半夏白术天麻汤治疗缺血性脑卒中急性期患者的临床疗效及其对凝血功能、脑血流动力学的影响  

Clinical Effect of Banxia Baizhu Tianma Decoction on Acute Ischemic Stroke and the Impact on Coagulation Function and Cerebral Hemodynamics

作　　者：赵心想 苑海霞 宋彩霞[2] 利娜[3] 安英娜 单雪飞[4] 闫薪廷 陈国杰[2] 康克楠 ZHAO Xinxiang;YUAN Haixia;SONG Caixia;LI Na;AN Yingna;SHAN Xuefei;YAN Xinting;CHEN Guojie;KANG Kenan(The People's Hospital of Raoyang County,Hengshui 053900,China;The People's Hospital of Xingtang,Shijiazhuang 050600,China3.The Traditional Chinese Medicine Hospital of Shijiazhuang,Shijiazhuang 050000,China;The Second People's Hospital of Fengrun District,Tangshan,Tangshan 064000,China;Emergency Center of Shijiazhuang,Shijiazhuang 050000,China)

机构地区：[1]河北省衡水市饶阳县人民医院,053900 [2]河北省石家庄市行唐县人民医院,050600 [3]河北省石家庄市中医院,050000 [4]河北省唐山市丰润区第二人民医院,064000 [5]河北省石家庄市急救中心,050000

出　　处：《实用心脑肺血管病杂志》2019年第4期59-63,共5页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：河北省中医药管理局科研计划项目(2019352).

摘　　要：目的分析半夏白术天麻汤治疗缺血性脑卒中急性期患者的临床疗效及其对凝血功能、脑血流动力学的影响。方法选取2016年1月-2019年1月衡水市饶阳县人民医院收治的缺血性脑卒中急性期患者156例,采用随机数字表法分为对照组和观察组,每组78例。对照组患者采取西医常规治疗,观察组患者在对照组治疗基础上采用半夏白术天麻汤治疗;两组患者均连续治疗14 d。比较两组患者临床疗效,治疗前后凝血功能指标[包括活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)及纤维蛋白原(FIB)]、患侧大脑中动脉(MCA)血流动力学指标[包括峰流速(Vp)、平均流速(Vm)、峰流速对称性差值(DVp)及平均流速对称性差值(DVm)]、美国国立卫生研究院卒中量表(NIHSS)评分、改良Barthel指数(mBI)评分;并观察两组患者治疗期间不良反应发生情况。结果(1)治疗期间,对照组和观察组各有2例患者退出研究。观察组患者临床疗效优于对照组(P<0.05)。(2)两组患者治疗前APTT、PT、TT、FIB比较,差异无统计学意义(P>0.05);观察组患者治疗后APTT长于对照组,PT、TT短于对照组,FIB低于对照组(P<0.05)。(3)两组患者治疗前患侧MCA的Vp、Vm、DVp、DVm比较,差异无统计学意义(P>0.05);观察组患者治疗后患侧MCA的Vp、Vm快于对照组,DVp、DVm小于对照组(P<0.05)。(4)两组患者治疗前NIHSS评分、m BI评分比较,差异无统计学意义(P>0.05);观察组患者治疗后NIHSS评分低于对照组,mBI评分高于对照组(P<0.05)。(5)两组患者治疗期间均未发生明显不良反应。结论半夏白术天麻汤治疗缺血性脑卒中急性期患者的临床疗效确切,能有效改善患者凝血功能及患侧脑血流动力学,减轻患者神经功能缺损程度,提高患者日常活动能力,且安全性较高。Objective To analyze the clinical effect of Banxia Baizhu Tianma decoction on acute ischemic stroke and the impact on coagulation function and cerebral hemodynamics. Methods From January 2016 to January 2019,a total of 156 patients with acute ischemic stroke were selected as subjects in the People’s Hospital of Raoyang County,Hengshui,and they were divided into control group and observation group according to random number table method,each with 78 cases. Patientsin control group were treated with routine Western medicine,while patients in observation group were treated with Banxia Baizhu Tianma decoction based on that of control group;both groups continuously treated for 14 days. Clinical effect,index of coagulation function(including APTT,PT,TT and FIB),hemodynamic index of MCA in affected side[including peak flow velocity(Vp),mean flow velocity(Vm),symmetry difference of peak flow velocity(DVp)and symmetry difference of mean flow velocity(DVm)],NIHSS score and modified Barthel Index(mBI)score before and after the treatment were compared between the two groups,and incidence of adverse reactions during treatment was observed. Results(1)During the treatment,2 cases in control group and 2 cases in observation group dropped out of this study. Clinical effect in observation group was statistically significantly better than that in control group(P<0.05).(2)There was no statistically significant difference in APTT,PT,TT or FIB between the two groups before treatment(P>0.05);after treatment,APTT in observation group was statistically significantly longer than that in control group,PT and TT in observation group were statistically significantly shorter than those in control group,while FIB in observation group was statistically significant lower than that in control group(P<0.05).(3)There was no statistically significant difference in Vp,Vm,DVp or DVm of MCA in affected side was found between the two groups before treatment(P>0.05);after treatment,Vp and Vm of MCA in affected side in observation group were statistical

关 键 词：卒中 半夏白术天麻汤 治疗结果 凝血功能 脑血流动力学 

分 类 号：R743[医药卫生—神经病学与精神病学]