脉络宁注射液、通督调神针刺法联合常规治疗对短暂性脑缺血发作患者的临床疗效  

Clinical effects of Mailuoning Injection,Tongdu Tiaoshen Acupuncture Method combined with conventional treatment on patients with transient ischemic attack

作　　者：陈莹 黄东勉 谭辉[3] CHEN Ying;HUANG Dong-mian;TAN Hui(Department of Acupuncture-Moxibustion and Rehabilitation,Haikou Municipal Hospital of Traditional Chinese Medicine,Haikou 570216,China;Hainan Provincial Medical Academic Exchange Management Center,Haikou 570216,China;College of Traditional Chinese Medicine,Anhui University of Chinese Medicine,Hefei 230012,China)

机构地区：[1]海口市中医医院针灸康复科,海南海口570216 [2]海南省医学学术交流管理中心,海南海口570216 [3]安徽中医药大学中医学院,安徽合肥230012

出　　处：《中成药》2021年第9期2360-2365,共6页Chinese Traditional Patent Medicine

基　　金：国家自然科学基金青年项目(81603523)。

摘　　要：目的探讨脉络宁注射液、通督调神针刺法联合常规治疗对短暂性脑缺血发作患者的临床疗效。方法129例患者随机分为对照组A、对照组B、观察组,每组43例,分别给予常规治疗(低分子右旋糖酐、阿加曲班等)、常规治疗+脉络宁注射液、常规治疗+脉络宁注射液+通督调神针刺法,疗程1个月。检测临床疗效、中医证候评分、脑氧代谢指标(CjvO_(2)、SjvO_(2))、脑部血流指标(LVA、RVA、BA血流速度)、凝血指标(APTT、PLT、PT、FIB)、血管内皮功能指标(vWF、VEGF、ET-1、NO)、LP-PLA2、ADMA、Hcy、IL-33、MMP-9、不良反应发生率变化。结果观察组总有效率高于对照组A、对照组B(P<0.05)。治疗后,观察组中医证候评分、vWF、ET-1、LP-PLA2、ADMA、Hcy、MMP-9低于对照组A、对照组B(P<0.05),脑氧代谢指标、脑部血流指标、VEGF、NO、IL-33更高(P<0.05),APTT、PT更长(P<0.05),PLT更短(P<0.05)。3组不良反应发生率比较,差异无统计学意义(P<0.05)。结论脉络宁注射液、通督调神针刺法联合常规治疗可安全有效地改善短暂性脑缺血发作患者脑血流指标及血清Hcy、IL-33、MMP-9水平,缓解临床症状。AIM To explore the clinical effects of Mailuoning Injection,Tongdu Tiaoshen Acupuncture Method combined with conventional treatment on patients with transient ischemic attack.METHODS One hundred and twenty-nine patients were randomly assigned into control group A(43 cases)for 1-month intervention of conventional treatment(low molecular dextran,argatroban anhydrous,etc.),control group B(43 cases)for 1-month intervention of conventional treatment+Mailuoning Injection,and observation group(43 cases)for 1-month intervention of conventional treatment+Mailuoning Injection+Tongdu Tiaoshen Acupuncture Method.The changes in clinical efficacy,TCM symptom scores,cerebral oxygen metabolism indices(CjvO_(2),SjvO_(2)),cerebral blood flow indices(blood flow velocities in LVA,RVA,BA),coagulation indices(APTT,PLT,PT,FIB),vascular endothelial function indices(vWF,VEGF,ET-1,NO),LP-PLA2,ADMA,Hcy,IL-33,MMP-9 and incidence of adverse reactions were detected.RESULTS The observation group demonstrated higher total effective rate than the control group A and control group B(P<0.05).After the treatment,the observation group demonstrated lower TCM symptom scores,vWF,ET-1,LP-PLA2,ADMA,Hcy and MMP-9 than the control group A and control group B(P<0.05),along with higher cerebral oxygen metabolism indices,cerebral blood flow indices,VEGF,NO and IL-33(P<0.05),longer APTT,PT(P<0.05)and shorter PLT(P<0.05).No obvious difference in incidence of adverse reactions was found among the three groups(P>0.05).CONCLUSION For the patients with transient ischemic attack,Mailuoning Injection,Tongdu Tiaoshen Acupuncture Method combined with conventional treatment can safely and effectively improve cerebral blood flow indices and serum Hcy,IL-33,MMP9 levels,and alleviate clinical symptoms.

关 键 词：脉络宁注射液 通督调神针刺法 常规治疗 短暂性脑缺血发作 

分 类 号：R287[医药卫生—中药学]