补阳还五汤加减对高血压合并脑梗死患者的疗效及血流动力学、炎症因子的影响  

Study on Effect of Buyang Huanwu Decoction Combined with Losartan Tablets on Hemodynamics in Patients with Hypertension Complicated with Cerebral Infarction

作　　者：赵文 王同单 ZHAO Wen;WANG Tongdan(Gastroenterology Department,The Sixth People's Hospital of Zhengzhou,Zhengzhou 450015,Henan,China)

机构地区：[1]郑州市第六人民医院消化内科,河南郑州450015

出　　处：《辽宁中医杂志》2020年第9期86-89,共4页Liaoning Journal of Traditional Chinese Medicine

基　　金：陕西省科学技术研究发展攻关计划基金(2002K10-G1-9)。

摘　　要：目的探讨补阳还五汤加减对高血压合并脑梗死患者的疗效及血流动力学、炎症因子的影响。方法选取本院2016年5月—2018年5月70例高血压合并脑梗死患者,随机分为两组,各35例,基础治疗用药均相同,对照组采用常规治疗;在此基础上,观察组采用补阳还五汤加减治疗,4周为1个疗程,共2个疗程。比较两组患者临床疗效、收缩压(systolic pressure,SBP)、舒张压(diastolic pressure,DBP)、神经功能缺损评分(National Institutes of health neurological deficit score,NIHSS)及大脑中动脉和基底动脉的血流速度(average blood ow rate,VM)、阻力指数(resistance index,RI)、血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)等,记录不良反应。结果对照组有效率77.14%(27/35),低于观察组94.29%(33/35),差异具有统计学意义(P <0.05)。治疗后对照组和观察组SBP为(137.81±13.26) mm Hg,(128.63±11.42) mm Hg,DBP为(84.13±7.86) mm Hg,(77.34±7.35) mm Hg,NIHSS量表为5.98±2.10、4.65±1.74,大脑中动脉VM为(53.17±9.69) cm/s、(62.28±8.74) cm/s,大脑中动脉RI为0.64±0.08、0.57±0.07,基底动脉VM为(38.84±9.67) cm/s、(45.61±8.9) cm/s,RI为0.67±0.09、0.58±0.08,TNF-α(42.91±13.51) ng/m L、(26.50±12.69) ng/m L,IL-6为(11.96±3.81) pg/m L、(9.14±3.54) pg/m L,对照组和观察组上述指标比较,差异具有统计学意义(P <0.05)。观察组出现2例胃部不适,服用为抑制胃酸药后缓解。结论补阳还五汤加减有助于提高高血压合并脑梗死患者的治疗效果,改善脑血流动力学和神经功能,降低血压和炎症因子水平,且患者可耐受,值得推广。Objective To investigate the effect of Buyang Huanwu Decoction combined with Losartan Tablets on hemodynamics in patients with hypertension complicated with cerebral infarction. Methods Seventy patients with hypertension complicated with cerebral infarction in our hospital from May 2016 to May 2018 were randomly divided into two groups,35 cases in each group. The basic treatment drugs were the same. The control group was treated with Losartan Tablets 50 mg orally. The observation group was treated with Losartan Tablets 50 mg orally combined with Buyang Huanwu Decoction. Four weeks was a course of treatment and there werea total of two courses. The clinical efficacy,systolic pressure( SBP),diastolic pressure( DBP),neurological deficit score( NIHSS),blood velocity( Vm) and resistance index( RI) of middle cerebral artery and basilar artery were compared between the two groups. Results The effective rate of the control group( 77. 14%,27/35) was lower than that of the observation group( 94. 29%,33/35)( P < 0. 05). After treatment,the SBP levels of control group and observation group were( 137. 81 ± 13. 26)mm Hg and( 128. 63 ± 11. 42) mm Hg and DBP levels were( 84. 13 ± 7. 86) mm Hg and( 77. 34 ± 7. 35) mm Hg,respectively.NIHSS scales of control group and observation group were( 5. 98 ± 2. 10) points and( 4. 65 ± 1. 74) points,respectively. The middle cerebral artery VM levels of control group and observation group were( 53. 17 ± 9. 69) cm/s and( 62. 28 ± 8. 74) cm/s and RI levels were 0. 67 ± 0. 09 and 0. 58 ± 0. 08,respectively and there were significant differences between the control group and the observation group( P < 0. 05). Two cases of gastric discomfort in the observation group were relieved after taking antacid. Conclusion Buyang Huanwu Decoction combined with Losartan Tablets is helpful to improve the therapeutic effect,cerebral hemodynamics and neurological function,and reduce blood pressure in patients with hypertension complicated with cerebral infarction. It is tolerable and worthy of promotio

关 键 词：补阳还五汤 高血压合并脑梗死 血流动力学 炎症因子 

分 类 号：R743[医药卫生—神经病学与精神病学]