补阳还五汤治疗脑梗死恢复期患者的临床疗效  

Clinical efficacy of Buyang Huanwu decoction in treating patients with convalescent cerebral infarction and its influence on neurological function and cognitive function

作　　者：凌东波[1] 陈凤兰[2] 何日晶 温庆辉[1] 张志斌 黄小琼[4] 李轩[2] LING Dong-bo;CHEN Feng-lan;HE Ri-jing;WEN Qing-hui;ZHANG Zhi-bin;HUANG Xiao-qiong;LI Xuan(Department of Laboratory,Dongguan People's Hospital,Dongguan 523000,Guangdong,China;Department of Traditional Chinese Medicine,Dongguan People's Hospital,Dongguan 523000,Guangdong,China;Department of Pharmacy,Dongguan People's Hospital,Dongguan 523000,Guangdong,China;Department of Neurology,Dongguan People's Hospital,Dongguan 523000,Guangdong,China)

机构地区：[1]东莞市人民医院检验科,广东东莞523000 [2]东莞市人民医院中医科,广东东莞523000 [3]东莞市人民医院药剂科,广东东莞523000 [4]东莞市人民医院神经内科,广东东莞523000

出　　处：《川北医学院学报》2024年第7期928-931,共4页Journal of North Sichuan Medical College

基　　金：广东省中医药局科研项目(20221414)。

摘　　要：目的:探究补阳还五汤治疗脑梗死恢复期患者的临床疗效。方法:按照治疗药物不同将84例气虚血瘀型脑梗死恢复期患者分为中药组和常规组,每组各42例。常规组采用常规药物治疗;中药组联合补阳还五汤辅助治疗。比较两组治疗前、治疗4周后的中医症候积分、神经功能、认知功能、肢体运动能力。结果:治疗4周后,两组患者中医症候积分各维度及总分、血清超敏C反应蛋白(hs-CRP)、血栓调节蛋白(TM)水平均低于治疗前,且中药组低于常规组(P<0.05);两组患者血清脱氢表雄酮(DHEA)、脑源性神经营养因子(BDNF)水平、蒙特利尔认知评估量表(MoCA)评分、Fugl-Meyer运动功能评分(FMA)均较治疗前升高(P<0.05),且中药组高于常规组(P<0.05);血清VEGF水平较治疗前降低(P<0.05),但中药组高于常规组(P<0.05)。结论:补阳还五汤可有效改善脑梗死恢复期患者临床症状,提高DHEA、BDNF水平和认知功能,促进肢体运动恢复。Objective:To explore the clinical efficacy of Buyang Huanwu decoction in the treatment of patients with convalescent cerebral infarction and its influence on neurological function and cognitive function.Methods:84 patients with convalescent cerebral infarction(qi deficiency and blood stasis type)were divided into Chinese medicine group(n=42)and routine group(n=42)by different treatment methods.Routine group was treated with routine medicine,and Chinese medicine group was supplemented with Buyang Huanwu decoction.The scores of TCM symptoms,neurological function,cognitive function and limb motor ability were compared between the two groups of patients before treatment and 4 weeks after treatment.Results:After 4 weeks of treatment,the scores of TCM symptoms,serum levels of hypersensitive-C-reactive-protein(hs-CRP)and thrombomodulin(TM)in the two groups were lower than those before treatment,and the above indexes in Chinese medicine group were lower than those in routine group(P<0.05).Serum levels of dehydroepiandrosterone(DHEA)and brain-derived neurotrophic factor(BDNF),score of Montreal Cognitive Assessment(MoCA)and Fugl-Meyer Motor Assessment(FMA)scale in the two groups were enhanced compared with those before treatment,level of serum vascular endothelial growth factor(VEGF)was lower than that before treatment,and the above indexes in Chinese medicine group were higher compared to routine group(P<0.05).Conclusion:Buyang Huanwu decoction can effectively improve the clinical symptoms in patients with convalescent cerebral infarction,increase the levels of DHEA and BDNF and cognitive function,and promote the recovery of limb motor ability.

关 键 词：脑梗死 气虚血瘀型 补阳还五汤 脱氢表雄酮 脑源性神经营养因子 认知功能 

分 类 号：R285.5[医药卫生—中药学] R743.3[医药卫生—中医学]