补阳还五汤合牵正散调节同型半胱氨酸的疗效观察  

Influence of byhwt with qzs on homocysteine and the clinical efficacy on patients of “Qi Deficiency and Blood Stasis Syndrome”with acute cerebral infarction

作　　者：黄月芳[1] 楼招欢[2] 陈坚翱[3] 

机构地区：[1]浙江省中医院神经内科,杭州市310006 [2]浙江中医药大学药物研究所,杭州市310053 [3]浙江中医药大学

出　　处：《中华全科医学》2014年第5期812-814,共3页Chinese Journal of General Practice

基　　金：浙江省医药卫生科技计划项目(2011KYA122);浙江省中医药管理局项目(2010ZA037;2013ZA046)

摘　　要：目的观察补阳还五汤合牵正散对气虚血淤证急性脑梗死患者同型半胱氨酸的影响及临床疗效,为揭示急性脑梗死中医"证"的本质规律及特异性客观指标寻找提供依据,为脑梗死患者的病情程度了解、治疗效果和预后的判断提供检测方法,并更好地指导临床实践,提高中医治疗急性脑梗死的疗效。方法选择符合中西医诊断标准及辨证属气虚血淤证的急性脑梗死患者120例,随机分治疗组和对照组各60例,治疗组用补阳还五汤合牵正散加常规西医治疗法,对照组用常规西医疗法,观察时间为3周。比较2组治疗前后的疗效、中医证候积分、同型半胱氨酸含量及血液流变学指标。结果治疗组在临床疗效、调节同型半胱氨酸方面优于对照组(P<0.05,P<0.01)。治疗组显效率53.33%,总有效率85.00%;对照组显效48.30%,总有效率73.30%。治疗组治疗前后血同型半胱氨酸含量分别为(24.60±5.18)μmol/L和(11.20±3.73)μmol/L,对照组治疗前后血同型半胱氨酸含量分别为(23.90±3.43)μmol/L和(16.60±6.51)μmol/L。结论补阳还五汤合牵正散能提高气虚血淤证急性脑梗死的临床治疗效果,降低同型半胱氨酸水平,对急性脑梗死的防治提供了新的方向。Objective To observe the effect of Buyanghuanwu Tang（BYHWT） with Qianzheng San（Qzs） on Homocys-teine in patients of ＂Qi deficiency and blood stasis syndrome＂ with acute cerebral infarction and its clinical efficacy. To reveal the essence rule of Traditional Chinese Medicine（TCM） syndrome for acute cerebral infarction and to provide the basis for the specific objective indexes, to provide the detection method for knowing about the condition, therapeutic effect and evaluating curative effect. Also to guide clinical practice better, and to improve the effectiveness of acute cerebral in- farction with TCM. Methods Selecting 160 patients of acute cerebral infarction belonging to＂Qi deficiency and blood stasis syndrome＂ which diagnosed by TCM and Western medicine,the 160 patients were randomly divided into the treat- ment group and the control group with 80 cases in each. The treatment group were treated with BYHWT with QZS and rou- tine western medicine therapy, while the control group were treated with routine western medicine therapy only, evaluating the curative effect 3 weeks later. Comparing the clinical efficacy, the neural function defect score, the TCM syndrome score,the homocysteine level and the hemodynamic indexes before and after treatment between the two groups. ）. Results The treatment group was better than the control group in the clinical efficacy and in regulating the homocysteine level（ P 〈 0.05 ）. The efficient rate was 53.33 % and the total effective rate was 85.00% in the treatment group ; the effi- cient rate was 48.30% and the total effective rate was 73.30% in the control group. The homocysteine levels of treatment group before and after the therapy were（ 24.60 ± 5.18 ） μmol/L and （ 11.20 ± 3.73 ） μmol/L. While the homocysteine levels of control group before and after the therapy were （23.90 ± 3.43 ） μmol/L and （16.60 ± 6.51 ） μmol/L. Conclu- sion BYHWT with QZS improves the clinical treatment effect of acute cerebral infarction belonging to �

关 键 词：补阳还五汤合牵正散 急性脑梗死 同型半胱氨酸 

分 类 号：R277.7[医药卫生—中医学] R743.33