天麻钩藤颗粒联合丁苯酞对风火痰阻型脑卒中恢复期患者神经功能及脑血管储备功能的影响  

Influence of butylphthalide combined with Tianma Gouteng Granula on neurological function and cerebrovascular reserve function in patients with wind-fire-phlegm obstructive stroke in convalescent period

作　　者：韩卫南 乔春友 许宁宁 祁博宇 石露露 HAN Wei-nan;QIAO Chun-you;XU Ning-ning(Department of Pharmacy,Zhangjiakou First Hospital,Zhangjiakou Hebei 075000,China)

机构地区：[1]张家口市第一医院药学部,河北张家口075000

出　　处：《临床和实验医学杂志》2024年第14期1478-1482,共5页Journal of Clinical and Experimental Medicine

基　　金：河北省中医药管理局科研计划(编号:2019539)。

摘　　要：目的探究天麻钩藤颗粒联合丁苯酞对风火痰阻型脑卒中恢复期患者血清血管内皮生长因子(VEGF)、脑源性神经营养因子(BDNF)水平及脑血管储备功能的影响。方法前瞻性选取2021年1月至2023年12月张家口市第一医院收治的122例风火痰阻型脑卒中恢复期患者为研究对象,按照随机数字表法将其分为对照组(n=61)和观察组(n=61)。两组均给予常规治疗,对照组给予丁苯酞治疗,观察组在对照组的基础上加用天麻钩藤颗粒治疗。比较两组患者疗效,比较两组治疗前和治疗28 d后的美国国立卫生研究院卒中量表(NIHSS)评分、日常生活活动能力(Barthel指数)、中医证候积分评分、血清VEGF和BDNF水平、脑血管储备功能指标[脑血管储备功能(CVR)、脉动指数(PI)];观察并记录两组研究过程中不良反应发生情况。结果观察组整体疗效优于对照组,且观察组总有效率为93.44%,显著高于对照组(77.05%),差异有统计学意义(P<0.05)。观察组治疗28 d后的NIHSS评分、中医证候积分分别为(4.93±1.30)、(10.17±2.27)分,均低于对照组[(6.88±1.79)、(13.96±2.46)分],Barthel指数评分为(71.61±12.29)分,高于对照组[(60.96±11.28)分],差异均有统计学意义(P<0.05)。观察组治疗28 d后的血清VEGF、BDNF水平分别为(241.61±51.79)、(9.12±1.36)μg/L,均高于对照组[(211.45±47.94)、(7.62±1.28)μg/L],差异均有统计学意义(P<0.05)。观察组治疗28 d后的CVR为(29.94±5.48)%,高于对照组[(25.61±5.37)%],PI为0.61±0.19,低于对照组(0.72±0.22),差异均有统计学意义(P<0.05)。两组患者在整个研究中均未发生明显不良反应。结论丁苯酞联合天麻钩藤颗粒可显著降低风火痰阻型脑卒中恢复期患者的中医证候积分,改善神经功能和脑血管储备功能,且对提高患者日常生活能力也具有显著的作用。Objective To explore the influences of butylphthalide combined with Tianma Gouteng Granula on serum vascular endothelial growth factor(VEGF),brain-derived neurotrophic factor(BDNF)levels and cerebrovascular reserve function in patients with wind-fire-phlegm obstructive stroke in convalescent period.Methods One hundred and twenty-two patients with wind-fire-phlegm obstructive stroke in convalescent period admitted to Zhangjiakou First Hospital from January 2021 to December 2023 were prospectively selected as the study subjects.They were divided into the control group(n=61)and the observation group(n=61)according to the random number table method.Both groups were given routine treatment,in addition,the control group was applied butylphthalide,and the observation group was given Tianma Gouteng Granules on the basis of the control group.The efficacy of the two groups was compared;the national institutes of health stroke scale(NIHSS)score,activities of daily living(Barthel index),traditional Chinese medicine syndrome scores,serum VEGF,BDNF levels,and cerebrovascular reserve function indicators[cerebrovascular reserve function(CVR),pulsatility index(PI)]before and 28 days after treatment were compared between the two groups.The occurrence of adverse reactions in the two groups was observed and recorded.Results The overall therapeutic effect of the observation group was better than that of the control group,and the total effective rate of the observation group was 93.44%,which was significantly higher than that of the control group(77.05%),the difference was statistically significant(P<0.05).After 28 days of treatment,the NIHSS score and traditional Chinese medicine syndrome score of the observation group were(4.93±1.30)and(10.17±2.27)points,respectively,which were lower than those of the control group[(6.88±1.79)and(13.96±2.46)points],the Barthel index score was(71.61±12.29)points,which was higher than those of the control group[(60.96±11.28)points],and the differences were statistically significant(P<0.05).After

关 键 词：血管内皮生长因子类 脑源性神经营养因子 日常生活活动 丁苯酞 天麻钩藤颗粒 风火痰阻型脑卒中 神经功能 

分 类 号：R743.3[医药卫生—神经病学与精神病学]