益气解毒通络汤联合尤瑞克林治疗急性脑梗死临床疗效观察  

Clinical Observation of Yiqi Jiedu Tongluo Decoction(益气解毒通络汤)Combined with Urinary Kallindinogenase in Treatment of Acute Cerebral Infarction

作　　者：张承亮 徐晏雯 郑康 杨铭 王传刘 ZHANG Chengliang;XU Yanwen;ZHENG Kang;YANG Ming;WANG Chuanliu(Quzhou Hospital Affiliated to Wenzhou Medical University,Quzhou 324300,Zhejiang,China)

机构地区：[1]温州医科大学附属衢州医院,浙江衢州324300

出　　处：《中华中医药学刊》2023年第3期223-226,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：浙江省自然科学基金(LY19H090013);浙江省医学会临床科研基金项目(2021ZYC-A210)。

摘　　要：目的分析益气解毒通络汤结合尤瑞克林治疗对急性脑梗死患者血流动力学的影响及疗效。方法选择2017年8月—2019年3月来医院接受治疗的60例急性脑梗死病人为观察对象。尤瑞克林组(30例):常规疗法+尤瑞克林;结合组(30例):常规疗法+尤瑞克林+益气解毒通络汤。对两组治疗前后神经功能缺损程度评估[国立卫生研究院卒中量表(natinal institute f health strke scale,NIHSS)评分、病情严重程度(modified rankin scale,mRS)评分量表、Barth指数(BI)评定量表]、脑梗死体积、炎症因子水平[肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-1α(interleukin-1α,IL-1α)、白细胞介素-1β(interleukin-1β,IL-1β)、白细胞介素-6(interleukin-6,IL-6)和白细胞介素17(interleukin-17,IL-17)]、氧化应激反应[脂蛋白磷脂酶A2(lipoprotein phospholipase A2,Lp-PLA2)、总超氧化物歧化酶(total superoxide dismutase,T-SOD)]及锰超氧化物歧化酶(manganese superoxide dismutase,Mn-SOD)]及临床疗效。结果治疗后病人NIHSS评分、mRS评分和脑梗死体积均减少,BI指数评分提高且结合组NIHSS评分、mRS评分、BI指数评分和脑梗死体积降幅更大(P<0.05);结合组临床总有效率高于尤瑞克林组(P<0.05);治疗后病人TNF-α、IL-1α、IL-1β、IL-6和IL-17均降低且结合组降幅更大(P<0.05);治疗后病人T-SOD和Mn-SOD水平升高,Lp-PLA2水平降低且结合组各指标优化幅度更大(P<0.05)。结论益气解毒通络汤结合尤瑞克林对抑制急性脑梗死病人相关炎症因子、氧化应激反应相关因子的表达有积极作用,能够优化病人神经功能及病情,减小脑梗死体积、提高疗效,值得推广。Objective To analyze the effect of Yiqi Jiedu Tongluo Decoction(益气解毒通络汤)combined with urinary kallindinogenase on hemodynamics of patients with acute cerebral infarction.Methods Sixty patients with acute cerebral infarction who received treatment in the hospital from August 2017 to March 2019 were selected as the observation objects.The urinary kallindinogenase group(30 cases)used conventional therapy+urinary kallindinogenase therapy.The combination group(30 cases)used conventional therapy+urinary kallindinogenase therapy+Yiqi Jiedu Tongluo Decoction.The degree of neurological impairment[National Institute of Health Stroke Scale(NIHSS)score],the severity of disease[Modified Rankin Scale(mRS)],Barth Index(BI)Scale,cerebral infarction volume,inflammatory factor levels[(tumor necrosis factor-α(TNF-α),interleukin-1α(IL-1α),interleukin-1β(IL-1β),interleukin-6(IL-6)and interleukin-17(IL-17)],oxidative stress reaction[lipoprotein phospholipase A2(LP-PLA2),total superoxide dismutase(T-SOD)]and manganese superoxide dismutase(Mn-SOD)]in the two groups before and after treatment and the clinical efficacy were compared.Results After treatment,the scores of NIHSS and mRS and cerebral infarction volume decreased,while BI index score increased.And the changes of NIHSS,mRS and BI index score and cerebral infarction volume were more obviously in the combination group(P<0.05).The total clinical effective rate in the combination group was higher than that in urinary kallindinogenase group(P<0.05).After treatment,the levels of TNF-α,IL-1α,IL-1β,IL-6 and IL-17 decreased,and the decrease was more significant in the combination group(P<0.05).After treatment,the levels of T-SOD and Mn-SOD in patients increased,while the levels of LP-PLA2 decreased,and the improvement of indexes in the combination group was greater(P<0.05).Conclusions Yiqi Jiedu Tongluo Decoction combined with urinary kallindinogenase therapy has a positive effect on inhibiting the expressions of inflammatory factors and oxidative stress response r

关 键 词：急性脑梗死 益气解毒通络汤 尤瑞克林治疗 炎症因素 超氧化物歧化酶 

分 类 号：R277.743.3[医药卫生—中医学]