补阳还五汤加味联合静脉溶栓治疗脑梗死的临床疗效及对其血脂指标、神经功能的影响  

Clinical Efficacy of Modified Buyang Huanwu Decoction Combined with Intravenous Thrombolysis in Treatment of Cerebral Infarction and Effect on Blood Lipid Indicators and Neurological Function

作　　者：谌敏 郭章宝[1] 万小林 CHEN Min;GUO Zhang-bao;WAN Xiao-lin(Wuhan No.1 Hospital,Wuhan Hubei 430000)

机构地区：[1]武汉市第一医院,湖北武汉430000

出　　处：《世界中西医结合杂志》2025年第2期308-313,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：湖北省卫生健康委科研项目(WJ2019F020)。

摘　　要：目的 探讨补阳还五汤加味联合静脉溶栓治疗脑梗死的疗效及对血脂指标、神经功能的影响。方法 选取2022年6月—2023年6月期间武汉市第一医院收治的脑梗死患者100例作为研究对象,采用编号随机抽签方法分为对照组和观察组,每组各50例。对照组进行静脉溶栓治疗,观察组在对照组基础上给予补阳还五汤加味治疗。两组患者均连续治疗2周。比较两组患者临床疗效、不良反应发生率,治疗前后中医证候积分、血脂[总胆固醇(Total cholesterol, TC)、三酰甘油(Triacyl glycerol, TG)、低密度脂蛋白(Low-density lipoprotein cholesterol, LDL-C)、高密度脂蛋白(High-density lipoprotein cholesterol, HDL-C)]水平、神经功能[美国卒中量表(National institute of health stroke scale, NIHSS)评分、中枢神经特异蛋白(Central nervous system specific protein, S100β)、神经元特异性烯醇化酶(Neuron specific enolase,NSE)]水平。结果 治疗后观察组患者临床疗效84.00%(42/50)明显高于对照组的66.00%(33/50),差异有统计学意义(P<0.05)。治疗后两组患者中医证候积分均较治疗前降低,差异有统计学意义(P<0.05);且观察组中医证候积分均低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血清TC、TG、LDL-C水平均较治疗前降低,HDL-C水平均较治疗前升高,差异有统计学意义(P<0.05);且观察组血清TC、TG、LDL-C水平低于对照组,HDL-C水平高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者NIHSS评分及血清S100β、NSE水平均较治疗前降低,差异有统计学意义(P<0.05);且观察组NIHSS评分及血清S100β、NSE水平低于对照组,差异有统计学意义(P<0.05)。治疗期间,两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论 在静脉溶栓治疗基础上,采用补阳还五汤加味治疗脑梗死,临床疗效显著,可有效改善患者神经功能,降低血脂水平,且具有较高安全性。Objective To investigate the efficacy of modified Buyang Huanwu Decoction combined with intravenous thrombolysis in the treatment of cerebral infarction and its effect on blood lipid indicators and neurological function.Methods A total of 100 patients with cerebral infarction,treated at Wuhan No.1 Hospital from June 2022 to June 2023,were randomly divided into a control group and an observation group with a random drawing method,with 50 patients in each group.The control group received intravenous thrombolysis treatment,while the observation group received modified Buyang Huanwu Decoction in addition to the control treatment.Both groups received continuous treatment for 2 weeks.Clinical efficacy,adverse reaction rates,traditional Chinese medicine(TCM)syndrome scores,blood lipid indicators[total cholesterol(TC),triacyl glycerol(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)],and neurological function[National Institutes of Health Stroke Scale(NIHSS)score,central nervous system specific protein(S10oβ),and neuron-specific enolase(NSE)] in both groups were compared before and after treatment.Results After treatment,the clinical efficacy in the observation group was 84.00%(42/50),significantly higher than 66.00%(33/50)in the control group(P<0.05).Both groups showed a significant reduction in TCM syndrome scores after treatment compared to those before treatment(P<0.05),and the observation group had significantly lower TCM syndrome scores than the control group(P<0.05).After treatment,the serum levels of TC,TG,and LDL-C were significantly lower,and HDL-C levels were significantly higher in both groups(P<0.05).The observation group had significantly lower levels of TC,TG,and LDL-C,and higher HDL-C levels than the control group(P<0.05).Both groups showed significant reductions in NIHSS scores and serum levels of S100βand NSE after treatment(P<0.05),and the observation group had significantly lower NIHSS scores and serum levels of S100βand NSE than the control group(P<0.05).T

关 键 词：补阳还五汤加味 静脉溶栓 脑梗死 血脂指标 神经功能 

分 类 号：R743.3[医药卫生—神经病学与精神病学]