温胆汤加减治疗气虚血瘀痰阻型缺血性脑卒中急性期的疗效及对NT-proBNP、ICAM-1和MCP-1的影响研究  

Efficacy of Modified Wendan Decoction in the Treatment of Acute Stage of Ischemic Stroke of Qi-Deficiency,Blood-Stasis and Phlegm-Obstruction and Its Effects on NT-proBNP,ICAM-1 and MCP-1

作　　者：金海涛[1] 张雯[1] 王非[1] JIN Haitao;ZHANG Wen;WANG Fei(Dept.of Brain Disease,Wuhan Hospital of Traditional Chinese Medicine,Wuhan 430014,China)

机构地区：[1]武汉市中医医院脑病科,武汉430014

出　　处：《中国医院用药评价与分析》2024年第6期681-684,共4页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：湖北省卫生健康委员会2018—2019年度中医药科研项目(面上项目)(No.ZY2019M035)。

摘　　要：目的:探讨温胆汤加减治疗气虚血瘀痰阻型缺血性脑卒中急性期患者的疗效,以及对N末端脑钠肽前体(NT-proBNP)、细胞间黏附分子-1(ICAM-1)和单核细胞趋化蛋白-1(MCP-1)水平的影响。方法:以2021年5月至2022年5月该院收治的气虚血瘀痰阻型缺血性脑卒中急性期患者100例为研究对象,根据随机数字表法分为对照组和观察组,每组50例。对照组患者给予常规治疗,观察组患者在对照组的基础上给予温胆汤加减治疗。比较两组患者的临床疗效,NT-proBNP、ICAM-1和MCP-1水平,美国国立卫生院卒中神经功能缺损评分量表(NIHSS)评分、改良Rankin量表(mRS)评分及中医证候积分。结果:治疗1个月后,观察组患者的总有效率为94.00%(47/50),显著高于对照组的80.00%(40/50),差异有统计学意义(P<0.05)。治疗1个月后,观察组患者NT-proBNP、ICAM-1和MCP-1水平显著低于对照组,血液流变学各指标(血浆黏度、血低切黏度、血高切黏度、纤维蛋白原和红细胞压积)水平显著低于对照组,差异均有统计学意义(P<0.05)。治疗7 d、1个月后,观察组患者的NIHSS评分低于对照组;治疗1个月后,观察组患者的mRS评分、中医证候积分低于对照组,差异均有统计学意义(P<0.05)。结论:温胆汤加减治疗气虚血瘀痰阻型缺血性脑卒中急性期患者的效果较好,可显著降低NT-proBNP、ICAM-1和MCP-1水平,促进血液流通和疾病的恢复,提高患者的生活质量。OBJECTIVE:To probe into the efficacy of modified Wendan decoction in the treatment of patients with acute stage of ischemic stroke of Qi-deficiency,blood-stasis and phlegm-obstruction and its effects on the levels of N-terminal pro-brain natriuretic peptide(NT-proBNP),intercellular adhesion molecule-1(ICAM-1)and monocyte chemoattractant protein-1(MCP-1).METHODS:A total of 100 patients with acute stage of ischemic stroke of Qi-deficiency,blood-stasis and phlegm-obstruction admitted into the hospital from May 2021 to May 2022 were selected as research objects,which were divided into control group and observation group using a randomnumber tablemethod,with 50 cases in each group.The control group was given conventional treatment,while the observation group received modified Wendan decoction based on the control group.The clinical efficacy,levels of NT-proBNP,NT-proBNP and MCP-1,the National Institutes of Health Stroke Scale(NIHSS)score,Modified Rankin Scale(mRS)score and traditional Chinese medicine(TCM)syndrome integral were compared between two groups.RESULTS:After 1 month of treatment,the total effective rate of the observation group was 94.00%(47/50),which was significantly higher than 80.00%(40/50)of the control group,with statistically significant difference(P<0.05).After 1 month of treatment,the NT-proBNP,NT-proBNP and MCP-1 levels of the observation group were significantly lower than those of the control group,the various hemorheological indicators(plasma viscosity,blood low-shear viscosity,blood high-shear viscosity,fibrinogen and hematokrit)of the observation group were significantly lower than those of the control group,with statistically significant differences(P<0.05).After 7 d and 1 month of treatment,the NIHSS scores of the observation group were lower than those of the control group;after 1 month of treatment,the mRS score and TCM integral of the observation group were lower than those of the control group,with statistically significant differences(P<0.05).CONCLUSIONS:The efficacy of modified Wendan

关 键 词：缺血性脑卒中 气虚血瘀痰阻证 温胆汤 N末端脑钠肽前体 细胞间黏附分子-1 单核细胞趋化蛋白-1 

分 类 号：R932[医药卫生—生药学]