观察  

The clinical observation and effect of HuaYu TongFu KaiQiaoFang on serum homocysteine in patients with acute cerebral infarction

作　　者：李兰[1] 陈立[1] 韩悦[2] 吕波[3] 张龙海 

机构地区：[1]贵州省中医院贵阳中医学院第一附属医院重症医学科,贵州贵阳550001 [2]贵州省中医院贵阳中医学院第一附属医院产科,贵州贵阳550001 [3]贵阳中医学院,贵州贵阳550002 [4]南京中西医结合医院急诊科,江苏南京220000

出　　处：《中国中西医结合急救杂志》2013年第4期220-222,共3页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：贵州省贵阳市科技计划项目

摘　　要：目的探讨化瘀通腑开窍方对急性脑梗死患者血清同型半胱氨酸（Hcy）的影响及临床疗效。方法选择2010年12月至2012年1月贵阳中医学院第一附属医院综合病房及重症监护病房（ICU）收治的急性脑梗死患者60例，按随机原则分为两组，每组30例。对照组仅给予常规治疗；治疗组在常规治疗基础上给予化瘀通腑开窍方（红花10 g，赤芍10 g，川芎10 g，三七10 g，归尾10 g，石菖蒲10 g，远志10 g，芒硝5 g，大黄6 g），每日1剂，口服或鼻饲，连用14 d。治疗前后采用酶联免疫吸附试验（ELISA）检测两组患者血清Hcy水平，并观察两组临床疗效。采用Pearson或Spearman相关分析法分析神经功能缺损程度评分（NDS）与Hcy水平的相关性。结果两组治疗前血清Hcy（μmol/L）、NDS（分）比较差异均无统计学意义（均P＞0.05），治疗后均较治疗前明显下降（P＜0.05或P＜0.01），且治疗组下降程度较对照组更为明显（Hcy：7.78±2.51比10.18±2.41，NDS：10.60±2.25比14.60±3.70，均P＜0.05）。治疗后治疗组总有效率显著高于对照组（90.0%比76.7%，P＜0.05）；治疗前患者NDS与Hcy水平呈显著正相关（r＝0.675，P＜0.05）。结论化瘀通腑开窍法能显著降低血清Hcy水平，改善神经功能，临床疗效显著。Objective To observe the clinical effect of HuaYu TongFu KaiQiaoFang on serum homocysteine （Hcy）in patients with acute cerebral infarction. Methods Sixty cases of acute cerebral infarction admitted into the comprehensive ward and intensive care unit（ICU）of the First Affiliated Hospital of Guiyang College of Traditional Chinese Medicine from December 2010 to January 2012 were randomly divided into two groups,each group including 30 cases. The control group was given conventional treatment,and based on the conventional therapy,the treatment group was additionally given HuaYu TongFu KaiQiaoFang（a traditional Chinese medicine decoction including the following ingredients：Safflower 10 g,Chishao 10 g,Chuanxiong 10 g,Notoginseng 10 g,Angelica Sinensis 10 g, Shichangpu 10 g,Polygalae 10 g,Glauber＇s salt 5 g,Rhubarb 6 g）,one dose a day by oral or nasal administration for consecutive 14 days. Before and after treatment in the two groups,the serum Hcy level was detected by enzyme-linked immunosorbent assay（ELISA）,and the clinical efficacy was assessed by Pearson or Spearman correlation analysis to observe the correlation between neurological deficit score（NDS）and Hcy levels. Results Before treatment, the difference of serum Hcy（μmol/L）and NDS levels between the two groups was not statistically significant（both P〉0.05）,while after treatment,the levels in the two groups were significantly decreased in comparison with those before treatment（P〈0.05 or P〈0.01）,and the degree of descent in treatment group was more obvious compared with that in control group（Hcy：7.78±2.51 vs. 10.18±2.41,NDS：10.60±2.25 vs. 14.60±3.70,both P〈0.05）. After treatment,the total effective rate in the treatment group was significantly higher than that in the control group （90.0%vs. 76.7%,P〈0.05）. Before treatment,the NDS was positively correlated with Hcy（r=0.675,P〈0.05）. Conclusion HuaYu TongFu KaiQiaoFang can significantly reduce the level of serum Hcy and improve the nerve function,th

关 键 词：急性脑梗死 化瘀通腑开窍方 同型半胱氨酸 中西医结合疗法 

分 类 号：R714.246[医药卫生—妇产科学]