芪参还五胶囊配合立体定向引流术治疗出血性中风的疗效及对脑血流动力学、氧化-抗氧化失衡的影响  

Effect of Qishen Huanwu capsule combined with stereotactic drainage on hemorrhagic stroke and its influence on cerebral hemodynamics and oxidation-antioxidation imbalance

作　　者：夏清岫[1] 苗志凯 王立胜[1] 罗艳艳[1] 潘亮[1] 孙宝山[1] 王庆海[1] XIA Qingyi;MIAO Zhikai;WANG Lisheng;LUO Yanyan;PAN Liang;SUN Baoshan;WANG Qinghai(Chuzhou Hospital of Integrated Traditional Chinese and Western Medicine,Zhangzhou 061001,Hebei,China)

机构地区：[1]河北省沧州中西医结合医院,河北沧州061001

出　　处：《现代中西医结合杂志》2019年第7期705-709,723,共6页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的观察芪参还五胶囊配合立体定向引流术治疗出血性中风的疗效及对脑血流动力学、氧化-抗氧化失衡的影响。方法将91例出血性中风患者随机分为观察组(46例)和对照组(45例),对照组给予立体定向引流术治疗,观察组在对照组的基础上给予芪参还五胶囊治疗,疗程均为8周。观察2组中医症状积分、神经功能、影像学和血清学指标改善情况;检测脑血流动力学、氧化-抗氧化失衡恢复情况,并比较2组临床预后。结果治疗后2组中医证候积分均显著降低(P均<0. 05),观察组积分均明显低于对照组(P均<0. 05);治疗后2组NIHSS评分、头颅CT检查指标(颅内血肿量、血肿周围水肿体积、脑中线移位)均有显著改善(P均<0. 05),观察组改善情况均显著优于对照组(P均<0. 05); 2组治疗后大脑中动脉和大脑前动脉收缩期峰值速度(Vs)、舒张期峰值速度(Vd)、平均血流速度(Vm)、血管阻力指数(RI)均显著改善(P均<0. 05),观察组以上指标改善情况均显著优于对照组(P均<0. 05); 2组治疗后血清髓过氧化物酶(MOP)、脂质过氧化物(LPO)、超氧化物歧化酶(SOD)、丙二醛(MAD)均显著改善(P均<0. 05),观察组以上指标改善情况均显著优于对照组(P均<0. 05)。观察组术后6个月随访时的GOS评分、BI评分分级和分值均显著优于对照组(P均<0. 05)。结论芪参还五胶囊配合立体定向引流术能够减轻出血性中风患者神经功能损伤,改善临床预后和日常活动能力,机制可能与其调节脑血流动力学,促进氧化-抗氧化平衡有关。Objective It is to observe the curative effect of Qishen Huanwu capsule combined with stereotactic drainage on hemorrhagic stroke and its influence on cerebral hemodynamics and oxidation-antioxidation imbalance.Methods 91 patients with hemorrhagic stroke were randomly divided into observation group(46 cases)and control group(45 cases).The control group was treated with stereotactic drainage.The observation group was treated with Qishen Huanwu capsule on the basis of the control group.Both courses of treatment were 8 weeks.The improvement of TCM symptom scores,neurological function,imaging and serological indicators in the two groups was observed;the recovery of cerebral hemodynamics and oxidation-antioxidation imbalance was detected,and the clinical prognosis of the two groups was compared.Results The scores of TCM syndromes after treatment were significantly lower than those before treatment in the two groups,and the scores in the observation group were higher than those in the control group(P<0.05).After treatment,NIHSS score,cerebral CT scan indexes(intracranial hematoma volume,edema volume around the hematoma,midline shift),the parameters Vs,Vd,Vm and RI of MCA and ACA in the two groups were significantly improved(P<0.05),the improvements of above indexes of the observation group were better than those of the control group(P<0.05).The serum LOP,MOP,SOD and MAD were significantly improved after treatment in the two groups(P<0.05),the improvements of above indexes of the observation group were better than those of the control group(P<0.05).The GOS score,BI score and classification of the observation group were better than those of the control group at 6 months follow-up(P<0.05).Conclusion Qishen Huanwu capsule combined with stereotactic drainage can alleviate the neurological damage,improve clinical prognosis and daily activity in patients with hemorrhagic stroke,,and its mechanism may be related to its regulation of cerebral hemodynamics and antioxidative-oxidative balance.

关 键 词：芪参还五胶囊 立体定向引流术 出血性中风 脑血流动力学 氧化-抗氧化系统 

分 类 号：R743.3[医药卫生—神经病学与精神病学]