通络扶正汤对脑卒中后遗症患者血清Wnt3a、Wnt5a表达量及神经功能影响分析  

Analysis of the Effect of Tongluo Fuzheng Decoction on Serum Wnt3a and Wnt5a Expression Levels and Neurological Function in Patients with Sequelae of Cerebral Apoplexy

作　　者：顾亮亮[1] 乔鑫 傅国惠 沈雷 梁燕 梁新明[1] 武海博 范崇桂[1] GU Liang-Liang;QIAO Xin;FU Guo-Hui;SHEN Lei;LIANG Yan;LIANG Xin-Ming;WU Hai-Bo;FAN Chong-Gui(Dept.of Neurology,Nanyang Central Hospital,Nanyang 473000 Henan,China)

机构地区：[1]南阳市中心医院神经内科,河南南阳473000

出　　处：《广州中医药大学学报》2024年第2期313-321,共9页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：河南省科技厅科技攻关项目(编号:202102310408)。

摘　　要：【目的】分析通络扶正汤(由胆南星、法半夏、桃仁、天麻、全蝎、红花、地龙等中药组成)对脑卒中后遗症患者神经功能及血清分泌型糖蛋白(Wnt)3a、Wnt5a表达量的影响。【方法】采用回顾性研究方法,根据治疗方案的不同将146例脑卒中后遗症风痰瘀阻证患者分为观察组和对照组,每组各73例。对照组给予常规西药及康复治疗,观察组在对照组的基础上给予通络扶正汤治疗,疗程为3周。观察2组患者治疗前后美国国立卫生研究院卒中量表(NIHSS)评分、Berg平衡量表(BBS)评分、Fugl-Meyer量表(FMA)评分、Holden步行功能分级(FAC)、躯干屈伸肌群表面肌电均方根值(RMS)及血清Wnt3a、Wnt5a表达量的变化情况,并比较2组患者的临床疗效和不良反应发生率。【结果】(1)治疗3周后,观察组的总有效率为95.89%(70/73),对照组为79.45%(58/73),组间比较,观察组的疗效明显优于对照组(P<0.01)。(2)治疗后,2组患者的NIHSS评分均较治疗前明显降低(P<0.05),BBS、FMA评分均较治疗前明显升高(P<0.05),且观察组对NIHSS评分的降低幅度及对BBS、FMA评分的升高幅度均明显优于对照组(P<0.01)。(3)治疗后,2组患者的FAC分级均较治疗前改善(P<0.05),且观察组对FAC分级的改善作用明显优于对照组(P<0.05)。(4)治疗后,2组患者的竖脊肌、腹直肌表面肌电RMS值均较治疗前明显升高(P<0.05),且观察组对竖脊肌、腹直肌表面肌电RMS值的升高幅度均明显优于对照组(P<0.01)。(5)治疗后,2组患者的血清Wnt3a、Wnt5a表达量均较治疗前明显升高(P<0.05),且观察组对血清Wnt3a、Wnt5a表达量的升高幅度均明显优于对照组(P<0.01)。(6)观察组的不良反应发生率为4.11%(3/73),对照组为6.85%(5/73),组间比较,差异无统计学意义(P>0.05)。【结论】通络扶正汤可有效减轻脑卒中后遗症患者神经功能受损程度及运动障碍,提高平衡能力及治疗效果,增强躯干屈伸肌群肌力,上�Objective To investigate the effects of Tongluo Fuzheng Decoction(mainly composed of the Chinese medicines of Arisaema Cum Bile,Pinelliae Rhizoma Praeparatum,Persicae Semen,Gastrodiae Rhizoma,Scorpio,Carthami Flos,and Pheretima)on the neurological function and the expression levels of serum secretory glycoprotein Wnt3a and Wnt5a in patients with sequelae of cerebral apoplexy.Methods A retrospective research was carried out in 146 patients with sequelae of cerebral apoplexy of wind-phlegm and stasis obstruction type.The patients were divided into observation group and control group according to the therapy,with 73 cases in each group.The control group was given conventional western medicine and rehabilitation treatment,while the observation group was given Tongluo Fuzheng Decoction on the basis of treatment for the control group.Both groups were treated for 3 weeks.Before and after treatment,the two groups were observed in the changes of National Institutes of Health Stroke Scale(NIHSS)score,Berg Balance Scale(BBS)score,Fugl-Meyer Scale(FMA)score,Holdenfunctionalambulationcategory(FAC)score,rootmeansquare(RMS)valueofsurfaceelectromyography of trunk flexors and extensors,and the expression levels of serum Wnt3a and Wnt5a.After treatment,the clinical efficacy and incidence of adverse reactions of the two groups were compared.Results(1)After 3 weeks of treatment,the total effective rate of the observation group was 95.89%(70/73),and that of the control group was 79.45%(58/73),and the intergroup comparison showed that the efficacy of the observation group was significantly superior to that of the control group(P<0.01).(2)After treatment,the NIHSS scores of the patients in the two groups were significantly lower(P<0.05)and the BBS and FMA scores were significantly higher than those before treatment(P<0.05),and the decrease of the NIHSS scores and the increase of the BBS and FMA scores in the observation group were significantly superior to those in the control group(P<0.01).(3)After treatment,the Holden FAC grading in

关 键 词：通络扶正汤 脑卒中后遗症 风痰瘀阻 临床疗效 分泌型糖蛋白 神经功能 

分 类 号：R255.2[医药卫生—中医内科学] R277.7[医药卫生—中医学]