枳实大黄汤加减联合通脑活络针刺法治疗脑梗死急性期的疗效观察  

Effect of Modified Zhishi Daihuang Decoction Combined with Tongnao Huoluo Acupuncture on Acute Cerebral Infarction

作　　者：张敬华[1] 惠振[1] 王苏雷[1] 曹凤娇 吕双 赵杨[1] ZHANG Jinghua;HUI Zhen;WANG Sulei;CAO Fengjiao;LYU Shuang;ZHAO Yang(Nanjing Chinese Medicine Hospital Affiliated to Nanjing University of Traditional Chinese Medicine,Nanjing 210022,Jiangsu,China)

机构地区：[1]南京中医药大学附属南京市中医院,南京210022

出　　处：《中西医结合心脑血管病杂志》2022年第7期1304-1307,共4页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：国家自然科学基金项目(No.81703975);南京市卫生科技发展专项资金项目(No.YKK19098);江苏省现代医院管理研究中心医院管理研究课题(No.JSY-3-2019-029);南京中医药大学附属南京中医院国自然科学基金院内培育项目(No.NBPY201711)。

摘　　要：目的观察枳实大黄汤加减联合通脑活络针刺法治疗脑梗死急性期的疗效以及对氧化应激因子表达水平的影响。方法选取南京中医药大学附属南京中医院2017年7月—2019年7月住院治疗的脑梗死急性期病人92例,随机分为观察组和对照组,每组46例。两组均给予脑梗死急性期常规治疗和通脑活络针刺法,观察组加用枳实大黄汤,观察两组治疗前后血清丙二醛(MDA)、超氧化物歧化酶(SOD)、一氧化氮(NO)水平及美国国立卫生研究院卒中量表(NIHSS)评分和中医证候积分的变化。结果治疗后,观察组中医证候疗效总有效率高于对照组,差异有统计学意义(P<0.05)。治疗后,两组血清MDA、NO水平均较治疗前明显降低,SOD水平较治疗前明显升高,差异有统计学意义(P<0.05);治疗后,观察组血清MDA、NO水平明显低于对照组,SOD水平明显高于对照组,差异均有统计学意义(P<0.05)。治疗后,两组NIHSS评分及中医证候积分均有下降,观察组中医证候积分下降较对照组明显(P<0.05)。结论运用枳实大黄汤加减联合通脑活络针刺法治疗脑梗死急性期,能够通腑泄浊,调控氧化应激水平,促进神经功能恢复。Objective To observe the curative effects of modified Zhishi Daihuang Decoction combined with Tongnao Huoluo acupuncture on acute cerebral infarction and the effect of oxidative stress factor expression.Methods A total of 92 patients with acute cerebral infarction were randomly divided into observation group and control group,with 46 cases in each group.Both groups were given routine treatment at acute stage of cerebral infarction and Tongnao Huoluo acupuncture.The observation group was added with Zhishi Daihuang Decoction.The serum malondialdehyde(MDA),superoxide dismutase(SOD)and nitric oxide(NO)levels,the National Institutes of Health Stroke Scale(NIHSS)score,and traditional Chinese medicine(TCM)syndrome score were observed before and after treatment.Results After treatment,the total effective rate of observation group was higher than that in control group(P<0.05).After treatment,the levels of MDA and NO in serum of 2 groups were significantly lower than that before treatment,while the level of SOD was significantly higher than that before treatment(P<0.05).After treatment,the serum MDA and NO levels in the observation group were significantly lower than those in the control group,and SOD level was significantly higher than that in the control group(P<0.05),NIHSS and TCM syndrome score of the two groups were decreased,and the TCM syndrome score of the treatment group was decreased significantly than that of the control group(P<0.05).Conclusion The application of Modified Zhishi Daihuang decoction combined with Tongnao Huoluo acupuncture in the treatment of acute cerebral infarction can relieve the turbidity,regulate the level of oxidative stress and promote the recovery of nerve function.

关 键 词：急性脑梗死 枳实大黄汤 超氧化物歧化酶 丙二醛 一氧化氮 

分 类 号：R277.7[医药卫生—中医学]