真方白丸子联合注射用阿替普酶对急性缺血性卒中风痰入络证患者血清炎症因子及血管内皮活性物质的影响  

Effects of Zhenfang Baiwanzi Decoction combined with alteplase injection on serum inflammatory factors and vascular endothelial active substances in the patients with acute ischemic stroke and syndrome of wind-phlegm invading collaterals

作　　者：宗芳[1] 陈永华 代玉强 Zong Fang;Chen Yonghua;Dai Yuqiang(Department of Encephalopathy,Mengcheng County Hospital of Traditional Chinese Medicine,Mengcheng 233500,China;Department of Encephalopathy,Anhui Provincial Hospital of Traditional Chinese Medicine,Hefei 230000,China)

机构地区：[1]蒙城县中医院脑病科,蒙城233500 [2]安徽省中医院干部脑病科,合肥230000

出　　处：《国际中医中药杂志》2023年第9期1075-1080,共6页International Journal of Traditional Chinese Medicine

基　　金：安徽高校自然科学研究项目(KJ2018A0286)。

摘　　要：目的探讨真方白丸子联合注射用阿替普酶对急性缺血性卒中(AIS)患者血清炎症因子、血管内皮活性物质的影响。方法随机对照试验研究。选择2019年6月-2022年7月蒙城县中医院87例AIS患者作为观察对象,按病历尾号分为治疗组44例、对照组43例。对照组在常规治疗基础上结合注射用阿替普酶溶栓,治疗组在对照组基础上服用真方白丸子。2组均治疗2周。分别于治疗前后进行中医症状评分;采用美国国立卫生研究院卒中量表(NIHSS)评估神经功能缺损程度,日常生活活动能力量表(ADL)评估生活质量,采用ELISA法检测血清IL-6、CRP、TNF-α、单核细胞趋化蛋白-1(MCP-1)、VEGF、NOS、内皮素-1(ET-1)水平,记录不良反应,评价临床疗效。结果治疗组总有效率为93.18%(41/44)、对照组为76.74%(33/43),2组比较差异有统计学意义(χ^(2)=4.62,P=0.032)。治疗组治疗后半身不遂、肌肤不仁、口眼歪斜、语言不利、头痛眩晕积分低于对照组(t值分别为3.38、3.77、2.69、2.60、2.36,P<0.01或P<0.05);NIHSS评分低于对照组(t=7.53,P<0.01),ADL评分高于对照组(t=2.99,P<0.01)。治疗后,治疗组血清IL-6、CRP、TNF-α、MCP-1水平低于对照组(t值分别为6.07、5.70、5.30、3.36,P<0.01);VEGF[(364.54±33.04)ng/L比(346.86±29.63)ng/L,t=2.63]水平高于对照组(P<0.05),NOS[(20.77±3.12)μmol/L比(29.46±5.36)μmol/L,t=9.27]、ET-1[(85.41±7.09)ng/L比(94.11±9.38)ng/L,t=4.89]水平低于对照组(P<0.01)。结论真方白丸子联合注射用阿替普酶可改善AIS患者的临床症状,降低炎症因子水平,保护血管内皮功能,提高疗效。Objective To explore the effects of Zhenfang Baiwanzi Decoction combined with alteplase injection on serum inflammatory factors and vascular endothelial active substances in patients with acute ischemic stroke(AIS).Methods Randomized controlled trial.A total of 87 patients with AIS admitted to Mengcheng County Hospital of Traditional Chinese Medicine between June 2019 and July 2022 were selected as the observation subjects by prospective cohort study,and they were divided into treatment group(44 cases)and control group(43 cases)according to the last number of medical records.The control group was given thrombolytic therapy with alteplase injection on the basis of routine therapy,and the treatment group was given Zhenfang Baiwanzi Decoction on the basis of the control group.Both groups were treated for 2 weeks.TCM symptoms were scored before and after treatment,and National Institutes of Health Stroke Scale(NIHSS)was used to evaluate the degree of neurological deficit,and Activity of Daily Living Scale(ADL)was applied to evaluate the quality of life.The levels of serum IL-6,CRP,TNF-α,monocyte chemoattractant protein-1(MCP-1),VEGF,NOS and endothelin-1(ET-1)were detected by ELISA.The adverse reactions were recorded and the clinical efficacy was evaluated.Results The total effective rate was 93.18%(41/44)in treatment group and 76.74%(33/43)in control group(χ^(2)=4.62,P=0.032).After treatment,the scores of hemiparalysis,skin insensitivity,deviated mouth and eye,inhibited speech and headache and dizziness in treatment group were significantly lower than those in the control group(t=3.38,3.77,2.69,2.60,2.36,P<0.01 or P<0.05).The NIHSS score was significantly lower than that of the control group(t=7.53,P<0.01)while the ADL score was significantly higher than that of the control group(t=2.99,P<0.01).After treatment,the levels of serum IL-6,CRP,TNF-αand MCP-1 in treatment group were significantly lower than those in the control group(t=6.07,5.70,5.30,3.36,P<0.01),and the levels of VEGF[(364.54±33.04)ng/L vs.(346.86±29

关 键 词：缺血性卒中 风痰入络 炎症因子 真方白丸子 注射用阿替普酶 

分 类 号：R743.3[医药卫生—神经病学与精神病学]