通瘀化痰熄风汤联合溶栓治疗急性脑梗死临床研究  

Clinical Study on Tongyu Huatan Xifeng Decoction Combined with Thrombolysis for Acute Cerebral Infarction

作　　者：谭海军 武继涛[2] 张耀光 TAN Haijun;WU Jitao;ZHANG Yaoguang(Department of Neurology,Fanxian Hospital of Chinese Medicine,Fanxian Henan 457500,China;Cerebropathy WardⅤ,the First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou Henan 450000,China)

机构地区：[1]范县中医院脑病科,河南范县457500 [2]河南中医药大学第一附属医院脑病五区,河南郑州450000

出　　处：《新中医》2024年第24期46-50,共5页New Chinese Medicine

摘　　要：目的:观察通瘀化痰熄风汤联合溶栓治疗急性脑梗死(ACI)的临床疗效及对血清氧化应激指标的影响。方法:按照随机数字表法将收治的ACI患者82例分为2组各41例。对照组采取静脉溶栓治疗,治疗组在对照组治疗方案的基础上加用通瘀化痰熄风汤治疗。比较2组治疗前后中医证候评分、美国国立卫生研究院卒中量表(NIHSS)和生活自理能力(BI)评分、氧化应激指标变化,观察2组临床疗效及不良反应情况。结果:治疗后,2组中医证候各项评分均降低,治疗组半身不遂、口舌歪斜、偏身麻木、头晕目眩评分均低于对照组,差异均有统计学意义(P<0.05)。治疗后,2组BI评分均升高、NIHSS评分均降低,治疗组BI评分高于对照组,NIHSS评分低于对照组,差异均有统计学意义(P<0.05)。治疗后,2组丙二醛(MDA)水平均降低,超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)水平均升高,治疗组MDA水平低于对照组,SOD、GSH-Px水平均高于对照组,差异均有统计学意义(P<0.05)。临床疗效总有效率治疗组97.56%,对照组80.49%,2组总有效率比较,差异有统计学意义(P<0.05)。不良反应发生率治疗组4.88%,对照组12.20%,2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:通瘀化痰熄风汤联合溶栓治疗ACI临床疗效显著,能够改善患者中医症状,促进神经功能修复,提高生活自理能力,且对血清氧化应激指标产生积极影响。治疗过程中不良反应发生率相对较低,具有较好的安全性。Objective:To observe the clinical effect of the therapy of Tongyu Huatan Xifeng Decoction combined with thrombolysis on acute cerebral infarction(ACI)and its effects on serum oxidative stress indexes.Methods:A total of 82 ACI patients were divided into two groups according to the random number table method,with 41 cases in each group.The control group was treated with intravenous thrombolysis,and the treatment group was additionally treated with Tongyu Huatan Xifeng Decoction based on the treatment plan of the control group.The changes of traditional Chinese medicine syndrome scores,the scores of National Institutes of Health Stroke Scale(NIHSS)and Barthel Index(BI)and the oxidative stress indexes were compared before and after treatment between the two groups.The clinical effects and incidence of adverse reactions in the two groups were observed.Results:After treatment,the traditional Chinese medicine syndrome scores of each item in the two groups were reduced,and the scores of hemiplegia,skewed mouth and tongue,hemianesthesia and dizziness in the treatment group were lower than those in the control group,differences being significant(P<0.05).After treatment,the BI scores in the two groups were elevated,and the NIHSS scores were reduced;the BI score in the treatment group was higher than that in the control group,and the NIHSS score was lower than that in the control group,differences being significant(P<0.05).After treatment,the levels of malondialdehyde(MDA)in the two groups were down-regulated,and the levels of superoxide dismutase(SOD)and glutathione peroxidase(GSH-Px)were elevated.The MDA level in the treatment group was lower than that in the control group,and the levels of SOD and GSH-Px were higher than those in the control group,differences being significant(P<0.05).The total clinical effective rate was 97.56%in the treatment group and 80.49%in the control group,the difference being significant(P<0.05).The incidence of adverse reactions was 4.88%in the treatment group and 12.20%in the control group,ther

关 键 词：急性脑梗死 静脉溶栓 通瘀化痰熄风汤 丙二醛 超氧化物歧化酶 谷胱甘肽过氧化物酶 

分 类 号：R743.3[医药卫生—神经病学与精神病学]