消栓宁心汤对急性心源性脑梗死患者的前瞻性随机对照研究  

Prospective randomized controlled study of Xiaoshuan Ningxin decoction in patients with acute cardiogenic cerebral embolism

作　　者：卢菲 张心愿 王东峰 Lu Fei;Zhang Xinyuan;Wang Dongfeng

机构地区：[1]济源市中医院内科,459000 [2]郑州大学附属郑州中心医院中医科,450000 [3]濮阳油田总医院中医科,457000

出　　处：《中国疗养医学》2022年第10期1117-1120,共4页Chinese Journal of Convalescent Medicine

摘　　要：目的探讨消栓宁心汤对急性心源性脑梗死(acute cardiogenic cerebral embolism,ACCE)患者神经功能缺损程度量表(NIHSS)评分、血液流变学及血清细胞因子水平的影响。方法选取2019年1月至2021年7月济源市中医院92例急性心源性脑梗死患者,根据就诊时间编号,应用电脑随机数字表随机分为常规组和研究组各46例。常规组应用马来酸桂哌齐特(CM)治疗,研究组基于常规组联合消栓宁心汤治疗,对比两组总有效率、神经功能、运动功能[Fugl-Meyer量表评分(FMA评分)]、认知功能[蒙特利尔认知评估量表评分(MoCA评分)]、血液流变学[红细胞比容(Hct)、粥样斑块(AP)缩小面积、血浆黏度(PV)、纤维蛋白原(FIB)]、血清细胞因子水平[纤溶酶原(PLG)、血浆β-血小板球蛋白(β-TG)、血栓素B_(2)(TXB_(2))、磷酸腺苷(cAMP)]及不良反应。结果研究组总有效率91.30%高于常规组76.09%(P<0.05);治疗后与常规组比较,研究组NIHSS评分较低,MoCA、FMA评分较高(P<0.05);治疗后,研究组PV短于常规组,Hct、FIB低于常规组,AP缩小面积小于常规组(P<0.05);治疗后与常规组比较,研究组β-TG、TXB_(2)、PLG较低,cAMP较高(P<0.05);治疗过程中不良反应发生率组间比较差异无统计学意义(P>0.05)。结论消栓宁心汤治疗ACCE可改善患者神经功能,能调节血液流变学,抑制血栓形成,改善纤溶功能,效果显著。Objective To explore the effect of Xiaoshuan Ningxin decoction on the score of National Institute of Health stroke scale(NIHSS),hemorheology and serum cytokine level in patients with acute cardiogenic cerebral embolism(ACCE).Methods A total of 92 patients with acute cardiogenic cerebral embolism(ACCE)in Jiyuan Hospital of Traditional Chinese Medicine from January 2019 to July 2021 were selected and randomly divided into conventional group and study group with 46 cases in each group by computer random number table according to the treatment time number.The conventional group was treated with cinnamopazide maleate(CM),while the study group was treated with cinnamopazide maleate combined with Xiaoshuan Ningxin decoction.The total effective rate,neurological function,motor function[Fugl-Meyer scale score(FMA score)],cognitive function[Montreal Cognitive Assessment Scale score(MoCA score)],hemorheology[specific volume of erythrocytes(Hct),reduced area of atherosclerotic plaque(AP),plasma viscosity(PV),fibrinogen(FIB)],serum cytokine levels[plasminogen(PLG),plasmaβ-thromboglobulin(β-TG),thromboxane B_(2)(TXB_(2)),adenosine monophosphate(cAMP)]and adverse reactions in the two groups were compared.Results The total effective rate of the study group was 91.30%and that of the conventional group was 76.09%(P<0.05).After treatment,compared with the conventional group,the NIHSS score in the study group was lower,and the MoCA and FMA scores were higher(P<0.05).After treatment,PV in the study group were shorter than that in the conventional group,Hct and FIB in the study group were lower than those in the conventional group,and AP reduced area was smaller than that in the conventional group(P<0.05).After treatment,compared with the conventional group,β-TG,TXB_(2),PLG were lower and cAMP was higher in the study group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups during treatment(P>0.05).Conclusion Xiaoshuan Ningxin decoction in the treatment of ACCE can improve the ne

关 键 词：心源性脑梗死 消栓宁心汤 马来酸桂哌齐特 

分 类 号：R277.7[医药卫生—中医学]