续命汤辨证加味联合阿司匹林对急性脑梗死病人脑血流、凝血功能的影响  

Effect of Xuming Tang Modified Based on Syndrome Differentiation Combined with Aspirin on Cerebral Blood Flow and Coagulation Function in Patients with Acute Cerebral Infarction

作　　者：吴兢[1] 邹忆怀[1] 马洪明[1] WU Jing;ZOU Yihuai;MA Hongming(Dongzhimen Hospital,Beijing University of Traditional Chinese Medicine,Beijing 101100,China)

机构地区：[1]北京中医药大学东直门医院,北京101100

出　　处：《中西医结合心脑血管病杂志》2024年第21期3874-3877,共4页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：第五批全国中医临床优秀人才研修项目,编号:〔2022〕1号。

摘　　要：目的:探讨续命汤辨证加味联合阿司匹林对急性脑梗死病人脑血流、凝血功能的影响。方法:回顾性收集我院2021年12月—2023年12月接受治疗的急性脑梗死病人80例的临床资料,根据治疗方式不同将仅服用阿司匹林片治疗的病人34例作为对照组,服用续命汤辨证加味联合阿司匹林片治疗的病人46例作为观察组,两组均治疗1个月。治疗前后分别利用颈动脉彩超检测颈动脉平均血流量(Qmean)、平均血流速度(Vmean)、外周阻力(RV)和脉动指数(PI),评价病人脑血流状况;全自动凝血分析仪检测凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)评价病人凝血功能;应用Fugl-Mayer运动功能评分量表(FMA)、美国国立卫生院卒中量表(NIHSS)分别评价两组运动功能和神经功能;记录不良反应发生情况。结果:治疗后,两组Qmean、Vmean均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05);两组RV、PI均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组PT、TT、APTT均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05);两组FIB均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组FMA评分高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05)。治疗后,两组NIHSS评分均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组不良反应发生率分别为15.22%、20.59%,观察组低于对照组,但差异无统计学意义(P>0.05)。结论:续命汤辨证加味联合阿司匹林可有效改善急性脑梗死病人的脑部血液循环及凝血功能,改善运动功能,减轻神经症状。Objective:To explore the effects of Xuming Tang modified combined with aspirin on cerebral blood flow and coagulation function in patients with acute cerebral infarction.Methods:Clinical data of 80 patients with acute cerebral infarction were retrospectively collected.According to different treatment methods,34 cases of patients treated with aspirin alone were taken as the control group,46 cases of patients treated with Xuming Tang modified based on syndrome differentiation combined with aspirin were taken as the observation group,and both groups were treated for 1 month.Carotid mean blood flow(Qmean),mean blood flow velocity(Vmean),peripheral resistance(RV),and pulsatility index(PI)were measured by carotid color ultrasound before and after treatment.Prothrombin time(PT),thrombin time(TT),activated partial thromboplastin time(APTT),and fibrinogen(FIB)were measured by automatic coagulation analyzer to evaluate the coagulation function of patients.Fugl-mayer Motor Function Scale(FMA)and National Institutes of Health Stroke Scale(NIHSS)were used to evaluate the motor function and neurological function of the two groups.Adverse reactions were recorded.Results:After treatment,Qmean and Vmean in both groups were higher than that before treatment,and that of observation group were higher than that of control group(P<0.05).RV and PI in both groups were lower than that before treatment,and observation group were lower than that of control group(P<0.05).After treatment,PT,TT and APTT in two groups were higher than that before treatment,and observation group were higher than that of control group(P<0.05).FIB in both groups was lower than that before treatment,and observation group was lower than that of control group(P<0.05).After treatment,FMA scores in both groups were higher than that before treatment,and the observation group was higher than that of control group(P<0.05).After treatment,NIHSS scores in both groups were lower than that before treatment,and the observation group was lower than that of control group(P<0.05

关 键 词：急性脑梗死 续命汤辨证加味 阿司匹林 脑部血液循环 凝血功能 

分 类 号：R743.33[医药卫生—神经病学与精神病学]