痰瘀阻络方联合丁苯酞治疗脑梗死急性期疗效及对患者脑血流灌注及血清6-k-PGF1a、Hcy、sICAM-1水平影响  

Effect of phlegm stasis blocking collateral combined with butylphthalide on cerebral blood flow perfusion and serum 6-k-PGFla,Hcy and sICAM-1 level in patients with acute cerebral infarction

作　　者：赵月臣 马兰 ZHAO Yuechen;MA Lan(Department of Neurology,Chaoyang Second Hospital,Chaoyang 122000)

机构地区：[1]辽宁省朝阳市第二医院神经内科,朝阳122000 [2]辽宁省中医院神经内科,沈阳112099

出　　处：《陕西中医》2020年第2期175-179,共5页Shaanxi Journal of Traditional Chinese Medicine

基　　金：辽宁省科学技术计划项目(2016021075)

摘　　要：目的:研究痰瘀阻络方联合丁苯酞治疗脑梗死急性期患者对脑血流灌注及血清6-醛前列环素F1a(6-k-pGF1a)、同型半胱氨酸(HCY)、可溶性细胞间黏附分子(sICAM-1)水平影响。方法:选择脑梗死急性期患者92例,随机分为观察组和对照组各46例。入组患者均给予常规治疗,对照组同时口服丁苯酞,观察组在对照组基础上给予痰瘀阻络方,两组均治疗28d。观察治疗后临床疗效,对比治疗前后脑血流动力指标(双侧脑动脉峰流速及平均流速)、血流灌注指数(PI)、脑血管储备能力(CVR),统计血清6-k-PGF1a、Hcy、sICAM-1水平,记录美国国立卫生研究院卒中量表(NIHSS)、改良Rankin量表、Barthel指数评分量表评分情况,统计药物不良反应发生情况。结果:观察组治疗后临床总有效率为89.13%,高于对照组71.74%(P<0.05)。观察组治疗后PI、CVR、双侧动脉各流速改善情况均优于对照组(P<0.05);观察组治疗后血清6-k-pGF1a、HCY、sICAM-1水平改善情况均优于对照组(P<0.05);观察组治疗后NIHSS量表、改良Rankin量表、Barthel指数评分改善情况均优于对照组(P<0.05);两组患者治疗期间其他检查结果均正常,轻微不良反应发生率相当(P>0.05)。结论:痰瘀阻络方联合丁苯酞对脑梗死急性期治疗效果较好,其能明显改善患者脑血流灌注情况,同时对血清6-k-PGF1a、Hcy、sICAM-1指标具有较好改善作用,有助于患者神经功能的提高。Objective:To study the effect of phlegm stasis blocking collateral combined with butylphthalide on cerebral blood flow perfusion and serum 6-k-PGFla,Hcy and sICAM-1 level in patients with acute cerebral infraction.Methods:Selected 92 patients with acute cerebral infarction,and divided them into the observation group(46 patients)and the control group(46 patients).All patients received routine treatment,meanwhile,the control group received butylphthalide,and the observation group received phlegm stasis blocking collateral besides butylphthalide,which lasted 28 days for both groups.Observed the clinical curative effect after treatment,compared the blood flow dynamic index(bilateral cerebral artery peak flow rate and mean flow rate),PI and CVR,made statistics on the levels of 6-k-PGF1 a,Hcy and slCAM-1,recorded the scores of NIHSS,modified Rankin scale,Barthel scale,and collected the occurrence of adverse drug reactions.Results:The total effective rate in the observation group after treatment ws89.13%,which was higher than that in the control group(71.74%,P<0.05).After treatment,PI,CVR and velocity of bilateral arteries in the observation group were better than those in the control group(P<0.05);the levels of 6-kpGF1 a,HCY and sICAM-1 in the observation group were better than those in the control group(P<0.05);the scores of NIHSS,modified Rankin and Barthel in the observation group were better than those in the control group(P<0.05);the other examination results were normal during the treatment period and the incidence of minor adverse reactions was comparable(P >0.05).Conclusions:Phlegm stasis blocking collateral combined with butylphthalide is effective in the treatment of acute cerebral infarction.It can significantly improve the cerebral blood flow perfusion of patients with cerebral infarction,meanwhile,it can improve the indexes of 6-k-PGF1 a,Hcy,sICAM-1,and can help to improve the neurological function of patients.

关 键 词：脑梗死 急性期 痰瘀阻络方 丁苯酞 脑血流灌注 6-酮-前列腺素F1α 同型半胱氨酸 细胞间黏附因子 

分 类 号：R743.3[医药卫生—神经病学与精神病学]