补阳还五汤合四君子汤加减治疗中风后疲劳气虚血瘀证和抗氧化及抗炎的作用  

Addition and Subtraction Therapy of Buyang Huanwutang Combined with Si Junzitang to Poststroke Fatigue and Antioxidant and Anti-inflammatory with Syndrome of Qi Deficiency and Blood Stasis

作　　者：王燕珍 王维峰[2] 安玉兰[2] 赵慧芳 张鹏 张在伟 张俊卿 WANG Yan-zhen;WANG Wei-feng;AN Yu-lan;ZHAO Hui-fang;ZHANG PENG;ZHANG Zai-wei;ZHANG Jun-qin(Xinzhou Vocational and Technical College,Xinzhou 034007,China;Third Hospital of Shanxi Medical College,Taiyuan 034006,China;Shanxi Xinzhou Traditional Chinese Medicine Hospital,Xinzhou 034007,China;Affiliated Hospital of Medical College of Datong University,Yuanping 034100,China)

机构地区：[1]忻州职业技术学院,山西忻州034007 [2]山西中医学院第三中医院,太原034006 [3]山西省忻州市中医医院,山西忻州034007 [4]大同大学医学院附属医院,山西原平034100

出　　处：《中国实验方剂学杂志》2020年第23期131-136,共6页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：山西省中医药管理局科研项目(2016ZYYZ15)。

摘　　要：目的:评价补阳还五汤合四君子汤加减联合针刺治疗中风后疲劳(PSF)气虚血瘀证及抗氧化和抗炎作用。方法:将144例患者根据随机数字表法,按1∶1分为对照组和观察组各72例。试验期间对照组脱落/失访和剔除病例分别有4例和2例,最终完成66例;观察组脱落/失访和剔除病例分别有2例和3例,最终完成67例。对照组采用针刺治疗,每日1次,6次/周;和口服葛芪通脉颗粒,10 g/次,3次/d;观察组针刺同对照组,并内服补阳还五汤合四君子汤加减,1剂/d。两组疗程均为连续治疗4周。进行治疗前后疲劳严重度量表(FSS),脑卒中专用生活质量量表(SS-QOL),气虚血瘀证,神经功能缺损(NIHSS)和日常生活能力(ADL)评分;检测治疗前后超氧化物歧化酶(SOD),同型半胱氨酸(Hcy),丙二醛(MDA)和谷胱甘肽过氧化物酶(GSH-Px),白细胞介素-1β(IL-1β),IL-6,肿瘤坏死因子-α(TNF-α)和C反应蛋白(CRP)水平;进行安全性评价。结果:观察组疾病疗效优于对照组(Z=2.118,P<0.05);观察组中医证候疗效优于对照组(Z=2.046,P<0.05);观察组患者FSS和气虚血瘀证评分均低于对照组(P<0.01);观察组SS-QOL和ADL评分均高于对照组(P<0.01),NIHSS评分低于对照组(P<0.01);治疗后观察组GSH-Px和SOD水平均高于对照组(P<0.01),IL-1β,IL-6,Hcy,CRP,TNF-α和MDA水平均低于对照组(P<0.01)。两组患者均未发现与药物相关安全性问题。结论:采用补阳还五汤合四君子汤联合针刺治疗PSF气虚血瘀证患者,具有抗氧化和抗炎作用的效果,可明显减轻疲劳程度和神经功能缺损程度,提高日常生活能力和生活质量,临床疗效显著且安全,值得进一步的研究与应用。Objective: To evaluate effect of addition and subtraction therapy of Buyang Huanwutang combined with Si Junzitang and acupuncture to poststroke fatigue(PSF)and syndrome of Qi deficiency and blood stasis,at the same time we studied the antioxidant and anti-inflammatory effects. Method: One hundred and forty-four patients were randomly divided into control group and observation group(1∶1)by random number table. 66 patients in control group completed the therapy(4 patients were falling off or missing visit,2 patients were eliminate),67 patients in observation group completed the therapy(2 patients were falling off or missing visit,3 patients were eliminate). In control group,patinets got acupuncture,1 time/day,6 times/week,they also got Geqi Tongmai grain,10 g/time,3 times/day. Patients in observation group got acupuncture(the same as which in control group),and addition and subtraction therapy of Buyang Huanwutang combined with Si Junzitang,1 dose/day,and courses of treatment in two groups were 4 weeks. Before and after treatment,fatigue severity scale(FSS),NIH stroke scale(NIHSS),syndrome of Qi deficiency and blood stasis,stroke specific quality of life scale(SS-QOL),and scores of ability of daily life(ADL)were recorded. And levels of superoxide dismutase(SOD),malondialdehyde(MDA),glutathione peroxidase(GSH-Px),homocysteine(Hcy),interleukin-1β(IL-1β),IL-6,tumor necrosis factor-α(TNF-α)and C-reactive protein(CRP)were detected. And the safety evaluated. Result: Disease effect in observation group was better than which in control group(Z=2.118,P<0.05). And effect after using traditional Chinese medicine(TCM)was also better than that in control group(Z=2.046,P<0.05). Scores of FSS,syndrome of Qi deficiency and blood stasis,NIHSS,and levels of IL-1β,IL-6,Hcy,CRP,TNF-α and MDA in observation group were all lower than those in control group(P<0.01),and scores of SS-QOL,ADL,and levels of GSH-Px and SOD were all higher than those in control group(P<0.01). Then there was no related safety issues caused by drug. Conc

关 键 词：中风后疲劳 气虚血瘀证 补阳还五汤 四君子汤 针刺 抗氧化 抗炎 

分 类 号：R289[医药卫生—方剂学] R25[医药卫生—中药学]