益气化瘀经验汤剂联合血塞通粉针治疗气虚血瘀证缺血性脑卒中患者的临床研究  

Clinical Research on Influence of Neurologic Improvement,MMP-9,SOD and MDA Levels for Treating Qi Deficiency and Blood Stasis Syndrome Ischemic Stroke Patients with Yiqihuayu Decoction and Sanqi Panax Notoginseng Injection

作　　者：孙彩丽[1] 张璐璐[1] 杨旭[1] 张艳[1] 张红涛[1] 

机构地区：[1]青岛市市立医院,青岛266011

出　　处：《世界中医药》2016年第9期1714-1717,共4页World Chinese Medicine

基　　金：山东省中医药科技发展计划(编号:2013-212)

摘　　要：目的:观察益气化瘀经验汤剂联合血塞通粉针治疗气虚血瘀证缺血性脑卒中患者的临床疗效,并探讨其对患者神经功能改善、基质金属蛋白酶-9(MMP-9)、血清超氧化物歧化酶(SOD)、丙二醛(MDA)水平的影响。方法:选取就诊于我院的气虚血瘀证缺血性脑卒中患者116例,按照随机数字表法分为对照组和观察组各58例。对照组患者给予依达拉奉注射液静脉滴注;观察组患者则给予益气化瘀经验汤剂内服联合血塞通粉针治疗,2组均连续用药4周。评价2组治疗的临床效果,采用神经功能评分量表(NIHSS)评价神经功能缺损程度,监测治疗前后患者血液流变改善情况,检测血清MMP-9、SOD、MDA水平的变化。结果:观察组的有效率91.3%高于对照组的75.9%(P<0.05);观察组患者经治疗后的神经功能改善优于对照组,其NIHSS与对照组相比显著降低(P<0.05);观察组患者的脑血管微循环改善优于对照组,其血液流变学各指标显著低于对照组患者(P<0.05);观察组患者经治疗后MMP-9、MDA水平显著下降,而SOD水平则显著升高,变化程度较对照组更为明显(P<0.05)。结论:益气化瘀经验汤剂联合血塞通粉针治疗气虚血瘀证缺血性脑卒中患者疗效肯定,其能显著提高患者的神经功能,改善脑血管微循环,其机制与药物的协同作用可调控MMP-9、SOD、MDA等因子水平有一定相关性。Objective： To investigate the clinical efficacy in the treatment of qi deficiency and blood stasis syndrome ischemic stroke patients with Qi-Tonifying and Stasis-Removing Decoction and sanqi panax notoginseng for injection,and explore the influence of neurologic improvement,MMP-9,SOD and MDA levels. Methods： A total of 116 patients were randomly divided into control group with 58 cases and observation group with 58 cases. Patients in the control group were treated with edaravone injection for intravenous drip,while patients in the observation group were treated with Qi-Tonifying and Stasis-Removing Decoction and sanqi panax notoginseng for injection,the treatment lasted for 4 weeks. The clinical effect,the patients＇ degree of nerve function defect,the change of hemorheology,MMP-9,SOD and MDA levels were detected. Results： The effective rate of patients in the observation group was 91. 3%,which was higher than that of the control group 75. 9%（ P〈0. 05）; The improvement of nerve function for the patients in the observation group was better than that of the control group after treatment,and the NIHSS scores were lower than that of the control group（ P〈0. 05）; The improvement of cerebral microcirculation for the patients in the observation group was better than that of the control group after treatment,and the blood rheology indicators were lower than that of the control group（ P〈0. 05）; The MMP-9 and MDA levels of the observation group were lower than the control group after treatment,while the SOD activity was higher than that of the control group（ P〈0. 05）. Conclusion： The therapy has good effect,for its improvement in patients＇ nerve function and cerebral microcirculation. The mechanism may be associated with regulating the levels of MMP-9,SOD and MDA.

关 键 词：缺血性脑卒中 气虚血瘀证 益气化瘀经验汤剂 血塞通粉针 神经功能 MMP-9 SOD MDA 

分 类 号：R242[医药卫生—中医临床基础] R256[医药卫生—中医学]