清热解毒通络汤辅助治疗对热毒痰瘀互阻型前循环短暂性脑缺血发作患者预后及血管内皮功能的影响  

Effect of adjuvant therapy with Qingre Jiedu Tongluo decoction on the prognosis and vascular endothelial function of patients with anterior circulation transient ischemic attack of type of heat-toxin,phlegm and blood accumulation

作　　者：翁翔 吴云虎[1] WENG Xiang;WU Yunhu(The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei 237000, Anhui, China)

机构地区：[1]安徽中医药大学第一附属医院,安徽合肥237000

出　　处：《现代中西医结合杂志》2020年第23期2536-2539,2561,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的观察清热解毒通络汤辅助治疗对热毒痰瘀互阻型前循环短暂性脑缺血发作(TIA)患者预后及血管内皮功能的影响。方法将2016年1月—2019年1月安徽中医药大学第一附属医院诊治的92例热毒痰瘀互阻型前循环TIA患者随机分为2组,对照组采用西医常规方案治疗,观察组在对照组治疗基础上给予清热解毒通络汤辅助治疗,连续治疗8周。对比2组主症积分(阵发性偏身麻木、一过性言语謇涩、短暂性偏身瘫软、一过性视岐昏瞀)、内皮功能指标[一氧化氮(NO)、内皮素(ET)、人血栓素B2(TXB2)]、血管内微栓子(MES)阳性率、颈动脉内膜中层厚度(IMT)、预后状况及不良反应发生情况。结果2组治疗后阵发性偏身麻木积分、一过性言语謇涩积分、短暂性偏身瘫软积分、一过性视岐昏瞀积分、TXB2、ET及MES阳性率均明显降低(P均<0.05),且观察组均明显低于对照组(P<0.05);2组治疗后NO水平均明显升高(P均<0.05),且观察组均明显高于对照组(P均<0.05);观察组治疗后IMT较治疗前明显降低(P<0.05),对照组治疗后IMT无明显变化(P>0.05);观察组治疗后复发率为6.5%(3/46),发展为脑梗死率为2.2%(1/46),对照组分别为23.9%(11/46)和15.2%(7/46),观察组均明显低于对照组(P均<0.05);2组治疗过程中均未发生严重药物不良反应。结论清热解毒通络汤辅助治疗热毒痰瘀互阻型前循环TIA,可明显改善患者主要临床症状和血管内皮功能,降低IMT和MES阳性率,改善预后。Objective It is to observe the effect of adjuvant therapy with Qingre Jiedu Tongluo decoction on the prognosis and vascular endothelial function of patients with anterior circulation transient ischemic attack(TIA)of type of heat-toxin,phlegm and blood accumulation.Methods 92 patients with anterior circulation TIA of type of heat-toxin,phlegm and blood accumulation diagnosed and treated in the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine from January 2016 to January 2019 were randomly divided into 2 groups.The control group was treated with conventional western medicine and the observation group were given adjuvant treatment with Qingre Jiedu Tongluo decoction on the basis of the treatment of the control group,both groups were treated for 8 weeks.The scores of main symptoms(paroxysmal hemiplegia,transient speak disability,transient hemiplegia,transient visual dizziness),endothelial function indicators[nitric oxide(NO),endothelin(ET),human thromboxane B2(TXB2)],positive rate of intravascular microemboli(MES),carotid artery intima-media thickness(IMT),prognosis and adverse reactions were compared between the two groups.Results After treatment,the scores of paroxysmal hemiplegia,transient speak disability,transient hemiplegia,transient visual dizziness,TXB2,ET and the positive rate of MES in the two groups were significantly reduced(P<0.05),and the indicators in the observation group were significantly lower than those in the control group(P<0.05);the levels of NO in the two groups were significantly increased(P<0.05),and the level in the observation group was significantly higher than that in the control group(P<0.05);IMT after treatment was significantly lower than that before treatment in the observation group(P<0.05),but there was no significant change in IMT after treatment in the control group(P>0.05);the recurrence rate in the observation group after treatment was 6.5%(3/46),and the rate of developing cerebral infarction was 2.2%(1/46),the control group was 23.9%(11/46)and 15.2

关 键 词：前循环短暂性脑缺血发作 清热解毒汤 热毒痰瘀互阻型 血管内皮功能 

分 类 号：R743.34[医药卫生—神经病学与精神病学]