桂陈宣化汤联合t-PA溶栓对缺血性脑卒中患者血液流变学指标及神经营养因子影响  

Effect of Guichen Xuanhua Decoction Combined with t-PA Thrombolytic Therapy on Hemorheology and Neurotrophic Factors in Patients with Ischemic Stroke

作　　者：尉建辉[1] 高李[1] 李蒙 邢麟[2] Wei Jianhui;Gao Li;Li Meng;Xing Lin(Baoji Central Hospital,Shaanxi,Baoji 721008,China)

机构地区：[1]陕西省宝鸡市中心医院,陕西宝鸡721008 [2]宝鸡职业技术学院医学分院,陕西宝鸡721000

出　　处：《中国中医急症》2024年第10期1756-1759,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：陕西省重点研发计划项目(2021SF05-106)。

摘　　要：目的 观察桂陈宣化汤联合组织型纤溶酶原激活剂(t-PA)溶栓对缺血性脑卒中患者血液流变学指标及神经营养因子影响。方法 选择94例缺血性脑卒中患者,采用随机数字表法分为研究组与对照组各47例。对照组给予t-PA溶栓治疗,研究组在此基础上给予桂陈宣化汤,两组均连续治疗14 d。分别于治疗前后采用超声诊断仪检测脑平均血流速度(MBF)、平均血流量(CBF)、动态阻抗(DR)水平;采用血细胞分析仪检测全血黏度、血浆黏度、红细胞比容;采用ELISA法检测神经元特异性烯醇化酶(NSE)、神经营养因子(NTF)、神经生长因子(NGF)水平;采用脑卒中量表(NIHSS)、改良Rankin量表(MRS)评估患者脑卒中症状,评价临床疗效。结果 研究组总有效率为95.74%,高于对照组的80.85%(P <0.05)。治疗后,研究组MBF、CBF水平高于对照组(P <0.05),DR水平低于对照组(P <0.05);全血黏度、血浆黏度、红细胞比容低于对照组(P <0.05);NTF、NGF水平高于对照组(P <0.05),NSE水平低于对照组(P <0.05);NIHSS、MRS水平低于对照组(P <0.05)。结论 桂陈宣化汤联合t-PA溶栓治疗缺血性脑卒中患者疗效显著,能改善脑血流动力学、血液流变学指标水平,提高神经营养因子水平并缓解神经炎症,改善卒中症状。Objective:To investigate the effect of Guichen Xuanhua Decoction combined with tissue-type plas-minogen activator(t-PA)thrombolytic therapy on hemorheology and neurotrophic factors in patients with ischemic stroke.Methods:A randomized controlled study was performed on 94 patients with ischemic stroke admitted.Pa-tients were grouped using random number table methods,each with 47 cases.The control group received thrombo-lytic therapy with t-PA,based on this,study group added Guichen Xuanhua Decoction.Treatment in both groups lasted for 14 d.The mean cerebral blood flow velocity(MBF),mean cerebral blood flow(CBF),and dynamic resis-tance(DR)were detected using ultrasonic techniques.Serum levels of neuron-specific enolase(NSE),neutron ther-apy facility(NTF),and nerve growth factor(NGF)were measured using ELISA.The clinical symptoms and clinical efficacy were evaluated using National Institute of Health stroke scale(NIHSS)and modified Rankin scale(MRS).Results:The overall efficacy rate was 95.74%in the study group,which was higher than 80.85%in the control group,with statistical difference(P<0.05).After treatment,the study group reported larger MBF and CBF values(P<0.05),smaller DR values(P<0.05),lower whole blood viscosity,plasma viscosity,and erythrocyte aggregation index(P<0.05),higher NTF and NGF levels(P<0.05)and lower NSE level(P<0.05)than those of control group.The study group scored lower on NIHSS and MRS than control group(P<0.05).Conclusion:The applica-tion of Guichen Xuanhua Decoction combined with t-PA thrombolytic therapy for patients with ischemic stroke can improve cerebral hemodynamics index,hemorheology index,increase neurotrophic factors and alleviate neuroinflam-mation,and alleviate stroke symptoms.

关 键 词：缺血性脑卒中 桂陈宣化汤 T-PA 神经营养因子 血液流变学 

分 类 号：R743.9[医药卫生—神经病学与精神病学]