祛风通络方辅助治疗风痰阻络型急性脑梗死临床研究  

Clinical Study on Qufeng Tongluo Prescription in Assisted Treatment of Acute Cerebral Infarction of Wind-Phlegm Obstructing Collaterals Type

作　　者：王华强[1] 李迪[1] 凌军[1] 周立峰[1] WANG Huaqiang;LI Di;LING Jun;ZHOU Lifeng

机构地区：[1]丽水市中医院脑病科,浙江丽水323000

出　　处：《新中医》2021年第19期69-73,共5页New Chinese Medicine

基　　金：浙江省中医药传承与创新“十百千”人才工程(杏林工程)省级中青年临床名中医项目(浙中医药[2017]27号)。

摘　　要：目的:观察祛风通络方辅助治疗风痰阻络型急性脑梗死的临床疗效。方法:选取风痰阻络型急性脑梗死患者80例,按随机数字表法分为观察组和对照组各40例。对照组采用常规治疗方案,观察组在对照组基础上给予祛风通络方治疗。比较2组临床疗效、美国国立卫生研究院卒中量表(NIHSS)评分、改良Rankin量表(mRS)积分、中医证候积分、Fugl-Meyer运动功能量表(FMA)评分,检测血清神经细胞因子、炎性因子水平。结果:观察组总有效率为95.0%,对照组为75.0%,2组比较,差异有统计学意义(P<0.05)。治疗前,2组各项中医证候积分比较,差异无统计学意义(P>0.05)。治疗后,2组各项中医证候积分较治疗前降低,且观察组各项中医证候积分低于对照组,差异均有统计学意义(P<0.05)。治疗前,2组血清细胞间黏附分子-1 (ICAM-1)、胰岛素样生长因子-1 (IGF-1)、血管内皮细胞生长因子(VEGF)、超敏C-反应蛋白(hs-CRP)、白细胞介素6(IL-6)及肿瘤坏死因子-α(TNF-α)水平比较,差异无统计学意义(P>0.05)。治疗后,2组血清ICAM-1、hs-CRP、IL-6及TNF-α水平较治疗前降低,观察组ICAM-1、hs-CRP、IL-6及TNF-α水平低于对照组(P<0.05);2组血清IGF-1及VEGF水平高于治疗前,观察组IGF-1及VEGF水平高于对照组(P<0.05)。治疗前,2组NIHSS、mRS及FMA评分比较,差异无统计学意义(P>0.05)。治疗后,2组NIHSS评分及mRS评分较治疗前降低,FMA评分较治疗前升高(P<0.05);观察组NIHSS评分及mRS评分低于对照组,FMA评分高于对照组(P<0.05)。结论:祛风通络方辅助治疗风痰阻络型急性脑梗死可有效改善患者临床症状,调节血清神经细胞因子及炎性因子水平,改善神经功能及运动功能。Objective:To observe the clinical effect of Qufeng Tongluo prescription in assisted treatment of acute cerebral infarction of wind-phlegm obstructing the collaterals type. Methods: A total of 80 cases of patients with acute cerebral infarction of wind-phlegm obstructing the collaterals type were selected and divided into the observation group and the control group according to the random number table method,40 cases in each group. The control group was given routine treatment scheme,and the observation group was additionally given Qufeng Tongluo prescription based on the treatment of the control group. The clinical effect,scores of National Institutes of Health Stroke Scale(NIHSS),modified Rankin Scale(mRS),and Fugl-Meyer Assessment(FMA),and Chinese medicine syndrome score were compared between the two groups. Levels of serum nerve cell factors and inflammatory factors were detected. Results: The total effective rate was 95.0% in the observation group and 75.0% in the control group,the difference being significant(P<0.05). Before treatment,there was no significant difference being found in the comparison of each Chinese medicine syndrome score between the two groups(P>0.05). After treatment,each Chinese medicine syndrome score in the two groups was decreased when compared with that before treatment, and each score in the observation group was lower than that in the control group, differences being significant(P<0.05). Before treatment,when compared levels of intercellular adhesion molecule-1(ICAM-1),insulinlike growth factor-1(IGF-1), vascular endothelial growth factor(VEGF), high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α) in serum between the two groups,there was no significance in the difference(P>0.05). After treatment, levels of ICAM-1, hs-CRP, IL-6, and TNF-α in serum in the two groups were decreased when compared with those before treatment,and the four levels in the observation group were lower than those in the control group(P<0.05);levels of IGF-1 and

关 键 词：急性脑梗死 祛风通络方 风痰阻络型 神经功能 中医证候积分 运动功能 细胞因子 炎性因子 

分 类 号：R743[医药卫生—神经病学与精神病学]