天麻钩藤饮合升降散化裁治疗急性脑梗死(风火上扰证)的临床研究  

Clinical research on modified Tianma Gouteng decoction and Shengjiang powder in the treatment of acute cerebral infarction(wind-fire disturbance syndrome)

作　　者：于莹 王娟 张肖 YU Ying;WANG Juan;ZHANG Xiao(Department of Encephalopathy,Huairou Hospital,Beijing Traditional Chinese Medicine Hospital,Beijing 101400,China)

机构地区：[1]北京中医医院怀柔医院脑病科,北京101400

出　　处：《上海医药》2024年第17期40-44,共5页Shanghai Medical & Pharmaceutical Journal

基　　金：北京中医医院怀柔医院科研项目(2020-MP04)。

摘　　要：目的:探究天麻钩藤饮合升降散化裁对急性脑梗死(ACI)(风火上扰证)患者的临床疗效。方法:对70例ACI(风火上扰证)患者进行回顾性分析,根据治疗方法不同分为观察组(n=35)和对照组(n=35),所有患者接受常规治疗,观察组加用天麻钩藤饮合升降散化裁口服,疗程均为1个月。比较2组患者治疗前后NIHSS评分、免疫学指标、血清D-二聚体及红细胞沉降率(ESR)、超敏C反应蛋白(hs-CRP)的变化情况,并比较临床疗效。结果:治疗后和随访时,观察组NIHSS评分、NK细胞比例、CD8^(+)比例、血清D-二聚体、ESR、hs-CRP水平低于对照组;CD4^(+)比例、CD4^(+)/CD8^(+)比值高于对照组(均P<0.05)。2组患者随访时NK细胞比例、CD8^(+)比例均较治疗后明显升高,观察组CD4^(+)/CD8^(+)比值较治疗后明显降低(均P<0.05)。观察组愈显率高于对照组(60.00%vs 22.86%,P<0.05)。结论:在ACI(风火上扰证)常规治疗基础上加用天麻钩藤饮合升降散化裁可显著改善神经功能缺损状态,临床疗效较好。Objective:To investigate the clinical efficacy of the modified Tianma Gouteng decoction and Shengjiang powder in patients with acute cerebral infarction(ACI)(wind-fire disturbance syndrome).Methods:Seventy cases of patients with wind-fire upper disturbance syndrome of ACI(wind-fire disturbance syndrome)were retrospectively analyzed and were divided into an observation group(n=35)and a control group(n=35)according to the different treatments.All the patients received conventional treatments,and the observation group was additionally treated with the modified Tianma Gouteng decoction and Shengjiang powder,and the treatments was lasted for a month.NIHSS scores,immunological indexes,serum D-dimer level and erythrocyte sedimentation rate(ESR),hypersensitive C-reactive protein(hs-CRP)level were compared between the two groups before and after treatment,and clinical efficacy was also compared.Results:After treatment and at follow-up,NIHSS score,NK^(+)^(+)cell proportion,CD8 proportion,serum D-dimer,ESR and hs-CRP levels were lower and CD4 proportion and CD4^(+)/CD8^(+)ratio^(+)were higher in the observation group than the control group(all P<0.05).NK cell proportion and CD8 proportion of the patients in the two groups were significantly higher at the follow-up than the post-treatment,and CD4^(+)/CD8^(+)ratio was significantly lower after treatment(all P<0.05).The recovery rate of the observation group was higher than that of the control group(60.00%vs 22.86%,P<0.05).Conclusion:On the basis of conventional treatment for ACI(wind-fire disturbance syndrome),the addition of the modified Tianma Gouteng decoction and Shengjiang powder can significantly improve the state of neurological deficits and the clinical efficacy is better.

关 键 词：急性脑梗死 风火上扰证 天麻钩藤饮 升降散 免疫学指标 D-二聚体 

分 类 号：R289.5[医药卫生—方剂学] R277.7[医药卫生—中药学]