平肝涤痰通络汤联合通脑活络针刺法治疗急性脑梗死及对神经功能的影响  

Effects of Pinggan Ditan Tongluo Decoction Combined with Acupuncture of Unblocking the Brain and Quickening the Collaterals on Acute Cerebral Infarction and Neurological Function

作　　者：夏溪 赵杨 梁艳 王琳 曹丽君[3] 倪卫东[4] Xia Xi;Zhao Yang;Liang Yan;Wang Lin;Cao Lijun;Ni Weidong(Nanjing University of Chinese Medicine,Nanjing 210000,China;The Third Affiliated Hospital of Nanjing University of Chinese Medicine(Nanjing Hospital of Traditional Chinese Medicine),Nanjing 210000,China;The First Affiliated Hospital of Xi′an Jiaotong University,Xi′an 710061,China;Jurong Hospital of Traditional Chinese Medicine,Zhenjiang 212000,China)

机构地区：[1]南京中医药大学,南京210000 [2]南京中医药大学第三附属医院/南京市中医院,南京210000 [3]西安交通大学第一附属医院,西安710061 [4]句容市中医院,镇江212000

出　　处：《世界中医药》2019年第6期1564-1568,共5页World Chinese Medicine

基　　金：南京市重大医学课题项目(ZKX0309)

摘　　要：目的:探讨平肝涤痰通络汤联合通脑活络针刺法治疗急性脑梗死(ACI)及对神经功能的影响。方法:选取2017年2月至2018年6月在南京中医药大学第三附属医院脑科治疗的ACI患者115例作为研究对象,随机分成汤剂组(n=58)和联合组(n=57)。在常规西医治疗的基础上,汤剂组采用平肝涤痰通络汤,联合组采用平肝涤痰通络汤联合通脑活络针刺法。观察和比较2组患者的有效率、神经功能、斑块面积、颈动脉内膜中层厚度(IMT)及内皮功能等指标。结果:治疗后,联合组患者的总有效率为94.83%,汤剂组患者的总有效率为82.46%,组间比较差异有统计学意义(P<0.05);治疗2周和4周后,2组患者的美国国立卫生研究院卒中量表(NIHSS)评分、脑钠肽前体N-末端肽(NT-proBNP)、S-100、斑块面积和IMT大小均低于治疗前(P<0.05),且联合组患者上述指标的改善较针刺组显著,差异有统计学意义(P<0.05);治疗2周和4周后,2组患者的血管内皮素(ET)水平均低于治疗前,一氧化氮(NO)及降钙素基因相关肽(CGRP)水平均高于治疗前(P<0.05),且联合组患者的ET水平显著低于针刺组,而NO和CGRP水平显著高于针刺组,差异有统计学意义(P<0.05)。结论:在常规西医治疗的基础上,平肝涤痰通络汤联合通脑活络针刺法治疗ACI,能有效改善患者神经功能缺损,更好地抑制动脉斑块形成,减少IMT厚度和保护血管内皮功能,更有利于患者预后。Objection:To investigate the effects of Pinggan Ditan Tongluo Decoction combined with acupuncture of unblocking the brain and quickening the collaterals on acute cerebral infarction(ACI)and neurological function. Methods: A total of 115 patients with ACI admitted in the department of brain in our hospital from February 2017 to June 2018 were randomly divided into a decoction group and a combination group,including 58 cases in the decoction group and 57 cases in the combination group.On the basis of conventional western medicine treatment,the decoction group was treated with Pinggan Ditan Tongluo Decoction,and the combination group was treated with Pinggan Ditan Tongluo Decoction combined with acupuncture of unblocking the brain and quickening the collaterals.Indicators like effective rate,neurological function,plaque area,carotid intima-media thickness(IMT)and endothelial function of the 2 groups were observed and compared. Results: After the treatment,the total effective rate was 94.83% in the combination group and 82.46% in the decoction group.The difference between the 2 groups was statistically significant( P <0.05).After 2-week and 4-week treatment,the National Institutes of Health Stroke Scale(NIHSS)score,brain natriuretic peptide precursor N-terminal peptide(NT-proBNP),S-100β,plaque area,and IMT were lower than those before the treatment( P <0.05).The improvement of the above indexes in the combination group was significantly higher than that in the acupuncture group,with statistically significant difference( P <0.05).After 2 and 4 weeks of treatment,the levels of endothelin(ET)in the 2 groups were lower than that before the treatment.The levels of nitric oxide(NO)and calcitonin gene-related peptide(CGRP)were higher than those before the treatment( P <0.05),and the ET level of the combination group was significantly lower than that of the acupuncture group,while the NO and CGRP levels were significantly higher than those of the acupuncture group.The difference was statistically significant( P <0.05). Conc

关 键 词：急性脑梗死 平肝涤痰通络汤 通脑活络针刺法 神经功能 内皮功能 颈动脉内膜中层厚度 

分 类 号：R285.6[医药卫生—中药学] R242[医药卫生—中医学]