脑梗通汤联合舒血宁注射液治疗脑梗死恢复期偏瘫44例  

Naogengtong Decoction Combined with Shuxuening Injection in Treatment of 44 Cases with Hemiplegia in Recovery Stage of Cerebral Infarction

作　　者：胡科[1] 张保朝[1] 贾东佩[1] 

机构地区：[1]南阳市中心医院,河南南阳473000

出　　处：《中国实验方剂学杂志》2015年第19期154-157,共4页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：河南省自然科学基金项目(0511041900)

摘　　要：目的:观察脑梗通汤联合舒血宁注射液治疗脑梗死恢复期的临床疗效及对白细胞介素-6(IL-6),白细胞介素-10(IL-10),肿瘤坏死因子-α(TNF-α),基质金属蛋白酶-9(MMP-9)的影响。方法:采用随机按数字表法将88例脑梗死患者分为对照组和观察组各44例。两组均给予常规治疗,对照组采用舒血宁注射液静脉输注,1次/d;观察在对照组基础上内服脑梗通汤;两组疗程均为4周。比较两组治疗前后巴塞尔(Barthel)指数(BI),傅格梅尔氏(Fugl-Meyer)评分(FMMS),残障率、脑卒中量表(CSS)及改良阿什沃思(Ashworth)评分,检测两组治疗前后血清IL-6,IL-10,TNF-α,MMP-9水平。结果:经Ridit分析,观察组临床疗效优于对照组(P<0.05);观察BI,上下肢FMMS评分高于对照(P<0.01);治疗后对照组残障率为25.12%,观察组为15.39%,差异无统计学意义;治疗后观察组CSS评分和改良Ashworth评分均低于对照组(P<0.01);观察组治疗后血清IL-6,IL-10,TNF-α和MMP-9水平均低于对照组(P<0.01)。结论:脑梗通汤联合舒血宁注射液能改善脑梗死恢复期偏瘫患者的日常生活能力,提高肢体运动能力和降低肌张力,改善神经功能缺损,其作用机制可能与其抑制炎症反应及下调基质蛋白酶-9密切相关。Objective： To observe the therapeutic efficacy of Naogengtong decoction combined with Shuxuening injection on hemiplegia in recovery stage of cerebral infarction and its impact on interieukin-6 （IL-6） , interieukin-10 （ IL-10）, tumor necrosis factor （TNF-α） , matrix-metalloproteinase-9 （MMP-9）. Method ： Eighty- eight patients of cerebral infarction were randomly divided into control group and observation group of 44 patients each by random number table. Both groups received conventional treatment. In control group, patients received Shuxuening injection （iv gtt and qd）. The patients in observation group were also treated with Naogengtong decoction （1 dose/d and bid） by oral administration based on the treatment of control group. Course of treatment were 4 weeks for both groups. Barthel Index （ BI）, Fugl-Meyer score （ FMMS）, disability rate, CSS score, and improved Ashworth score were compared between two groups. IL-6, IL-10, TNF-α, and MMP-9 in serum were detected and compared between two groups. Result： The clinical efficacy in observation group was superior to that of control group by ridit analysis （P 〈 0.05）. The BI and FMMS score of upper and lower limbs in the observation group were higher than those of control group （P 〈 0.01 ）. After treatment, the disability rate in control group and observation group was 25.12% and 15.39% respectively, which showed no statistical significance. After treatment, CSS scores and improvement Ashworth scores in observation group were lower than those in control group （P 〈 0.01）. IL-6, IL-10, TNF-α and MMP-9 levels in observation group were lower than those in control group（P 〈 0.01）. Conclusion： Naogengtong decoction combined with Shuxuening injection can improve activity of daily living, FMMS score, muscular tension, and neurologic impairment in patients with hemiplegia in recovery stage of cerebral infarction, and its mechanism may be related with inhibiting the inflammatory response and down- regulating the

关 键 词：脑梗通汤 舒血宁注射液 偏瘫 白细胞介素-6 白细胞介素-10 肿瘤坏死因子-α 基质金属蛋白酶-9 

分 类 号：R287[医药卫生—中药学]