黄角汤治疗脑梗死急性期临床研究  

Clinical study on Huangjiao decoction in the treatment of acute cerebral infarction

作　　者：邢惠娟 黄乾坤 马效麟 常红[1] 孙强[1] XING Huijuan;HUANG Qiankun;MA Xiaolin;CHANG Hong;SUN Qiang(Department of Neurology,Dalian Third People’s Hospital,Dalian 116000,China)

机构地区：[1]大连市第三人民医院神经内科,辽宁大连116000 [2]上海市闵行区精神卫生中心,上海201112 [3]大连市第三人民医院中医科,辽宁大连116000

出　　处：《陕西中医》2021年第11期1536-1538,1543,共4页Shaanxi Journal of Traditional Chinese Medicine

基　　金：国家科技支撑计划项目(2019-1006)。

摘　　要：目的:探讨黄角汤治疗急性期脑梗死的疗效及对患者糖化血红蛋白(HbA1c)、纤维蛋白原(FIB)、脑动脉血流动力学的影响。方法:选择急性脑梗死患者97例,采用随机数字表法分为常规组48例和研究组49例。常规组参照脑梗死指南给予常规治疗,此基础上,研究组再给予黄角汤治疗。比较治疗前后两组中医证候积分变化情况;比较两组治疗前及治疗2周后两组平均血流流速(Vm)、平均血流量(Qm)及血管阻力指数(RI)、HbA1c、FIB指标、神经功能损伤、炎症水平、肢体运动功能、日常生活能力变化及疗效情况。结果:治疗5、7、14 d后,两组中医证候积分均下降,且研究组比常规组下降更明显(P<0.05)。治疗后,两组Vm、Qm升高,RI、HbA1c、FIB及NIHSS评分降低,研究组比常规组更明显(P<0.05);两组治疗后S100β、NSE以及GFAP水平降低,研究组更明显(P<0.05);两组治疗后TNF-α、IL-1β以及hs-CRP均降低,研究组低于常规组(P<0.05)。研究组治疗后mRS分级优于常规组,预后良好率高于常规组(P<0.05)。结论:黄角汤可有效改善急性期脑梗死患者颅内血流动力学,降低血清HbA1c、FIB因子表达水平,改善神经缺损症状。Objective:To investigate the curative effect of Huangjiao decoction on acute cerebral infarction and its influence on glycosylated hemoglobin(HbA1c),fibrinogen(FIB)and cerebral artery hemodynamics.Methods:97 patients with acute cerebral infarction were selected.They were randomly divided into routine group(48 cases)and study group(49 cases).The control group was given routine treatment according to the guidelines for cerebral infarction.On this basis,the study group was given Huangjiao decoction.The changes of TCM syndrome integral before and after treatment were compared between the two groups;the hemodynamic indexes(Vm,Qm,RI),glycosylated hemoglobin(HbA1c),fibrinogen(FIB),changes of neurological deficit,motor function,activities of daily living and curative effect were compared between the two groups before and 2 weeks after treatment.Results:After 5,7 and 14 days of treatment,the TCM syndrome scores of the two groups decreased significantly,and the decrease in the study group was more obvious than that in the routine group(P<0.05).After treatment,Vm and Qm increased,RI,HbA1c,FIB and NIHSS scores decreased in the two groups,and the study group was more obvious than the conventional group(P<0.05).After treatment,S100β、the levels of NSE and GFAP were significantly decreased,especially in the study group(P<0.05).After treatment,TNF-αin both groups decreased-α、IL-1βand hs-CRP were lower in the study group than in the routine group(P<0.05).After treatment,the mRS grade of the study group was better than that of the conventional group,and the good prognosis rate of the study group was higher than that of the conventional group(P<0.05).Conclusion:Huangjiao decoction can effectively improve the intracranial hemodynamics of patients with acute cerebral infarction,reduce the expression levels of serum HbA1c and FIB factor,improve the symptoms of nerve defect.

关 键 词：脑梗死 急性期 黄角汤 糖化血红蛋白 纤维蛋白原 

分 类 号：R743.3[医药卫生—神经病学与精神病学]