补阳还五汤联合依达拉奉治疗急性缺血性脑卒中的临床疗效及安全性评价  

Clinical efficacy and safety evaluation of Buyang Huanwu Decoction combined with edaravone in the treatment of acute ischemic stroke

作　　者：钟芳芳[1] 吴承龙[1] 桂小红[1] 娄一萍 王赵伟[1] ZHONG Fangfang;WU Chenglong;GUI Xiaohong;LOU Yiping;WANG Zhaowei(Department of Neurology,Shaoxing People′s Hospital in Zhejiang Province,Shaoxing Hospital of Zhejiang University,Shaoxing 312000,China)

机构地区：[1]浙江省绍兴市人民医院浙江大学绍兴医院神经内科,浙江绍兴312000

出　　处：《中国现代医生》2021年第25期51-54,共4页China Modern Doctor

基　　金：浙江省基础公益研究计划项目(LGF18H090018);浙江省绍兴市卫生计生科技计划项目(2017ZH003)。

摘　　要：目的 评估补阳还五汤联合依达拉奉治疗急性缺血性脑卒中的临床疗效、安全性及可能的作用机制。方法选取2017年10月至2019年12月本院住院的720例急性脑梗死患者,随机分为联用组与对照组,每组各360例。两组患者入组后均予抗血小板、他汀降脂、控制血压等常规治疗,对照组加用依达拉奉治疗,联用组在对照组基础上加补阳还五汤联合治疗,两组均连续治疗2周。观察两组治疗前后神经功能评分(NIHSS)评分和日常生活能力(ADL)评定,分析临床疗效,检测两组治疗前后血液流变学指标(血浆黏度、全血低切黏度、高切黏度、红细胞聚集指数),并观察各组患者的不良反应。结果 治疗后两组NIHSS评分较治疗前明显降低、ADL评分明显升高,且联用组NIHSS评分和ADL评分较对照组有明显改善(P<0.01)。联用组总有效率为91.67%,显著高于对照组的71.11%(P<0.01)。治疗后联用组血浆黏度、全血低切黏度、高切黏度、红细胞聚集指数较对照组明显降低(P<0.01)。联用组不良反应总发生率为3.06%,对照组为2.78%,两组比较,差异无统计学意义(P>0.05)。结论 补阳还五汤联合依达拉奉治疗急性缺血性脑卒中的临床效果确切,能显著改善缺血性脑卒中患者的血液黏稠度与神经功能,且用药安全性较好。Objective To evaluate the clinical efficacy,safety and possible mechanism of Buyang Huanwu Decoction combined with edaravone in the treatment of acute ischemic stroke.Methods A total of 720 patients with acute cerebral infarction in our hospital from October 2017 to December 2019 were selected and randomLy divided into the combination group and the control group,with 360 cases in each group.The two groups were given conventional treatments such as antiplatelet,statin lipid-lowering,and blood pressure control.The control group was treated with edaravone,and the combination group was treated with Buyang Huanwu Decoction based on the treatment of the control group.The two groups were continuously treated for two weeks.The neurological function score(NIHSS)and the ability of daily living(ADL)evaluation before and after treatment were observed.The clinical efficacy was analyzed.The hemorheological indexes,including plasma viscosity,whole blood low-shear viscosity,high-shear viscosity,erythrocyte aggregation index,of the two groups before and after treatment were detected.The adverse reactions of each group were observed.Results The NIHSS score of the two groups after treatment was significantly lower than that before the treatment.The ADL score was significantly increased.The NIHSS score and ADL score of the combination group was significantly better than that of the control group(P<0.01).The total effective rate of the combination group was 91.67%,which was significantly higher than 71.11%of the control group(P<0.01).After treatment,the plasma viscosity,whole blood low-shear viscosity,high-shear viscosity,and red blood cell aggregation index in the combination group were significantly lower than those in the control group(P<0.01).The total incidence of adverse reactions was 3.06%in the combined group and 2.78%in the control group.There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Buyang Huanwu Decoction combined with edaravone has a definite clinical ef

关 键 词：补阳还五汤 依达拉奉 脑梗死 神经功能评分 日常生活能力评定 血液流变学 

分 类 号：R743.3[医药卫生—神经病学与精神病学]