益气活血降浊汤配合丁苯酞对TIA患者的疗效及机制  

The curative effects of Yiqi Huoxue Jiangzhuo decoction combined with butylphthalide on patients with TIA and its mechanism

作　　者：刘振 刘世梅 王晓丽 王颖[1] LIU Zhen;LIU Shimei;WANG Xiaoli;WANG Ying(Nanyang First Peoples Hospital,Nanyang,Henan 473000,China)

机构地区：[1]南阳市第一人民医院,河南省南阳市473000

出　　处：《中国动脉硬化杂志》2024年第7期597-605,共9页Chinese Journal of Arteriosclerosis

基　　金：河南省医学科技攻关计划联合共建立项项目(LHGJ20200904)。

摘　　要：[目的]探讨益气活血降浊汤配合丁苯酞治疗短暂性脑缺血发作(TIA)的临床疗效和初步机制。[方法]选取南阳市第一人民医院2022年1月—2023年3月收治的120例TIA患者为研究对象,随机分为三组,各40例。对照1组予以丁苯酞,对照2组予以益气活血降浊汤,观察组予以益气活血降浊汤配合丁苯酞,治疗2个月。治疗2个月后比较三组临床疗效、不良反应发生率。比较治疗前及治疗1个月、2个月三组ABCD2评分、美国国立卫生研究院卒中量表(NIHSS)评分及血清生物化学指标[可溶性CD40配体(sCD40L)、脂蛋白相关磷脂酶A2(Lp-PLA2)、高敏C反应蛋白(hs-CRP)]水平、外周血Kelch样环氧氯丙烷相关蛋白1(Keap1)-核因子E2相关因子2(Nrf2)/抗氧化反应元件(ARE)信号通路相关蛋白(Keap1、Nrf2、ARE)水平及血流动力学指标[血流平均流速(Vm)、平均血流量(Qm)、脑血管阻力(R)]。[结果]观察组临床总有效率显著高于对照1组、对照2组(P<0.05),但两对照组之间比较差异无显著性(P>0.05);相较于治疗前,三组治疗1个月、2个月ABCD2评分和NIHSS评分呈显著下降趋势,且观察组下降幅度较对照1组、对照2组大(P<0.05),但两对照组比较差异无显著性(P>0.05);相较于治疗前,三组治疗1个月、2个月sCD40L、Lp-PLA2、hs-CRP呈显著下降趋势,且观察组下降幅度显著大于对照1组和对照2组(P<0.05);相较于治疗前,三组治疗1个月、2个月Keap1蛋白呈显著下降趋势,且观察组下降幅度较对照1组、对照2组大(P<0.05),但两对照组比较差异无显著性(P>0.05);相较于治疗前,三组治疗1个月、2个月Nrf2蛋白和ARE蛋白呈显著升高趋势,且观察组升高幅度较对照1组、对照2组大(P<0.05),但两对照组比较差异无显著性(P>0.05);相较于治疗前,三组治疗1个月、2个月Qm、Vm呈明显升高趋势,R呈显著下降趋势,且观察组Qm、Vm明显较对照1组、对照2组高,R显著较对照1组、对照2组低(P<0.05)�Aim To investigate the clinical efficacy and preliminary mechanism of Yiqi Huoxue Jiangzhuo decoction combined with butylphthalide in the treatment of transient ischemic attack(TIA).Methods A total of 120 patients with TIA admitted to the First Peoples Hospital of Nanyang from January 2022 to March 2023 were selected as the research subjects and randomly divided into three groups with 40 cases in each group.The control group 1 was given butylphthalide,the control group 2 was given Yiqi Huoxue Jiangzhuo decoction,and the observation group was given Yiqi Huoxue Jiangzhuo decoctionn combined with butylphthalide for 2 months of treatment.After 2 months of treatment,the clinical efficacy and adverse reaction rate were compared among the three groups.The ABCD2 scores,national institute of health stroke scale(NIHSS)scores,and serum biochemical indicators(soluble CD40 ligand(sCD40L),lipoprotein-associated phospholipase A2(Lp-PLA2),high-sensitive C-reactive protein(hs-CRP)),peripheral blood Kelch-like epichlo-rohydrin-related protein-1(Keap1)-nuclear factor E2-related factor 2(Nrf2)/antioxidant response element(ARE)signaling pathway-related protein levels(Keap1,Nrf2,ARE),and hemodynamic indicators(mean blood flow velocity(Vm),mean blood flow volume(Qm),cerebral vascular resistance(R))were compared before treatment and at 1 and 2 months after treatment in the three groups.Results The total clinical efficacy rate in observation group was significantly higher than that in control group 1 and control group 2(P<0.05),but there was no significant difference between the two control groups(P>0.05).Compared with before treatment,the ABCD2 scores and NIHSS scores in the three groups showed a significant downward trend after 1 month and 2 months of treatment,and the decrease in observation group was larger than that in control group 1 and control group 2(P<0.05),but there was no significant difference between the two control groups(P>0.05).Compared with before treatment,sCD40L,Lp-PLA2,and hs-CRP in the three groups showed a signific

关 键 词：短暂性脑缺血发作 益气活血降浊汤 丁苯酞 Kelch样环氧氯丙烷相关蛋白1 核因子E2相关因子2 抗氧化反应元件 治疗效果 

分 类 号：R5[医药卫生—内科学]