半夏白术天麻汤合补阳还五汤加减结合西医常规疗法治疗缺血性卒中气虚血瘀证的临床研究  

Clinical study of Banxia Baizhu Tianma Decoction combined with modified Buyang Huanwu Decoction and routine western medicine in the treatment of ischemic stroke with qi-deficiency blood stasis syndrome

作　　者：杨丽霞 彭志华 袁双双 崔韶阳 Yang Lixia;Peng Zhihua;Yuan Shuangshuang;Cui Shaoyang(Department of Rehabilitation,Shenzhen Hospital(Futian),Guangzhou University of Chinese Medicine,Shenzhen 518034,China)

机构地区：[1]广州中医药大学深圳医院(福田)康复科,深圳518034

出　　处：《国际中医中药杂志》2023年第1期37-41,共5页International Journal of Traditional Chinese Medicine

摘　　要：目的评价半夏白术天麻汤合补阳还五汤加减结合西医常规疗法治疗缺血性卒中的疗效。方法前瞻性队列研究。将符合入选标准的2019年6月-2021年6月本院120例缺血性卒中患者,采用随机数字表法分为2组,每组60例。对照组予以西医常规疗法治疗,治疗组在对照组基础上予以半夏白术天麻汤合补阳还五汤加减治疗。2组均治疗4周。采用美国国立卫生研究院卒中量表(NIHSS)评价神经功能缺损程度,Barthel指数评价日常生活能力,以全自动血液流变仪检测患者全血高切黏度(HWBV)、全血低切黏度(LWBV)、纤维蛋白原(FIB)、血浆黏度(PV),ELISA法检测MDA、SOD、NO水平,评价临床疗效。结果治疗组总有效率为93.3%(56/60)、对照组为75.0%(45/60),2组比较差异有统计学意义(χ^(2)=7.56,P=0.006)。治疗组治疗后NIHSS评分低于对照组(t=2.38,P=0.019),Barthel指数高于对照组(t=13.28,P<0.01)。治疗后,治疗组HWBV[(5.02±0.13)mPa∙s比(6.18±0.28)mPa∙s,t=29.11]、LWBV[(1.18±0.21)mPa∙s比(1.73±0.32)mPa∙s,t=11.13]、FIB[(2.26±0.28)g/L比(3.13±0.39)g/L,t=14.04]、PV[(8.87±1.44)mPa∙s比(10.34±1.31)mPa∙s,t=5.85]低于对照组(P<0.01);MDA[(4.14±1.23)mmol/L比(5.23±1.35)mmol/L,t=204.30]水平低于对照组(P<0.01),SOD[(113.34±0.28)mg/L比(96.59±0.57)mg/L,t=4.62]、NO[(26.01±3.26)μmol/L比(20.84±3.74)μmol/L,t=8.07]水平高于对照组(P<0.01)。结论半夏白术天麻汤合补阳还五汤加减结合西医常规疗法可有效修复缺血性卒中患者的神经功能,改善血液流变学和氧化应激指标,提高疗效及日常生活能力。Objective To evaluate the effect of Banxia Baizhu Tianma Decoction combined with modified Buyang Huanwu Decoction and routine western medicine on ischemic stroke.Methods Prospective cohort study.According to random number table method,120 patients with ischemic stroke who met inclusion criteria in the hospital were divided into control group and treatment group,60 in each group.The control group was given routine western medicine,while the treatment group was additionally given Banxia Baizhu Tianma Decoction and modified Buyang Huanwu Decoction.All were treated for 4 weeks.The severity of neurological deficits was evaluated by National Institute of Health Stroke Scale(NIHSS).The activities of daily living were evaluated by Barthel index.The high blood shear viscosity(HWBV),low blood shear viscosity(LWBV),plasma fibrinogen(FIB)and plasma viscosity(PV)were detected by full-automatic blood rheometer.The levels of MDA,SOD and NO were detected by ELISA.The clinical responsive rate was assessed.Results The differences in total response rate between treatment group and control group were statistically significant[93.3%(56/60)vs.75.0%(45/60),χ^(2)=7.56,P=0.006].After treatment,NIHSS score in treatment group was significantly lower than that in control group(t=2.38,P=0.019),while Barthel index was significantly higher than that in control group(t=13.28,P<0.01).After treatment,HWBV[(5.02±0.13)mPa∙s vs.(6.18±0.28)mPa∙s,t=29.11],LWBV[(1.18±0.21)mPa∙s vs.(1.73±0.32)mPa∙s,t=11.13],FIB[(2.26±0.28)g/L vs.(3.13±0.39)g/L,t=14.04]and PV[(8.87±1.44)mPa∙s vs.(10.34±1.31)mPa∙s,t=5.85]in treatment group were significantly lower than those in control group(P<0.01),and the MDA[(4.14±1.23)mmol/L vs.(5.23±1.35)mmol/L,t=204.30]in treatment group was significantly lower than that in control group(P<0.01),and levels of SOD[(113.34±0.28)mg/L vs.(96.59±0.57)mg/L,t=4.62]and NO[(26.01±3.26)μmol/L vs.(20.84±3.74)μmol/L,t=8.07]in treatment group were significantly higher than those in control group(P<0.01).Conclusion Th

关 键 词：缺血性卒中 中风(中医) 半夏白术天麻汤 补阳还五汤 血液流变学 氧化性应激 

分 类 号：R743.3[医药卫生—神经病学与精神病学]