益气活血通络汤联合醒脑静注射液治疗脑出血临床研究  

Clinical Study on Yiqi Huoxue Tongluo Decoction Combined with Xingnaojing Injection for Cerebral Hemorrhage

作　　者：吴云龙 雷兵[2] 林聪利 WU Yunlong;LEI Bing;LIN Congli

机构地区：[1]仙居县中医院外科,浙江仙居317300 [2]浙江省人民医院神经外科,浙江杭州310014

出　　处：《新中医》2023年第6期31-36,共6页New Chinese Medicine

摘　　要：目的:观察在常规疗法基础上加用益气活血通络汤联合醒脑静注射液治疗脑出血患者的效果。方法:纳入70例气虚血瘀型脑出血患者,通过随机数字表法分为对照组、观察组各35例。2组均予脱水降颅压、吸氧,平衡水、电解质等常规疗法与醒脑静注射液治疗,观察组加予益气活血通络汤治疗。2组均治疗14 d。分别于治疗前1 d及治疗14 d后评定中医证候积分,通过中国卒中量表(CSS)评定患者的神经功能,通过脑血管血液动力学分析仪检测脑血管平均血流速度、血管外周阻力,通过血流动力学分析仪检测收缩峰血流速度(Vs)、平均血流速度(Vm),检测肿瘤坏死因子-α (TNF-α)、白细胞介素-10 (IL-10)、视黄醇结合蛋白4 (RBP4)、趋化因子受体-4 (CXCR-4)水平。比较2组的临床疗效。结果:治疗14 d后,观察组临床疗效总有效率高于对照组(P<0.05)。2组CSS评分及气短乏力、偏身麻木、言语謇涩、感觉减退积分均较治疗前降低,差异均有统计学意义(P<0.05);观察组以上5项分值均低于对照组,差异均有统计学意义(P<0.05)。2组脑血管平均血流速度、Vs、Vm均较治疗前加快,血管外周阻力值均较治疗前降低,差异均有统计学意义(P<0.05);观察组脑血管平均血流速度、Vs、Vm均较对照组加快,血管外周阻力值低于对照组,差异均有统计学意义(P<0.05)。2组TNF-α、RBP4水平均较治疗前降低,IL-10、CXCR-4水平均较治疗前升高,差异均有统计学意义(P<0.05);观察组TNF-α、RBP4水平均低于对照组,IL-10、CXCR-4水平均高于对照组,差异均有统计学意义(P<0.05)。结论:在常规疗法基础上使用益气活血通络汤联合醒脑静注射液对气虚血瘀型脑出血患者进行治疗,可有效改善脑血管功能,恢复神经功能,减轻炎症反应,改善血流动力学,调节机体免疫应答,显著改善病情。Objective:To observe the clinical effect of Yiqi Huoxue Tongluo Decoction combined with Xingnaojing Injection on patients with cerebral hemorrhage based on routine therapies. Methods:A total of70 patients with cerebral hemorrhage with qi deficiency and blood stasis syndrome were included and divided into the control group and the observation group according to the random number table method,with 35 cases in each group. The two groups were given routine therapies, including dehydration for lowering intracranial pressure,oxygen inhalation and maintaining water and electrolyte balance,as well as Xingnaojing Injection, and the observation group was additionally treated with Yiqi Huoxue Tongluo Decoction. The two groups were treated for 14 days. Before treatment and after fourteen days of treatment,the traditional Chinese medicine(TCM) syndrome scores in both groups were determined,the neurological function of patients were evaluated by Chinese Stroke Scale(CSS),the mean blood velocity and peripheral resistance of cerebral vessel were detected by cerebral vessel hemodynamic analysis,the peak systolic velocity(Vs),mean blood velocity(Vm) were detected by hemodynamic monitor and levels of tumor necrosis factor-α(TNF-α),interleukin-10(IL-10),retinol binding protein 4(RBP4) and chemokine receptor-4(CXCR-4) were detected. The clinical effects in the two groups were compared. Results:After fourteen days of treatment,the total clinical effective rate in the observation group was higher than that in the control group(P<0.05). The CSS scores and TCM syndrome scores of shortness of breath and lack of strength,hemianesthesia,dysphasia and hypoesthesia in both groups were decreased when compared with those before treatment,differences being significant(P<0.05);the above 5 scores in the observation group were lower than those in the control group(P<0.05). The mean blood velocity of cerebral vessel,Vs and Vm in both groups were increased when compared with those before treatment,and the peripheral resistance of cerebral vessel wa

关 键 词：脑出血 气虚血瘀证 益气活血通络汤 视黄醇结合蛋白4 趋化因子受体-4 

分 类 号：R743.34[医药卫生—神经病学与精神病学] R277.7[医药卫生—临床医学]