基于脑肠联动理论的凉血通瘀法治疗缺血性中风瘀热互结证的疗效观察  

Clinical Efficacy of Cooling Blood and Promoting Blood Stasis Method in the Treatment of Ischemic Stroke with Stasis-heat Interconnection

作　　者：何小刚[1] 张蓉 阚丽娟[1] 张怡 蔡秋芳[1] 许春阳 HE Xiaogang;ZHANG Rong;KAN Lijuan;ZHANG Yi;CAI Qiufang;XU Chunyang(Kunshan Hospital of Chinese Medicine,Kunshan 215300,Jiangsu,China)

机构地区：[1]昆山市中医医院,江苏昆山215300

出　　处：《中西医结合心脑血管病杂志》2023年第23期4416-4420,共5页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：2018年昆山市级科技专项项目(No.KS18024)。

摘　　要：目的:探讨基于脑肠联动理论的凉血通瘀法治疗缺血性中风瘀热互结证的疗效。方法:选取2020年1月—2022年1月100例缺血性中风瘀热互结证病人,按照随机信封法分为西药组、联合组,各50例。西药组给予西医常规治疗,联合组在此基础上给予基于脑肠联动理论的凉血通瘀法治疗。比较两组临床疗效、安全性以及治疗前、治疗14 d后美国国立卫生研究院卒中量表(NIHSS)评分、日常生活活动能力评定量表(ADL)评分、胃肠功能障碍评分、胃肠症状积分、脑肠肽(CCK-8)、核因子-κB(NF-κB)、白细胞介素-1(IL-1)、肿瘤坏死因子-α(TNF-α),采用Pearson分析胃肠功能与CCK-8、NF-κB、IL-1、TNF-α的相关性,CCK-8与NF-κB、IL-1、TNF-α、NIHSS评分的相关性。结果:联合组治疗14 d后总有效率96.00%,高于西药组的84.00%(P<0.05);联合组治疗14 d后NIHSS评分低于西药组,ADL评分高于西药组(P<0.01);联合组治疗14 d后胃肠功能障碍评分、胃肠症状积分低于西药组(P<0.001);联合组治疗14 d后CCK-8、NF-κB、IL-1、TNF-α低于西药组(P<0.001);联合组不良反应发生率为2.00%,与西药组的4.00%比较,差异无统计学意义(P>0.05);治疗前、治疗14 d后胃肠功能障碍评分、胃肠症状积分与对应时间点CCK-8、NF-κB、IL-1、TNF-α呈正相关(P<0.001);治疗前、治疗14 d后CCK-8与对应时间点NF-κB、IL-1、TNF-α呈正相关(P<0.001);治疗前、治疗14 d后CCK-8、NF-κB、IL-1、TNF-α与对应时间点NIHSS评分呈正相关(P<0.001)。结论:基于脑肠联动理论的凉血通瘀法治疗中风瘀热互结证,可改善胃肠功能,调控脑-肠轴CCK-8/NF-κB/IL-1信号通路,发挥抗炎与减少神经功能缺损作用,从而增强疗效,提高病人日常生活能力。Objective:To explore the effect and mechanism of the method of cooling blood and promoting blood stasis in the treatment of apoplexy with stasis and heat.Methods:A total of 100 patients with ischemic stroke syndrome of stasis and heat interjunction were divided into western medicine group and combined group according to random envelope method,with 50 cases of each group.The western medicine group was given the conventional western medicine,and the combined group was given the treatment of cooling blood and promoting blood stasis based on the theory of brain-gut linkage.The efficacy,safety,and scores of National Institutes of Health Stroke Scale(NIHSS),Activities of Daily Living(ADL)scale,gastrointestinal dysfunction score,gastrointestinal symptom score,before and after 14 days of treatment were compared between two groups.The relationship between gastrointestinal function and brain-gut peptide(CCK-8),nuclear factor-κB(NF-κB),interleukin-1(IL-1),tumor necrosis factor-α(TNF-α),the relationship between CCK-8 and NF-κB,IL-1 and TNF-α,and the relationship between CCK-8 and NIHSS score were analyzed by Pearson.Results:After 14 days of treatment,the total effective rate of the combination group was 96.00%,which was higher than that of the western medicine group(84.00%)(P<0.05).After treatment,the NIHSS score in combination group was lower than that of the western medicine group,ADL score was higher than that of the western medicine group(P<0.01).After treatment,the gastrointestinal dysfunction score and gastrointestinal symptoms score in combination group were lower than those in the western medicine group(P<0.001).After treatment,CCK-8,NF-κB,IL-1,and TNF-αin combination group were lower than those in the western group(P<0.001).There was no significant difference in the incidence of adverse reactions between the combined group(2.00%)and the western group(4.00%)(P>0.05).Gastrointestinal dysfunction score and gastrointestinal symptom score were positively correlated with CCK-8,NF-κB,IL-1,and TNF-αat the correspo

关 键 词：中风 脑肠联动理论 凉血通瘀法 瘀热互结证 胃肠功能 脑肠肽 核因子-ΚB 白细胞介素-1 

分 类 号：R255.2[医药卫生—中医内科学]