补阳还五汤联合西药治疗缺血性脑卒中后血管性痴呆疗效及对血清炎症因子、氧化应激指标和血管内皮活性物质的影响  

Efficacy of Buyang Huanwu Decoction combined with western medicine in the treatment of vascular dementia after ischemic stroke and its effect on serum inflammatory factors,oxidative stress indexes and vascular endothelial active substances

作　　者：王峥[1] 林琳[1] WANG Zheng;LIN Lin(Tangshan Hospital of Traditional Chinese Medicine, Tangshan 063000, Hebei, China)

机构地区：[1]唐山市中医医院,河北唐山063000

出　　处：《现代中西医结合杂志》2022年第4期469-473,490,共6页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：河北省中医药管理局科研计划项目(2021394)。

摘　　要：目的观察补阳还五汤联合西药治疗缺血性脑卒中后血管性痴呆疗效及对血清炎症因子、氧化应激指标和血管内皮活性物质的影响。方法将2020年3月—2021年3月唐山市中医医院收治的86例缺血性脑卒中血管性痴呆患者随机分为2组,每组43例。对照组给予奥拉西坦治疗,研究组在其基础上加用补阳还五汤治疗,2组疗程均为12周。比较2组患者治疗前后中医症状积分、神经功能指标[美国国立卫生院神经功能缺损程度(NIHSS)评分]、认知功能指标[简易精神状态量表(MMSE)评分]、痴呆程度指标[临床痴呆量表(CDR)评分]、炎性因子指标[肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)]、氧化应激指标[谷胱甘肽过氧化物酶(GSH-Px)活性、超氧化物歧化酶(SOD)、丙二醛(MDA)]、血管内皮活性物质[一氧化氮(NO)、内皮素-1(ET-1)、血栓素B_(2)(TXB_(2))]水平变化,观察2组临床疗效及不良反应发生情况。结果与治疗前比较,治疗后2组患者MMSE评分及血清SOD、GSH-Px、NO水平均显著升高(P均<0.05),中医症状积分、NIHSS评分、CDR评分及血清TNF-α、IL-6、hs-CRP、MDA、ET-1、TXB_(2)水平均显著降低(P均<0.05),且研究组患者上述指标改善情况均显著优于对照组(P均<0.05)。治疗后,研究组总有效率为90.7%(39/43),对照组为74.4%(32/43),研究组明显高于对照组(P<0.05)。2组均无明显不良反应发生。结论补阳还五汤联合西药治疗可有效改善缺血性脑卒中血管性痴呆患者临床症状、神经功能与痴呆程度,提高患者认知能力,其发挥上述作用机制可能与降低炎性因子水平、减弱氧化应激损伤有关。Objective It is to observe the efficacy of Buyang Huanwu Decoction combined with western medicine in the treatment of vascular dementia after ischemic stroke and its effect on serum inflammatory factors,oxidative stress indexes and vascular endothelial active substances.Methods A total of 86 patients with ischemic stroke and vascular dementia who were treated in Tangshan Hospital of Traditional Chinese Medicine from March 2020 to March 2021 were randomly divided into two groups,with 43 cases in each group.The control group was treated with oxiracetam,and the study group was additionally treated with Buyang Huanwu Decoction based on the control group.The course of treatment in both groups was 12 weeks.The changes in the traditional Chinese medicine syndrome scores,neurological function indicators[the National Institutes of Health Stroke Scale score],cognitive function indicators[Minimal Mental State Scale(MMSE)score],and dementia degree indicators[Clinical Dementia Rating(CDR)score],inflammatory factor indicators[tumor necrosis factor(TNF-α),interleukin-6(IL-6),high-sensitivity C-reactive protein(hs-CRP)],oxidative stress indicators[glutathione peroxidase(GSH-Px)activity,superoxide dismutase(SOD),malondialdehyde(MDA)],vascular endothelial active substances[nitric oxide(NO),endothelin-1(ET-1),thromboxane B_(2)(TXB_(2))]of the patients before and after treatment were observed in the two groups,the clinical efficacy and occurrence of adverse reactions of the two groups were observed.Results Compared with before treatment,the scores of MMSE,and the levels of serum SOD,GSH-Px and NO were significantly increased after treatment in the two groups(all P<0.05),the TCM syndrome score,NIHSS score,CDR score,and the levels of TNF-α,IL-6,hs-CRP,MDA,ET-1,TXB_(2)were significantly decreased in the two groups(all P<0.05),and the improvement of the above indicators in the study group was significantly better than that in the control group(P<0.05).After treatment,the total effective rate was 90.7%(39/43)in the study group and 74.4

关 键 词：补阳还五汤 缺血性脑卒中 血管性痴呆 炎症因子 氧化应激 血管内皮活性物 

分 类 号：R743.33[医药卫生—神经病学与精神病学]