化瘀通脉汤联合rt-PA静脉溶栓治疗气虚血瘀证脑卒中临床观察  

Clinical observation of Huayu Tongmai Decoction combined with rt-PA intravenous thrombolysis in treatment of cerebral apoplexy with Qi deficiency and blood stasis syndrome

作　　者：张慧媛 王伟伟[1] 邓福宝 杨晓倩[1] 张静静[1] ZHANG Huiyuan;WANG Weiwei;DENG Fubao(Department of Neurology,People's Hospital of Liaocheng City,Liaocheng Shandong 252000,China;Department of Traditional Chinese Medicine,People's Hospital of Liaocheng City,Liaocheng Shandong 252000,China)

机构地区：[1]聊城市人民医院神经内科,山东聊城252000 [2]聊城市人民医院中医科,山东聊城252000

出　　处：《四川中医》2024年第5期129-132,共4页Journal of Sichuan of Traditional Chinese Medicine

基　　金：山东省中医药科技重点项目(编号:Z-2022040)。

摘　　要：目的:探讨化瘀通脉汤联合rt-PA静脉溶栓治疗气虚血瘀证脑卒中的临床效果。方法:回顾性选取2020年9月~2023年9月聊城市人民医院收治的100例气虚血瘀证脑卒中患者为研究对象,根据治疗方法分为研究组61例及对照组39例。研究组采用化瘀通脉汤联合rt-PA静脉溶栓治疗,对照组采用rt-PA静脉溶栓治疗,比较两组临床症状评分、凝血状态、脑血流动力学及血清标志物水平。结果:治疗后研究组美国国立卫生院卒中量表(NIHSS)评分低于对照组,卒中影响量表(SIS)、Berg平衡量表(BBS)评分高于对照组(P<0.05);治疗后研究组凝固时间(KT)、凝血反应时间(RT)高于对照组,最大振幅(MA)、凝固角(α)低于对照组(P<0.05);治疗后研究组平均脑部动脉血流速度(Vm)、收缩期血流速度(Vs)、舒张末期血流速度(Vd)高于对照组,阻力指数(RI)低于对照组(P<0.05);治疗后研究组胶质纤维酸性蛋白(GFAP)、血管性血友病因子(vWF)、血管细胞黏附分子(VCAM-1)水平低于对照组(P<0.05)。结论:化瘀通脉汤联合rt-PA静脉溶栓治疗气虚血瘀证脑卒中可以降低患者神经功能损伤,改善日常活动能力,改善凝血状态,提高脑血流灌注,降低神经炎症。Objective To investigate the clinical effect of Huayu Tongmai Decoction combined with rt-PA intravenous thrombolytic therapy on stroke caused by Qi deficiency and blood stasis.Methods 100stroke patients with Qi-deficiency and blood-stasis syndrome admitted to Liaocheng People's Hospital from September 2019to September 2023(please add the name of the unit)were selected as the study objects,and were divided into 61cases in the study group and 39cases in the control group according to the treatment methods.The study group was treated with Huayu Tongmai Decoction combined with rt-PA intravenous thrombolytic therapy,and the control group was treated with rt-PA intravenous thrombolytic therapy.The clinical symptom score,coagulation status,cerebral hemodynamics and serum marker levels were compared between the two groups.Results After treatment,the score of National Institutes of Health Stroke Scale(NIHSS)in the study group was lower than that in the control group,and the score of Stroke Impact Scale(SIS)and Berg Balance Scale(BBS)was higher than that in the control group(P<0.05).After treatment,the coagulation time(KT)and coagulation reaction time(RT)of the study group were higher than those of the control group,and the maximum amplitude(MA)and coagulation Angle(α)of the study group were lower than those of the control group(P<0.05).After treatment,the average cerebral arterial blood flow velocity(Vm),systolic blood flow velocity(Vs)and end-diastolic blood flow velocity(Vd)of the study group were higher than those of the control group,and the resistance index(RI)was lower than that of the control group(P<0.05).After treatment the levels of glial fibrinolytic acid protein(GFAP),von Willefibrilia factor(vWF)and vascular cell adhesion molecule(VCAM-1)of the study group were lower than those of the control group(P<0.05).Conclusion Huayu Tongmai Decoction combined with rt-PA intravenous thrombolytic therapy for stroke syndrome of Qi deficiency and blood stasis can reduce nerve function injury,improve daily activity ability

关 键 词：化瘀通脉汤 RT-PA静脉溶栓 气虚血瘀证 脑卒中 

分 类 号：R743.3[医药卫生—神经病学与精神病学]