小续命汤联合常规西医治疗风火上扰型急性缺血性脑卒中患者的疗效  

Efficacy of Xiaoxuming decoction combined with conventional western medicine in treatment of patients with acute ischemic stroke of wind-fire disturbance type

作　　者：张建平 王震 王文[1] 刘章峰 Zhang Jianping;Wang Zhen;Wang Wen;Liu Zhangfeng(Department of Encephalopathy,Shangluo Hospital of Traditional Chinese Medicine,Shangluo 726000,China;Department of Encephalopathy,Hospital Affiliated to Shangluo Vocational and Technical College,Shangluo 726000,China)

机构地区：[1]商洛市中医医院脑病科,商洛726000 [2]商洛职业技术学院附属医院脑病科,商洛726000

出　　处：《国际医药卫生导报》2024年第13期2123-2129,共7页International Medicine and Health Guidance News

基　　金：陕西省卫生健康科研基金(20220013320)。

摘　　要：目的探讨小续命汤联合常规西医治疗风火上扰型急性缺血性脑卒中的疗效与作用机制。方法前瞻性选取2020年1月至2022年1月商洛市中医医院收治的188例风火上扰型急性缺血性脑卒中患者,采用随机数字表法分为对照组与研究组。对照组94例,男48例、女46例,年龄(67.50±6.23)岁,病程(7.21±1.15)h,基底节、大脑、小脑病变分别为58、27、9例;研究组94例,男49例、女45例,年龄(67.00±8.46)岁,病程(7.14±1.04)h,基底节、大脑、小脑病变分别为59、25、10例。对照组给予常规西医治疗,研究组给予小续命汤联合常规西医治疗,均连续治疗28 d。对比治疗前与治疗28 d后的中医症状积分、美国国立卫生研究院卒中量表(NIHSS)评分、Barthel指数评分以及临床疗效,治疗前后血清胶质纤维酸性蛋白(GFAP)、基质细胞衍生因子(SDF-1)、脑源性神经营养因子(BDNF)、单核细胞趋化蛋白-1(MCP-1)、同型半胱氨酸(Hcy)、C反应蛋白(CRP)、过氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)、丙二醛(MDA)、血液黏度、纤维蛋白原(FIB)、D-二聚体(D-D)水平变化情况及治疗期间的安全性。采用t检验、χ^(2)检验、秩和检验进行统计分析。结果治疗28 d后,对照组和研究组中医症状积分[(13.00±2.64)分、(9.50±1.71)分]、NIHSS评分[(9.50±1.76)分、(6.00±1.21)分]及GFAP[(5.02±1.25)μg/L、(4.21±0.98)μg/L]、MCP-1[(112.28±10.29)μg/L、(92.58±7.41)μg/L]、Hcy[(15.25±2.67)μmol/L、(8.56±2.21)μmol/L]、CRP[(10.50±2.12)mg/L、(6.89±1.24)mg/L]、MDA[(7.58±1.05)mol/L、(5.42±1.12)mol/L]、全血高切黏度[(4.85±1.23)mPa/s、(2.58±1.05)mPa/s]、全血低切黏度[(16.45±3.56)mPa/s、(10.89±1.98)mPa/s]、血浆黏度[(1.56±0.19)mPa/s、(1.35±0.15)mPa/s]、FIB[(3.25±0.47)g/L、(2.68±0.35)g/L]、D-D[(1.91±0.29)mg/L、(1.39±0.26)mg/L]均低于治疗前(均P<0.001),且研究组更低(均P<0.001);对照组和研究组Barthel指数评分[(65.00±9.35)分、(74.50�Objective To analyze the efficacy and mechanism of Xiaoxuming decoction combined with conventional western medicine in the treatment of patients with acute ischemic stroke of wind-fire disturbance type.Methods One hundred and eighty-eight patients with acute ischemic stroke of wind-fire disturbance syndrome type treated at Shangluo Hospital of Traditional Chinese Medicine from January 2020 to January 2022 were selected for the randomized controlled trial.They were divided into a control group and a study group by the random number table method,with 94 cases in each group.There were 48 males and 46 females in the control group;they were(67.50±6.23)years old;their disease course was(7.21±1.15)h;58 cases had lesions in basal ganglia,27 cases brains,and 9 cases cerebellums.There were 49 males and 45 females in the study group;they were(67.00±8.46)years old;their disease course was(7.14±1.04)h;59 cases had lesions in basal ganglia,25 cases brains,and 10 cases cerebellums.The control group were treated with conventional western medicine,and the study group with Xiaoxuming decoction and conventional western medicine,for 28 d.The traditional Chinese medicine(TCM)symptom scores,scores of National Institute of Health Stroke Scale(NIHSS),and Barthel index scores before the treatment and after 28 days'treatment and the clinical efficacies were compared between the two groups.The levels of serum glial fibrillary acidic protein(GFAP),stromal cell-derived factor(SDF-1),brain-derived neurotrophic factor(BDNF),monocyte chemoattractant protein-1(MCP-1),homocysteine(Hcy),C-reactive protein(CRP),superoxide dismutase(SOD),glutathione peroxidase(GSH-Px),malondialdehyde(MDA),blood viscosity,fibrinogen(FIB),and D-dimer(D-D)before and after the treatment were compared.The safety during the treatment was compared.t test,χ^(2) test,and rank sum test were used.Results After 28 days'treatment,the TCM symptom scores[(13.00±2.64)and(9.50±1.71)],NIHSS scores[(9.50±1.76)and(6.00±1.21)]and levels of GFAP[(5.02±1.25)μg/L and(4.21±0.98)

关 键 词：小续命汤 急性缺血性脑卒中 风火上饶型 氧化应激反应 血液流变学 基质细胞衍生因子 

分 类 号：R743.31[医药卫生—神经病学与精神病学]