凉血通瘀方对脑出血实证患者血清神经营养因子和氧化应激的影响  

Effects of Liangxue Tongyu Formula (凉血通瘀方) on Serum Neurotrophic Factors and Oxidative Stress in Cerebral Hemorrhage Patients with Excess Syndrome

作　　者：李建香[1] 丁德经[2] 张兰坤 何小刚[4] 过伟峰[5] 赵杨[1] 王敬卿[1] LI Jianxiang;DING Dejing;ZHANG Lankun;HE Xiaogang;GUO Weifeng;ZHAO Yang;WANG Jingqing(Nanjing Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Traditional Chinese Medicine,Nanjing,210022;Traditional Chinese Medicine Hospital of Suining County,Jiangsu Province;Second Affiliated Hospital of Nanjing University of Traditional Chinese Medicine;Traditional Chinese Medicine Hospital of Kunshan City,Jiangsu Province;Nanjing University of Chinese Medicine)

机构地区：[1]南京中医药大学附属南京中医院,江苏省南京市210022 [2]江苏省睢宁县中医院 [3]南京中医药大学第二附属医院 [4]江苏省昆山市中医医院 [5]南京中医药大学

出　　处：《中医杂志》2020年第15期1330-1333,共4页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(81704017);中央本级重大增减支项目(2060302);南京市卫生科技发展专项资金项目(JQX18006,ZKX15038);南京市卫生青年人才培养工程(QRX17186);南京中医药大学护理学优势学第三期开放课题(2019YSHL093)。

摘　　要：目的观察凉血通瘀方治疗脑出血实证患者的临床疗效,并探讨可能作用机制。方法将85例脑出血患者随机分为对照组42例和治疗组43例,对照组给予西医内科治疗,治疗组在对照组基础上口服或鼻饲凉血通瘀方,每日1剂,疗程均为14天。观察两组治疗前及治疗7、14天后中风病类诊断评分、美国国立卫生研究院卒中量表(NIHSS)评分,检测血清脑源性神经营养因子(BDNF)、神经生长因子(NGF)、超氧化物歧化酶(SOD)和丙二醛(MDA)水平,治疗后评价临床疗效。结果治疗组临床疗效总有效率为93.0%,高于对照组的83.3%(P<0.05)。与本组治疗前比较,治疗组治疗7、14天后中风病类诊断评分和NIHSS评分降低,血清BDNF和SOD水平升高,MDA水平降低(P<0.05或P<0.01);与对照组同时间比较,治疗组治疗14天后中风病类诊断评分和NIHSS评分降低,血清BDNF、NGF和SOD水平升高,MDA水平降低(P<0.01)。结论凉血通瘀方治疗脑出血实证患者可改善症状和体征,促进神经功能恢复,提高临床疗效,其作用机制可能与提高神经营养因子和减轻氧化应激有关。Objective To observe the clinical efficacy of Liangxue Tongyu Formula(凉血通瘀方) in treating cerebral hemorrhage patients with excess syndrome, and to explore the possible mechanism. Methods A total of 85 patients were randomly divided into 42 cases in the control group and 43 cases in the treatment group. The control group was treated with internal medicine of western medicine. The treatment group received oral or nasal feeding Liangxue Tongyu Formula on the basis of the control group, 1 dose per day, all courses for 14 days. The stroke diagnosis score, the National Institutes of Health Stroke Scale(NIHSS) score, serum brain-derived neurotrophic factor(BDNF), nerve growth factor(NGF), superoxide dismutase(SOD) and malondialdehyde(MDA) were observed in both groups before treatment and after 7 and 14 days of treatment. Clinical efficacy was evaluated after treatment. Results The total effective rate of clinical efficacy of the treatment group was 93.0%, which was higher than that in the control group, 83.3%(P<0.05). Compared with those before treatment in this group, after 7 and 14 days of treatment, stroke diagnostic score and NIHSS score decreased, serum BDNF and SOD levels increased, and MDA levels decreased(P<0.05 or P<0.01) in the treatment group;Compared with the same time of the control group, the stroke diagnosis score and NIHSS score decreased, serum BDNF, NGF, and SOD levels increased, and MDA levels decreased after 14 days of treatment in the treatment group(P<0.01). Conclusion Liangxue Tongyu Formula can improve the symptoms and signs, promote the recovery of nerve function and improve the clinical efficacy of cerebral hemorrhage patients with excess syndrome. Its mechanism may be related to the improvement of neurotrophic factors and the reduction of oxidative stress.

关 键 词：凉血通瘀方 脑出血 实证 神经营养因子 氧化应激 超氧化物歧化酶 丙二醛 

分 类 号：R277.7[医药卫生—中医学]