桂枝茯苓丸加味辅助治疗急性脑梗死临床观察及作用机制研究  

Analysis of modified Guizhi Fuling Pill as adjuvant in treatment of acute cerebral infarction in patients and its Mechanism

作　　者：候娜娜[1] 潘光辉[1] 魏建萍 刘洋[1] 孙欣[1] HOU Nana;PAN Guanghui;WEI Jianping;LIU Yang;SUN Xin(Department of Traditional Chinese Medicine,Weifang People's Hospital,Shandong,Weifang 261041;不详)

机构地区：[1]山东省潍坊市人民医院中医科,山东潍坊261041 [2]山东省潍坊市人民医院急诊科,山东潍坊261041

出　　处：《河北中医》2021年第9期1440-1443,共4页Hebei Journal of Traditional Chinese Medicine

基　　金：山东省中医药科技发展计划项目(2019—2020年度)(编号:2019-0715)。

摘　　要：目的观察桂枝茯苓丸加味辅助治疗急性脑梗死的临床疗效并探讨其作用机制。方法将91例急性脑梗死患者采用抽签法随机分为2组,对照组45例予西医常规治疗,治疗组46例在对照组基础上联合桂枝茯苓丸加味治疗。2组均治疗2周后统计疗效,比较2组治疗前后美国国立卫生院卒中量表(NIHSS)评分、临床神经功能缺损程度量表(NFD)评分变化情况,比较2组治疗前后内皮素1(ET-1)、神经元特异性烯醇化酶(NSE)、神经营养因子(NTF)及凝血酶原时间(PT)、凝血酶时间(TT)、纤维蛋白原(FIB)水平变化情况,观察2组治疗期间不良反应情况。结果治疗组总有效率91.30%(42/46),不良反应发生率6.52%(3/46),对照组分别为68.89%(31/45)、11.11%(5/45),治疗组总有效率高于对照组(P<0.05),不良反应发生率与对照组比较差异无统计学意义(P>0.05)。2组治疗后NIHSS评分、NFD评分与本组治疗前比较均降低(P<0.05),且治疗组治疗后评分均低于对照组(P<0.05)。与本组治疗前比较,2组治疗后ET-1、NSE、FIB水平均降低(P<0.05),NTF、PT、TT水平均升高(P<0.05),且治疗组治疗后各指标改善均优于对照组(P<0.05)。结论桂枝茯苓丸加味辅助治疗急性脑梗死疗效确切,可明显保护患者神经功能,改善神经缺损症状,提高临床疗效,且无明显不良反应,其作用机制可能与降低ET-1、NSE水平,升高NTF水平,改善凝血功能有关。Objective To observe the clinical efficacy of modified Guizhi Fuling Pill as adjuvant in treatment of acute cerebral infarction(ACI)in patients and to analyze its mechanism.Methods Totally 91 ACI patients were randomly divide into two groups by drawing lots,45 cases in control group were treated with conventional western medicine,and 46 cases in treatment group with modified Guizhi Fuling Pill on the basis of control group.Treated for 2 weeks,the aim was to compare National Institute of Health Stroke Scale(NIHSS),degree of nerve function defect(NFD),endothlin-1(ET-1),neuron-specific enolase(NSE),neurotrophic factor(NTF),prothrombin time(PT),thrombin time(TT),fibrinogen(FIB);the curative effect and adverse reactions were counted.Results The total effective rates in treatment group were better than those in control group[91.30%(42/46)vs 68.89%(31/45),(P<0.05),respectively].The adverse reactions in treatment group and control group were 6.52%(3/46)and 11.11%(5/45),respectively,the difference was not statistically significant between groups(P>0.05).After treatment,NIHSS score and NFD score in groups were decreased when compared with those before treatment(P<0.05),which were lower in treatment group than in control group(P<0.05);ET-1,NSE,FIB in groups were decreased(P<0.05),NTF,PT,TT were increased(P<0.05),improvement of which in treatment group were significantly better(P<0.05).Conclusion Modified Guizhi Fuling Pill as adjuvant in treatment of ACI patients has definite curative effect,can protect nerve function,improve nerve defect symptoms and clinical efficacy,and has no obvious adverse reactions.Its mechanism may be related to decreased ET-1,NSE,increased NTF,and improved coagulation function.

关 键 词：脑梗死 急性病 中风 中药疗法 桂枝茯苓丸 

分 类 号：R255.2[医药卫生—中医内科学] R743.3[医药卫生—中医学]