蛭龙活血通瘀胶囊联合依达拉奉治疗缺血性脑血管病的疗效及对血清sCD40L、Lp-PLA2、GA水平的影响  

Therapeutic Efficacy of Zhi Long Huoxue Tongyu Capsules Combined with Edaravone in the Treatment of Ischemic Cerebrovascular Disease and Their Effect on Serum sCD40L,Lp-PLA2,and GA Levels

作　　者：郭敏[1] 蓝纯英 王建成[1] 豆志伟 GUO Min;LAN Chunying;WANG Jiancheng;DOU Zhiwei(Dept.of Gerontology,Handan Hospital of Traditional Chinese Medicine,Handan 056001 Hebei,China;The Second Division of Dept.of Gerontology,Handan Hospital of Traditional Chinese Medicine,Handan 056001 Hebei,China)

机构地区：[1]邯郸市中医院老年病科,河北邯郸056001 [2]邯郸市中医院老年二科,河北邯郸056001

出　　处：《广州中医药大学学报》2025年第3期583-592,共10页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：河北省重点研发计划项目(编号:22010382048D);邯郸市科学技术研究与发展计划项目(编号:19422083019-2)。

摘　　要：【目的】探讨蛭龙活血通瘀胶囊联合依达拉奉治疗缺血性脑血管病(ICVD)气虚血瘀证患者的疗效及其对血清可溶性细胞表面分化抗原40配体(sCD40L)、脂蛋白磷脂酶A2(Lp-PLA2)、糖化白蛋白(GA)的影响。【方法】将2022年3月至2023年10月在邯郸市中医院接受治疗的117例ICVD气虚血瘀证患者随机分为对照1组、对照2组和研究组,每组各39例。3组均给予利尿、调节血脂、抗血小板、降压等基础治疗,在此基础上,对照1组给予依达拉奉治疗,对照2组给予蛭龙活血通瘀胶囊治疗,研究组给予蛭龙活血通瘀胶囊联合依达拉奉治疗,疗程均为14 d。观察3组患者治疗前后神经功能美国国立卫生研究院脑卒中量表(NIHSS)评分、日常生活能力改良Barthel指数(MBI)评分、脑血流动力学指标[收缩期峰流速(PSV)、舒张期末流速(EDV)、平均流速(Vm)、血管搏动指数(PI)、阻力指数(RI)]、神经因子[神经元特异性烯醇化酶(NSE)、S100β蛋白(S100β)、人脑髓鞘碱性蛋白(MBP)]、血管内皮功能指标[血管性血友病因子(vWF)、内皮素1(ET-1)、一氧化氮(NO)]以及血清sCD40L、Lp-PLA2、GA水平的变化情况,比较3组患者的临床疗效及不良反应发生率。【结果】(1)疗效方面,治疗14 d后,研究组的总有效率为94.87%(37/39),明显高于对照1组的71.79%(28/39)和对照2组的76.92%(30/39),差异均有统计学意义(P<0.05);而对照1组与对照2组比较,差异无统计学意义(P>0.05)。(2)脑血流动力学指标方面,治疗后,3组患者大脑中动脉(MCA)的PSV、EDV、Vm、PI均较治疗前升高(P<0.05),RI均较治疗前下降(P<0.05),且研究组对MCA的PSV、EDV、Vm、PI的升高幅度及对RI的下降幅度均明显优于对照1组和对照2组(P<0.05);而对照1组与对照2组治疗后MCA的PSV、EDV、Vm、PI、RI比较,差异均无统计学意义(P>0.05)。(3)血清sCD40L、Lp-PLA2、GA水平方面,治疗后,3组患者的血清sCD40L、Lp-PLA2、GA水平均较治疗前�Objective To investigate the therapeutic efficacy of Zhi Long Huoxue Tongyu Capsules combined with Edaravone in the treatment of patients with ischemic cerebrovascular disease(ICVD)of qi deficiency and blood stasis syndrome,and to explore their effect on serum levels of soluble cluster of differentiation 40 ligand(sCD40L),lipoprotein phospholipase A2(Lp-PLA2),and glycated albumin(GA).Methods A total of 117 patients with ICVD of qi deficiency and blood stasis syndrome were randomly divided into control group 1,control group 2,and study group,with 39 patients in each group.The three groups were all given basic treatment with agents of diuretic,lipid regulation,antiplatelet,and antihypertensive,and additionally,control group 1 was given Edaravone,control group 2 was given Zhi Long Huoxue Tongyu Capsules,and the study group was given Zhi Long Huoxue Tongyu Capsules combined with Edaravone.The course of treatment for the three groups covered 14 days.Before and after treatment,the three groups were observed in the changes of National Institutes of Health Stroke Scale(NIHSS)scores for neurological function,modified Barthel Index(MBI)scores for activities of daily living(ADL),cerebral hemodynamics indicators[peak systolic velocity(PSV),end-diastolic velocity(EDV),mean velocity(Vm),pulsatility index(PI),and resistance index(RI)],neurofactors[neuron-specific enolase(NSE),S100βprotein(S100β),and myelin basic protein(MBP)],vascular endothelial function indicators[von Willebrand factor(VWF),endothelin 1(ET-1),and nitric oxide(NO)],and levels of serum sCD40L,Lp-PLA2,and GA.After treatment,the clinical efficacy and the incidence of adverse reactions among the three groups of patients were compared.Results(1)After 14 days of treatment,the total effective rate of the study group was 94.87%(37/39),which was significantly higher than that of control group 1[71.79%(28/39)]and control group 2[76.92%(30/39)],the differences being statistically significant(P<0.05).No statistically significant difference was shown between control grou

关 键 词：缺血性脑血管病 气虚血瘀证 依达拉奉 蛭龙活血通瘀胶囊 血流动力学 神经因子 血管内皮功能 神经功能 可溶性细胞表面分化抗原40配体 sCD40L 脂蛋白磷脂酶A2 LP-PLA2 糖化白蛋白 GA 

分 类 号：R277.7[医药卫生—中医学]