侯氏黑散方加减对短暂性脑缺血发作患者血管内皮功能、血清MMP-9、Lp-PLA2水平的影响研究  

Effect of Modified HOU’s Black Scattered Recipe on Cognitive Function, Serum BDNF and ET Levels for Patients with Vascular Dementia of Kidney-deficiency Blood-stasis Syndrome

作　　者：于晓娟[1] 蒋辉[1] 吴雪 李静[1] 陈志慧[1] 范海青[1] YU Xiaojuan;JIANG Hui;WU Xue(Brain Disease Center,Jiangsu Provincial Hospital of Traditional Chinese Medicine,Nanjing Jiangsu 210029,China)

机构地区：[1]江苏省中医院脑病中心,江苏南京210029

出　　处：《四川中医》2021年第12期158-161,共4页Journal of Sichuan of Traditional Chinese Medicine

基　　金：江苏省中医药管理局项目(YB201908)。

摘　　要：目的:观察候氏黑散方加减对短暂性脑缺血发作(TIA)患者血管内皮功能、血清基质金属蛋白酶-9(MMP-9)、脂蛋白相关磷脂酶A2(Lp-PLA2)水平的影响。方法:采用随机数表法将本院于2018年7月~2019年12月收治的104例TIA患者分为对照组与治疗组,各52例。对照组行西医常规治疗,治疗组在对照组的基础上予以候氏黑散方加减治疗,两组均治疗4周。对比两组治疗前后中医主症积分情况,并对血管内皮功能、血清基质金属蛋白酶-9(MMP-9)、脂蛋白相关磷脂酶A2(Lp-PLA2)水平以及凝血功能等指标进行检测,并对疗效进行评价。结果:两组的临床有效率分别为92.31%和80.77%,治疗组高于对照组(P<0.05)。治疗后治疗组的阵发性偏身麻木、发作性眩晕、短暂性偏身瘫软、一过性视物昏瞀等中医主症积分均低于对照组(P<0.05)。两组治疗后的一氧化氮(NO)水平较治疗前提高,内皮素-1(ET-1)、人血栓素B;(TXB;)和血管性血友病因子(vFW)水平较治疗前下降(P<0.05),且治疗组变化幅度大于对照组(P<0.05)。治疗组治疗后的MMP-9、血管紧张素-(Ang-Ⅱ)以及Lp-PLA2水平均低于对照组(P<0.05)。治疗后,治疗组的红细胞积压(HCT)、红细胞沉降率(ESR)及血小板聚集率(PAR)均低于对照组,凝血酶原时间(PT)高于对照组(P<0.05)。结论:候氏黑散方加减治疗短暂性脑缺血发作,可明显缓解患者主要症状,下调MMP-9、Lp-PLA2水平,改善血管内皮、凝血功能。Objective: To explore the effect of Modified HOU’s Black Scattered Recipe on cognitive function, serum brain-derived nutritional factor(BDNF) and endothelin(ET) levels for patients with vascular dementia(VD) of kidney-deficiency blood-stasis syndrome.Methods: A total of 108 VD patients of kidney-deficiency blood-stasis syndrome who were admitted to the hospital from July 2018 to December 2019 were enrolled and divided into a controlled group and an observation group by the random number table method, 54 cases in each group.The controlled group was treated with oral nimodipine, while the observation group was additionally treated with Modified HOU’s Black Scattered Recipe.Both groups were treated for 8 weeks.The cognitive function of patients were evaluated by mini-mental state examination(MMSE) and clinical dementia rating(CDR).The changes in levels of ET,serum nitric oxide(NO),homocysteine(HCY),BDNF,nerve growth factor(NGF),glial cell line-derived neurotrophicfactor(GDNF) and neuron specific enolase(NSE) before and after intervention were compared between the two groups.The curative effect and scores of TCM symptoms were evaluated.Results: The clinical response rate in the observation group was higher than that in the controlled group(90.74% vs 75.93%)(P<0.05).After 8 weeks, scores of TCM symptoms such as aponea, headaches, and cyanochroia of lips and paws in the observation group were lower than those in the controlled group(P<0.05).Compared with those before treatment, CDR score was decreased, while MMSE scores was increased after 8 weeks in both groups(P<0.05).And change amplitude in the observation group was greater than that in the controlled group(P<0.05).After 8 weeks, ET and HCY levels in the observation group were lower than those in the controlled group, while BDNF,NGF and GDNF levels were higher than those in the controlled group(P<0.05).Conclusion: Using Modified HOU’s Black Scattered Recipe in the treatment of vascular dementia of kidney-deficiency blood-stasis syndrome can significantly impro

关 键 词：短暂性脑缺血发作 候氏黑散 血管内皮功能 血清基质金属蛋白酶-9 脂蛋白相关磷脂酶A2 

分 类 号：R743.31[医药卫生—神经病学与精神病学]