醒神活血通络汤加减联合丁苯酞序贯疗法治疗急性缺血性脑卒中临床研究  

Clinical Study on Modified Xingshen Huoxue Tongluo Decoction Combined with Butylphthalide Sequential Therapy for Acute Ischemic Stroke

作　　者：李庆利 李颖 李娜 LI Qingli;LI Ying;LI Na(Stroke Center,the People's Hospital of Hebi,Hebi Henan 458030,China)

机构地区：[1]鹤壁市人民医院脑卒中中心,河南鹤壁458030

出　　处：《新中医》2024年第20期42-47,共6页New Chinese Medicine

摘　　要：目的:观察醒神活血通络汤加减联合丁苯酞序贯疗法治疗急性缺血性脑卒中(AIS)的临床疗效。方法:采用随机数字表法将92例AIS患者分为观察组、对照组各46例。2组均给予常规基础治疗,对照组加用丁苯酞序贯疗法治疗,观察组加用醒神活血通络汤加减联合丁苯酞序贯疗法治疗,2组均治疗4周。比较2组治疗前后中医证候积分、美国国立卫生研究院卒中量表(NIHSS)、简易智能精神状态检查量表(MMSE)、Fugl-Meyer量表(FMA)评分;比较2组治疗前后脑血流量(CBF)、脑血容量(CBV)、剂达峰时间(TTP)、血流平均通过时间(MTT)、内皮素-1 (ET-1)、一氧化氮(NO)水平,并评估2组临床疗效及不良反应发生情况。结果:治疗期间,观察组剔除1例,纳入研究45例;对照组剔除2例,纳入研究44例。治疗后,观察组总有效率95.56%,高于对照组79.55%(P<0.05)。治疗后,2组中医证候积分、NIHSS评分、TTP、MTT及血清ET-1水平均较治疗前降低(P<0.05),MMSE评分、FMA评分、CBF、CBV及血清NO水平升高(P<0.05);观察组中医证候积分、NIHSS评分、TTP、MTT及血清ET-1水平低于对照组(P<0.05),MMSE评分、FMA评分、CBF、CBV及血清NO水平高于对照组(P<0.05)。观察组、对照组不良反应发生率分别为8.89%、11.36%,差异无统计学意义(P>0.05)。结论:醒神活血通络汤加减配合丁苯酞序贯疗法治疗AIS疗效显著,能够修复患者神经功能,提高认知功能、运动功能,改善脑血流灌注及血管内皮功能,安全性较高。Objective:To observe the clinical effect of modified Xingshen Huoxue Tongluo Decoction combined with butylphthalide sequential therapy for acute ischemic stroke(AIS).Methods:A total of 92 AIS patients were divided into the observation group and the control group according to the random number table method,with 46 patients in each group.Both groups received routine basic treatment,and the control group was treated with butylphthalide sequential therapy.The observation group was treated with modified Xingshen Huoxue Tongluo Decoction combined with butylphthalide sequential therapy.Both groups were treated for four weeks.Compared the traditional Chinese medicine(TCM)syndrome scores,National Institutes of Health Stroke Scale(NIHSS)scores,Mini-Mental State Examination(MMSE),and Fugl-Meyer Assessment Scale(FMA)scores between the two groups before and after treatment.Compared cerebral blood flow(CBF),cerebral blood volume(CBV),time to peak(TTP),mean transit time(MTT),and the levels of endothelin-1(ET-1)and nitric oxide(NO)before and after treatment in the two groups.Evaluated the clinical effects and incidence of adverse reactions in the two groups.Results:During the treatment period,one case was excluded from the observation group and 45 cases were included in the study;two cases were excluded from the control group and 44 cases were included in the study.After treatment,the total effective rate was 95.56%in the observation group,which was higher than that of 79.55%in the control group(P<0.05).After treatment,the TCM syndrome scores,NIHSS scores,TTP,MTT,and serum ET-1 levels in both groups were declined when compared with those before treatment(P<0.05),and MMSE scores,FMA scores,CBF,CBV,and serum NO levels were increased(P<0.05);the TCM syndrome score,NIHSS score,TTP,MTT,and serum ET-1 level in the observation group were lower than those in the control group(P<0.05),and the MMSE score,FMA score,CBF,CBV,and serum NO level were higher than those in the control group(P<0.05).The incidence of adverse reactions was 8.89%in

关 键 词：急性缺血性脑卒中 醒神活血通络汤 丁苯酞序贯疗法 脑血流灌注 血管内皮功能 

分 类 号：R743.3[医药卫生—神经病学与精神病学]