黄芪桂枝五物颗粒联合阿加曲班治疗大动脉粥样硬化性缺血性脑卒中患者对其炎症因子及神经损伤标志物的影响  

Effect of Huangqi Guizhi Wuwu Granule Combined with Argatroban on Inflammatory Factors and Nerve Injury Markers in Patients with Large Artery Atherosclerotic Ischemic Stroke

作　　者：陈曦光 张慧永[1] 李林[1] 乔艳丽[2] 张国妮[1] CHEN Xi-guang;ZHANG Hui-yong;LI Lin;QIAO Yan-li;ZHANG Guo-ni(First Department of Encephalopathy,Anyang Hospital of Traditional Chinese Medicine,Anyang Henan 455000;Department of Emergency,Anyang Hospital of Traditional Chinese Medicine,Anyang Henan 455000)

机构地区：[1]河南省安阳市中医院脑病一科,河南安阳455000 [2]河南省安阳市中医院急诊科,河南安阳455000

出　　处：《世界中西医结合杂志》2023年第2期319-323,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：河南省中医药科学研究专项课题/安阳市科技计划项目(2015ZY03023)。

摘　　要：目的探讨黄芪桂枝五物颗粒联合阿加曲班治疗大动脉粥样硬化性缺血性脑卒中患者对其炎症因子及神经损伤标志物的影响。方法选取2020年1月—2022年1月期间河南省安阳市中医院收治的大动脉粥样硬化型缺血性脑卒中患者100例,按随机数字表法分为对照组和观察组,每组各50例。两组患者均予以基础治疗,对照组采用硫酸氢氯吡格雷片联合阿加曲班注射液治疗,观察组在对照组的基础上加用黄芪桂枝五物颗粒治疗。两组患者均连续用药14 d后进行疗效评估,检测治疗前后两组患者炎症因子[肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、白细胞介素-6(Interleukin-6,IL-6)]及神经损伤标志物[S100β蛋白(S100βprotein)、神经元特异性烯醇化酶(Neuron-specific enolase,NSE)、谷氨酸(Glutamic acid,Glu)]水平,比较两组患者治疗前后中医证候积分、美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分,并记录两组患者用药期间不良反应发生情况。结果治疗后观察组治疗总有效率92.00%(46/50)高于对照组72.00%(36/50),差异有统计学意义(P<0.05)。治疗后两组患者中医证候积分及NIHSS评分均较治疗前下降,差异有统计学意义(P<0.05);且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血清炎症因子及神经损伤标志物较治疗前降低,差异有统计学意义(P<0.05);且观察组血清S100β蛋白、NSE、Glu、IL-6及TNF-α水平明显低于对照组,差异有统计学意义(P<0.05)。观察组用药期间不良反应发生率8.00%(4/50)低于对照组10.00%(5/50),差异有统计学意义(P<0.05)。结论黄芪桂枝五物颗粒联合阿加曲班是治疗LAA缺血性脑卒中的有效方案,调节炎症因子及神经损伤标志物水平,从而改善患者临床症状,促进神经功能恢复。Objective To explore the effect of Huangqi Guizhi Wuwu Granule combined with Argatroban on inflammatory factors and nerve injury markers in patients with large artery atherosclerotic ischemic stroke.Methods A total of 100 patients with large artery atherosclerotic ischemic stroke treated in Anyang Hospital of Traditional Chinese Medicine from January 2020 to January 2022 were divided into a control group(n=50)and an observation group(n=50)according to random number table.Both groups were given basic treatment.The control group was treated with Clopidogrel Hydrogen Sulfate Tablets combined with Argatroban injection,while the observation group was treated with Huangqi Guizhi Wuwu Granule on the basis of the control group.After 14 days of continuous treatment,the efficacy of the two groups was evaluated,and the levels of inflammatory factors including tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and nerve injury markers[S100βprotein,neuron-specific enolase(NSE)and glutamic acid(Glu)],traditional Chinese medicine(TCM)syndrome score,and National Institutes of Health Stroke Scale(NIHSS)score in the two groups before and after treatmentwere detected and compared.The adverse reactions in the two groups during treatment were also recorded.Results The total effective rate of the observation group(92.00%,46/50)was higher than that(72.00%,36/50)of the control group(P<0.05).Compared with the conditions before treatment,the TCM syndrome score and the NIHSS score in both groups after treatment were decreased(P<0.05),and the observation group had more decrease than the control group(P<0.05).Additionally,the levels of serum inflammatory factors(IL-6 and TNF-α)and nerve injury markers(S100βprotein,NSE,Glu)in both groups after treatment were lower than those before treatment(P<0.05),and the observation group had more reduction than the control group in the above indexes(P<0.05).There was difference in the incidence of adverse reactions between the observation group(8.00%,4/50)and the control group(10.00%,5/50)during treat

关 键 词：黄芪桂枝五物颗粒 阿加曲班 大动脉粥样硬化型 缺血性脑卒中 炎症因子 神经损伤标志物 

分 类 号：R743[医药卫生—神经病学与精神病学]