通痹活络方联合丁苯酞治疗对急性缺血性脑梗死患者脑血管储备能力及血清MCP-1、MMP-9的影响  

Effect of Tongbi Huoluo Formula(通痹活络方)Combined with Butylphthalide on Cerebrovascular Reserve Capacity and Serum MCP-1 and MMP-9 in Patients with Acute Ischemic Cerebral Infarction

作　　者：李韵清 唐臻一 董雯[1] 王颖[1] LI Yunqing;TANG Zhenyi;DONG Wen;WANG Ying(Department of Encephalopathy,Affiliated Hospital of Tianjin Academy of Traditional Chinese Medicine,Tianjin 300020,China;Department of Orthopedics,Tianjin Beichen Hospital of Traditional Chinese Medicine,Tianjin 300020,China)

机构地区：[1]天津市中医药研究院附属医院脑病一科,天津300041 [2]天津市北辰区中医医院骨科,天津300000

出　　处：《辽宁中医杂志》2024年第10期100-104,共5页Liaoning Journal of Traditional Chinese Medicine

摘　　要：目的探究通痹活络方联合丁苯酞治疗对急性缺血性脑梗死(AICI)患者脑血管储备能力及血清单核细胞趋化蛋白-1(MCP-1)、基质金属蛋白酶-9(MMP-9)的影响。方法按照随机数字表法将2021年1月—2023年1月天津中医药研究院附属医院脑病一科收治的200例AICI患者分为观察组和对照组,每组100例。对照组患者于发病入院的24 h内给予丁苯酞注射治疗,观察组在对照组基础上给予通痹活络方治疗。比较两组患者中医证候积分、脑血管储备功能(CVR)、大脑中动脉(MCV)血流速度、血流灌注指标(PI)、血液流变学指标(血浆黏度、全血高切黏度、红细胞比积水平)、炎症因子指标MCP-1、MMP-9及临床疗效。结果治疗后观察组总有效为95.00%,高于对照组90.00%(χ^(2)=1.802,P=0.179);治疗后口舌歪斜、感官障碍、半身不遂等主症和次症中医证候积分明显降低,且观察组低于对照组(P<0.05);治疗后两组MCV血流速度、CVR均提高,且观察组高于对照组,治疗后PI降低,且观察组低于对照组(P<0.05);治疗后两组患者血浆黏度、全血高切黏度均明显降低,且观察组低于对照组;而治疗后两组患者红细胞比积明显升高,且观察组高于对照组;治疗后两组MCP-1、MMP-9水平均明显降低,且观察组低于对照组(P<0.05);两组患者治疗后观察组总不良反应率为5.00%,低于对照组11.00%(χ^(2)=3.907,P=0.048)。结论通痹活络方联合丁苯酞治疗AICI患者效果确切,能够有效改善患者中医证候积分,提高脑血管储备能力,降低血液黏度和MCP-1、MMP-9水平,值得临床推广应用。Objective To investigate the effect of Tongbi Huoluo Formula(通痹活络方)combined with butylphthalide on cerebrovascular reserve capacity and serum monocyte chemoattractant protein-1(MCP-1)and matrix metalloproteinase-9(MMP-9)in patients with acute ischemic cerebral infarction(AICI).Methods A total of 200 patients with AICI admitted to the hospital from January 2021 to January 2023 were divided into the observation group and the control group by random number table method with 100 patients in each group.The patients in the control group were treated with butylphthalide injection within 24 h after admission,while those in the observation group were treated with Tongbi Huoluo Formula on the basis of the treatment of control group.TCM syndrome scores,cerebrovascular reserve(CVR),middle cerebral artery(MCV)blood flow velocity,blood perfusion index(PI),hemorheological indicators(plasma viscosity,whole blood high shear viscosity and hemotocrit),MCP-1,MMP-9 and clinical effects were compared between the two groups.Results After treatment,the total response rate in the observation group(95.00%)was higher than that in the control group(90.00%)(χ^(2)=1.802,P=0.179).After treatment,the scores for main and secondary symptoms decreased significantly,and the scores in the observation group were lower than those in the control group(P<0.05).The values of MCV and CVR in the two groups increased,and the two indicators in the observation group were higher than those in the control group.The levels of PI in two groups decreased and the level of PI in the observation group was lower than that in the control group(P<0.05).Plasma viscosity and whole blood high shear viscosity in both groups decreased significantly,and the two indicators in the observation group were lower than those in the control group.Hemotocrit in the two groups increased significantly,and hemotocrit in the observation group was higher than that in the control group.The levels of MCP-1 and MMP-9 in the two groups decreased significantly,and the levels in the o

关 键 词：急性缺血性脑梗死 通痹活络方 丁苯酞 脑血管储备能力 单核细胞趋化蛋白-1、基质金属蛋白酶-9 

分 类 号：R285[医药卫生—中药学]