益气通络汤加减治疗脑梗死恢复期临床研究  

Clinical Study on Modified Yiqi Tongluo Decoction for Cerebral Infarction in Convalescence

作　　者：陈和禾 许美飞[1] 余静[1] 张禄晗 祝飞虹[1] 潘雅莉[1] 朱伟新[1] CHEN Hehe;XU Meifei;YU Jing;ZHANG Luhan;ZHU Feihong;PAN Yali;ZHU Weixin

机构地区：[1]金华市中心医院,浙江金华321000

出　　处：《新中医》2023年第7期85-89,共5页New Chinese Medicine

基　　金：金华市社会发展类重点项目(2020-3-044)。

摘　　要：目的:观察益气通络汤加减治疗脑梗死恢复期的临床疗效及对血清血小板活化因子(PAF)、同型半胱氨酸(HCY)、白细胞介素-18(IL-18)、内皮素-1(ET-1)、一氧化氮(NO)、内脂素的影响。方法:将110例脑梗死恢复期患者按随机数字表法分为治疗组和常规组各55例,常规组予常规西药治疗,治疗组在常规组的基础上给予益气通络汤加减治疗。比较2组临床疗效,并比较2组治疗前后中医证候积分、血管内皮功能、简化肢体运动功能Fugl-Meyer(FMA)评分、美国国立卫生研究院卒中量表评分(NIHSS)及血清PAF、HCY、IL-18、内脂素水平。结果:治疗组临床总有效率94.55%,高于常规组72.73%(P<0.05)。治疗前,2组偏瘫、神识昏蒙、言语謇涩、口舌歪斜、面色无华、气短乏力中医证候积分比较,差异均无统计学意义(P>0.05);治疗后,2组上述中医证候积分均降低(P<0.05),且治疗组低于常规组(P<0.05)。治疗前,2组NO、ET-1水平比较,差异无统计学意义(P>0.05);治疗后,2组NO水平均升高(P<0.05),ET-1水平均降低(P<0.05),且治疗组NO水平高于常规组(P<0.05),ET-1水平低于常规组(P<0.05)。治疗前,2组FMA、NIHSS评分比较,差异无统计学意义(P>0.05);治疗后,2组FMA评分上升(P<0.05),NIHSS评分下降(P<0.05),且治疗组FMA评分高于常规组(P<0.05),NIHSS评分低于常规组(P<0.05)。治疗前,2组血清PAF、HCY、IL-18、内脂素水平比较,差异无统计学意义(P>0.05);治疗后,2组血清PAF、HCY、IL-18、内脂素水平均降低(P<0.05),且治疗组低于常规组(P<0.05)。结论:益气通络汤加减联合常规西药治疗脑梗死恢复期不仅能提升临床有效率,改善患者中医证候、血管内皮、肢体运动及神经功能,还能降低血清PAF、HCY、IL-18、内脂素水平。Objective:To observe the clinical effect of modified Yiqi Tongluo Decoction for cerebral infarction in convalescence and its effect on platelet activating factor(PAF),homocysteine(HCY),interleukin-18(IL-18),endothelin-1(ET-1),nitric oxide(NO),and visfatin in serum.Methods:A total of 110 cases of patients with cerebral infarction in convalescence were divided into the treatment group and the routine group according to the random number table method,with 55 cases in each group.The routine group was treated with routine western medicine,and the treatment group was additionally treated with modified Yiqi Tongluo Decoction based on the treatment of the routine group.The traditional Chinese medicine(TCM)syndrome scores,vascular endothelial function,simplified Fugl-Meyer Assessment(FMA)scores,National Institutes of Health Stroke Scale(NIHSS)scores,and levels of PAF,HCY,IL-18,and visfatin in serum before and after treatment,as well as the clinical effects were compared between the two groups.Results:The total clinical effective rate was 94.55%in the treatment group,higher than that of 72.73%in the routine group(P<0.05).Before treatment,there was no significant difference being found in the comparison of TCM syndrome scores including hemiplegia,mental confusion,sluggish speech,deviated mouth and tongue,white complexion,and short breath and fatigue between the two groups(P>0.05).After treatment,the above TCM syndrome scores in the two groups were decreased(P<0.05),and the scores in the treatment group were lower than those in the routine group(P<0.05).Before treatment,there was no significant difference being found in the comparison of levels of NO and ET-1 between the two groups(P>0.05).After treatment,the NO levels in the two groups were increased(P<0.05),and ET-1 levels were decreased(P<0.05);NO level in the treatment group was higher than that in the routine group(P<0.05),and ET-1 level was lower than that in the routine group(P<0.05).Before treatment,there was no significant difference being found in the comparison of

关 键 词：脑梗死恢复期 益气通络汤 血小板活化因子 同型半胱氨酸 白细胞介素-18 内脂素 中医证候积分 神经功能 

分 类 号：R743.33[医药卫生—神经病学与精神病学] R277.7[医药卫生—临床医学]