蛭龙活血通瘀胶囊联合丁苯酞治疗非致残性缺血性脑血管病的效果及其对相关分子标志物的影响  

Effect of Zilong Huoxue Tongyu Capsules combined with butylphthalide in the treatment of non-disabling ischemic cerebrovascular disease and its impact on related molecular markers

作　　者：刘良琼 张海云 宋志秀[1] LIU Liang-qiong;ZHANG Hai-yun;SONG Zhi-xiu(Department of General Medicine,the First Affiliated Hospital of Xinxiang Medical College,Xinxiang 453100,Henan,CHINA;Department of Gastroenterology,the First Affiliated Hospital of Xinxiang Medical College,Xinxiang 453100,Henan,CHINA)

机构地区：[1]新乡医学院第一附属医院全科医学科,河南新乡453100 [2]新乡医学院第一附属医院消化内科,河南新乡453100

出　　处：《海南医学》2024年第23期3354-3359,共6页Hainan Medical Journal

基　　金：二〇二二年度新乡医学院第一附属医院青年培育基金项目(编号:QN-2022-B13)。

摘　　要：目的探讨蛭龙活血通瘀胶囊联合丁苯酞治疗非致残性缺血性脑血管病(NICE)的效果及其对相关分子标志物的影响。方法选取2022年1月至2024年1月新乡医学院第一附属医院收治的108例NICE患者纳入研究,按随机数表法分为研究组和对照组各54例。两组患者均给予基础治疗,在此基础上,对照组给予丁苯酞治疗,研究组给予蛭龙活血通瘀胶囊+丁苯酞治疗。治疗14 d后比较两组患者的治疗效果,治疗前后的血流动力学[椎动脉(VA)、基底动脉(BA)、大脑中动脉(MCA)的平均流速(Vm)、血管搏动指数(PI)]、相关分子标志物[神经元特异性烯醇化酶(NSE)、S100β蛋白(S100β)、神经生长因子(NGF)、脑源性神经营养因子(BDNF)]、炎性因子[肿瘤坏死因子α(TNF-α)、超敏C-反应蛋白(hs-CRP)、白细胞介素(IL-6)、IL-8]、神经功能缺损程度(NIHSS)评分和改良Barthel指数(MBI)评分,随访3个月,比较两组患者的终点事件发生情况和治疗期间的不良反应发生情况。结果治疗14 d后,研究组患者的总有效率为92.59%,明显高于对照组的77.78%,差异有统计学意义(P<0.05);治疗14 d后,研究组患者的VA、BA、MCA的Vm分别为(21.09±2.63)cm/s、(27.58±4.53)cm/s、(24.37±3.17)cm/s,明显高于对照组的(19.27±2.31)cm/s、(23.65±4.09)cm/s、(21.42±2.95)cm/s,VA、BA、MCA的PI分别为1.12±0.10、1.10±0.11、1.08±0.09,明显低于对照组的1.27±0.12、1.22±0.13、1.21±0.11,差异均有统计学意义(P<0.05);治疗14 d后,研究组患者的血清NSE、S100β水平分别为(20.04±4.69)U/L、(0.28±0.09)μg/L,明显低于对照组的(27.18±5.03)U/L、(0.44±0.10)μg/L,BDNF、NGF水平分别为(5.52±0.55)ng/mL、(151.39±16.23)pg/mL,明显高于对照组的(4.37±0.42)ng/mL、(130.22±12.37)pg/mL,差异均有统计学意义(P<0.05);治疗14 d后,研究组患者的血清hs-CRP、IL-6、IL-8、TNF-α水平分别为(5.12±0.64)mg/L、(3.57±0.40)ng/L、(13.62±2.61)pg/mL、(8.36±1.10)ng/L,明显低于对�Objective To explore the effect of Zhilong Huoxue Tongyu Capsules combined with butylphthalide in the treatment of non-disabling ischemic cerebrovascular disease(NICE)and its impact on related molecular markers.Methods A total of 108 NICE patients from the First Affiliated Hospital of Xinxiang Medical College from January 2022 to January 2024 were selected and randomly divided into a study group(54 cases)and a control group(54 cases)according to a random number table method.Based on basic treatment,patients in the control group were given butylphthalide treatment,while those in the study group were given Zhilong Huoxue Tongyu Capsules combined with butylphthalide treatment.After 14 days,the therapeutic effects of the two groups of patients were compared,as well as hemodynamic parameters(mean velocity[Vm]and pulsatility index[PI]of vertebral artery[VA],basilar artery[BA],and middle cerebral artery[MCA]),relevant molecular markers(neuron-specific enolase[NSE],S100βprotein[S100β],nerve growth factor[NGF],brain-derived neurotrophic factor[BDNF]),inflammatory factors(tumor necrosis factor alpha[TNF-α],high-sensitivity C-reactive protein[hs-CRP],interleukin[IL-6],IL-8),degree of neurological impairment(NIHSS)score,and modified Barthel index(MBI)score.The patients were followed up for 3 months,and the occurrence of end-point events and adverse reactions during treatment were compared between the two groups.Results After 14 days of treatment,the total effective rate of patients in the study group was 92.59%,which was significantly higher than 77.78%of the control group(P<0.05).After 14 days of treatment,the Vm of VA,BA,and MCA in the study group were(21.09±2.63)cm/s,(27.58±4.53)cm/s,and(24.37±3.17)cm/s,respectively,which were significantly higher than(19.27±2.31)cm/s,(23.65±4.09)cm/s,and(21.42±2.95)cm/s in the control group;the PI of VA,BA,and MCA were 1.12±0.10,1.10±0.11,and 1.08±0.09,respectively,which were significantly lower than 1.27±0.12,1.22±0.13,and 1.21±0.11 in the control group;the differences we

关 键 词：蛭龙活血通瘀胶囊 丁苯酞 非致残性缺血性脑血管病 疗效 炎性因子 血流动力学 神经因子标志物 

分 类 号：R743[医药卫生—神经病学与精神病学]