自拟化痰通络方治疗脑梗死恢复早期痰瘀阻络证疗效及对脑血流动力学和血管神经修复因子的影响  

Clinical Efficacy of Self-made Huatan Tongluo Prescription for the Treatment of Early Recovery of Cerebral Infarction with Phlegm and Stasis Obstructing Collaterals Syndrome and the Effects on Cerebral Hemodynamics and Vascular Nerve Repair Factors

作　　者：夏毅[1] 徐进友[2] 王海东[1] 陆倩[1] XIA Yi;XU Jinyou;WANG Haidong;LU Qian(The Affiliated Brain Hospital of Nanjing Medical University,Nanjing 210029,China;Jiangsu Provincial Hospital of Integrated Traditional Chinese and Western Medicine,Nanjing 210028,China)

机构地区：[1]南京医科大学附属脑科医院,江苏南京210029 [2]江苏省中西医结合医院,江苏南京210028

出　　处：《中国中医药信息杂志》2022年第2期109-114,共6页Chinese Journal of Information on Traditional Chinese Medicine

基　　金：江苏省药学会2018年度医院药学科研项目(Q2019033)。

摘　　要：目的观察自拟化痰通络方治疗脑梗死恢复早期痰瘀阻络证的临床疗效,及其对脑血流动力学和血管神经修复因子的影响。方法采用随机数字表法将120例患者分为对照组与观察组各60例。对照组予西医基础治疗及阿托伐他汀钙片、阿司匹林肠溶片,每日1片,口服;观察组在对照组基础上予自拟化痰通络方,每日1剂,每日2次,口服。观察2组临床疗效,比较2组治疗前后神经功能缺损评分(NIHSS)、Barthel指数、病变侧大脑血流最大峰值流速(Vs)、血管阻力指数(RI)、血管搏动指数(PI)、脑血管储备(CVR)、血管内皮生长因子(VEGF)、神经元特异性烯醇化酶(NSE)、脑源性神经营养因子(BDNF)、血管细胞黏附因子-1(VCAM-1)、超氧化物歧化酶(SOD)及丙二醛(MDA)水平。结果观察组总有效率为96.67%(58/60),对照组为86.67%(52/60),2组比较差异有统计学意义(P<0.05)。与本组治疗前比较,2组治疗后NIHSS评分降低、Barthel指数升高(P<0.05);2组治疗后比较,观察组NIHSS评分低于对照组,Barthel指数高于对照组(P<0.05)。与本组治疗前比较,2组治疗后Vs、CVR水平升高,RI、PI降低(P<0.05);2组治疗后比较,观察组治疗后Vs、CVR高于对照组,RI、PI低于对照组(P<0.05)。与本组治疗前比较,2组治疗后VEGF、BDNF水平升高,NSE、VCAM-1水平降低(P<0.05);2组治疗后比较,观察组治疗后VEGF、BDNF高于对照组,NSE、VCAM-1低于对照组(P<0.05)。与本组治疗前比较,2组治疗后SOD水平升高,MDA水平降低(P<0.05);2组治疗后比较,观察组SOD高于对照组,MDA低于对照组(P<0.05)。结论自拟化痰通络方治疗脑梗死恢复早期痰瘀阻络证患者疗效显著,可通过改善血流动力学、减轻脂质过氧化损伤、调节血管神经修复因子,以减轻患者神经功能缺损程度,提高其日常生活能力。Objective To explore the clinical effect of self-made Huatan Tongluo Prescription in the treatment of early recovery of cerebral infarction with phlegm and blood stasis obstruction syndrome,and its effect on cerebral hemodynamics and vascular nerve repair factors.Methods Totally 120 patients were divided into control group and observation group according to random number table method,with 60 cases in each group.The control group was given atorvastatin calcium tablets and aspirin enteric-coated tablets on the basis of Western medicine,1 tablet a day,orally;the observation group was treated with self-made Huatan Tongluo Prescription,one dosage per day,twice a day,orally.Clinical efficacy of both groups was compared.Neurological impairment score(NIHSS),Barthel index,maximum peak blood flow velocity(Vs)on the affected side of the brain,vascular resistance index(RI),vascular pulsatility index(PI),cerebro vascular reserve(CVR),vascular endothelial growth factor(VEGF),neuron-specific enolase(NSE),brain-derived neurotrophic factor(BDNF),vascular cell adhesion factor-1(VCAM-1),superoxide dismutase(SOD)and malondialdehyde(MDA)levels were compared between the two groups before and after treatment.Results The total effective rate of the observation group was 96.67%(58/60),and the control group was 86.67%(52/60),with statistical significance(P<0.05).Compared with before treatment,the NIHSS score of the two groups decreased and the Barthel index increased(P<0.05);after treatment,the NIHSS score of the observation group was lower than that of the control group,and the Barthel index was higher than that of the control group(P<0.05).Compared with before treatment,the levels of Vs and CVR in the two groups increased,while RI and PI decreased(P<0.05);after treatment,the Vs and CVR of the observation group were higher than those of the control group,while RI and PI were lower than those of the control group(P<0.05).Compared with before treatment,the levels of VEGF and BDNF in the two groups increased,and the level of NSE and VCAM-1

关 键 词：脑梗死恢复早期 痰瘀阻络证 自拟化痰通络方 神经功能缺损 临床研究 

分 类 号：R277.733[医药卫生—中医学]