镇肝熄风汤联合针刺治疗老年急性脑梗死(阴虚风动证)的临床观察  

Clinical Observation of Zhengan Xifeng Decoction Combined with Acupuncture on Elderly Acute Cerebral Infarction(Stirring Wind due to Yin Deficiency Type)

作　　者：江丽 孙蔚 祝青青 刘天易[2] 祝明浩 Jiang Li;Sun Wei;Zhu Qingqing;Liu Tian-yi;Zhu Minghao(Jimo Hospital of TCM Affiliated to Shandong University of Traditional Chinese Medicine,Shandong,Qingdao 266200,China)

机构地区：[1]山东中医药大学附属青岛市即墨区中医医院,山东青岛266200 [2]山东中医药大学附属医院,山东济南250001

出　　处：《中国中医急症》2021年第9期1616-1619,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：山东省名老中医药专家传承工作室建设项目(鲁卫函[2019]92号)。

摘　　要：目的观察镇肝熄风汤联合针刺治疗老年急性脑梗死(阴虚风动证)的疗效,并探讨其作用机制。方法将140例老年急性脑梗死(阴虚风动证)患者随机分为对照组与观察组各70例。对照组实施常规治疗,观察组在常规治疗基础上加用镇肝熄风汤联合针刺治疗,2周后比较两组患者的临床疗效和不良反应;治疗前后进行神经功能缺损(NIHSS)和日常生活能力(ADL)评分;检测脑血流CT灌注指标[脑血容量(CBV)、脑血流量(CBF)、峰值时间(TTP)、平均通过时间(MTT)]、脑血流动力学参数[搏动指数(PI)、阻力指数(RI)、平均血流速度(MFV)]、氧化应激指标[超氧化物歧化酶(SOD)、脂质过氧化物(LPO)、丙二醛(MDA)]、肿瘤坏死因子-α(TNF-α)、可溶性细胞间黏附分子-1(sICAM-1)和可溶性血管细胞黏附分子-1(sVCAM-1)水平。结果观察组总有效率优于对照组(P<0.05);观察组NIHSS评分低于对照组,ADL评分高于对照组(P<0.05);观察组的CBV和CBF显著高于对照组,TTP和MTT显著低于对照组(P<0.05);观察组的PI和RI显著低于对照组,MFV显著高于对照组(P<0.05);观察组的SOD显著高于对照组,LPO和MDA显著低于对照组(P<0.05);观察组的sICAM-1、sVCAM-1和TNF-α显著低于对照组(P<0.05)。结论镇肝熄风汤联合针刺治疗老年急性脑梗死(阴虚风动证)具有较好的临床疗效,可能与治疗改善脑血流CT灌注、脑血流动力学及氧化应激水平,降低炎症因子水平有关。Objective:To observe the therapeutic effect of Zhengan Xifeng Decoction combined with acupuncture in the treatment of elderly acute cerebral infarction(ACI,stirring wind due to yin deficiency type),and to explore its mechanism of action. Methods:A total of 140 elderly patients with ACI of stirring wind due to yin deficiency type were randomly divided into control group(70 cases)and observation group(70 cases). The control group was given conventional treatment while the observation group was given Zhengan Xifeng Decoction combined with acupuncture on the basis of the control group. After 2 weeks,the clinical efficacy and adverse reactions were compared,neurological deficit(NIHSS)and activities of daily living(ADL)before and after treatment were scored;the cerebral blood flow CT perfusion index(CBV、CBF、TTP、MTT),cerebral hemodynamic parameters(PI、RI、MFV),oxidative stress index(SOD、LPO、MDA),TNF-α,sICAM-1 and sVCAM-1 were examined. Results:The total effective rate in the observation group was better than the control group(P < 0.05);the score of NIHSS in the observation group was lower than which of the control group,and the ADL was higher than the control group(P <0.05);CBV and CBF of the observation group were significantly higher than those of the control group,and TTP and MTT were significantly lower than those of the control group(P < 0.05);PI and RI of the observation group were significantly lower than those of the control group,and MFV was significantly higher than the control group(P < 0.05);SOD of the observation group was significantly higher than those of the control group,LPO and MDA were significantly lower than the control group(P < 0.05);sICAM-1,sVCAM-1 and TNF-α of the observation group were significantly lower than those of the control group(P < 0.05). Conclusion:Zhengan Xifeng Decoction combined with acupuncture has good clinical effect in treating elderly ACI of stirring wind due to yin deficiency type. It may be related to the improvement of cerebral blood flow CT perfusion,brain h

关 键 词：急性脑梗死 阴虚风动型 镇肝熄风汤 针刺 脑血流灌注 脑血流动力学 氧化应激 

分 类 号：R743.9[医药卫生—神经病学与精神病学]