补阳还五汤对机械取栓后急性脑梗死患者的影响及安全性研究  

Effect and Safety of Buyang Huanwu Decoction(补阳还五汤)on Vascular Revascularization Rate in Patients with Acute Cerebral Infarction after Mechanical Thrombectomy

作　　者：孙炎 王刚[1] 刘宏娜 梁盼盼 SUN Yan;WANG Gang;LIU Hongna;LIANG Panpan(The First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,Hebei,China)

机构地区：[1]河北北方学院附属第一医院,河北张家口075000

出　　处：《中华中医药学刊》2025年第3期124-128,共5页Chinese Archives of Traditional Chinese Medicine

基　　金：国家科技支撑计划项目(2011BAI11B04);河北省医学科学研究计划项目(20220590)。

摘　　要：目的观察补阳还五汤对机械取栓后急性脑梗死患者的血管再通率等指标的影响。方法选择2022年6月—2023年6月在河北北方学院附属第一医院神经内科收治的60例急性脑梗死患者作为研究对象,按照随机数字表法将患者平均分为对照组和观察组,各组30例,对照组患者接受器械取栓治疗,观察组患者在对照组基础上予以补阳还五汤治疗。观察两组患者的临床效果、凝血指标、预后情况、神经功能、血管再通情况以及不良事件发生情况。结果对照组患者的有效率为66.67%,观察组患者的有效率为90.00%,与对照组比较,观察组的有效率明显升高(P<0.05)。对照组和观察组共60例,对照组患者的血管再通率(m-TICI为2b或3级)为66.67%,观察组患者的血管再通率为73.33%,两组的血管再通率差异无明显统计学意义(P>0.05)。治疗前,两组NIHSS评分差异无明显统计学意义(P>0.05)。与治疗前比较,两组患者在治疗后24 h和治疗后3个月的卒中量表(NIHSS)评分均显著降低(P<0.01)。与对照组比较,观察组患者的治疗后24 h和治疗后3个月的NIHSS评分显著降低(P<0.01)。治疗前,两组患者的PLT、D-D、APTT、PT、TT以及INR等凝血指标差异无明显统计学意义(P>0.05)。干预完成后,观察组患者的PLT、D-D、APTT以及PT水平相较于对照组均明显降低,差异具有统计学意义(P<0.01,P<0.05)。对照组和观察组3个月的mRS预后良好率分别为43.33%、70.00%,与对照组比较,观察组患者的预后良好率显著升高(P<0.05)。治疗期间两组患者的主要不良事件有口腔、皮肤黏膜、消化道出血以及肝肾损害,对照组和观察组的不良事件总发生率分别为13.33%、20.00%,差异无统计学意义(P>0.05)。结论补阳还五汤联合机械取栓能够更好地改善急性脑梗死患者神经功能,改善凝血指标和预后情况,适宜推广。Objective To observe the effect of Buyang Huanwu Decoction(补阳还五汤)on vascular revascularization rate and other indexes in patients with acute cerebral infarction after mechanical thrombectomy.Methods A total of 60 patients with acute cerebral infarction admitted to the Department of Neurology and Emergency Department of the hospital from June 2022 to June 2023 were selected as the research objects.According to the random number table method,the patients were evenly divided into control group and observation group,with 30 cases in each group.The patients in the control group received instrument thrombec-tomy treatment,and those in the observation group were treated with Buyang Huanwu Decoction on the basis of the control group.The clinical effect,coagulation index,prognosis,nerve function,vascular recanalization and adverse events of the two groups were observed.Results The effective rate of the control group was 66.67%,and that of the observation group was 90.00%,which was significantly higher than that of the control group(P<0.05).The vascular recirculation rate(m-TICI level 2b or 3)of the con-trol group was 66.67%,and that of the observation group was 73.33%,with no significant statistical significance between the two groups(P>0.05).Before treatment,there was no significant difference in National Institute of Health stroke scale(NIHSS)score between the two groups(P>0.05).Compared with those before treatment,NIHSS scores in both groups were significantly lower at 24 hours and 3 months after treatment(P<0.01).Compared with those in the control group,the NIHSS scores in the observation group were significantly lower at 24 hours and 3 months after treatment(P<0.01).Before treatment,there were no significant differences in coagulation indexes such as platelet count(PLT),D-dimer(D-D),activated partial thromboplastin time(APTT),prothrombin time(PT),thrombin time(TT)or international normalized ratio(INR)between two groups(P>0.05).After the intervention,the levels of PLT,D-D,APTT and PT in the observation group

关 键 词：急性脑梗死 器械取栓 补阳还五汤 血管再通 安全性 临床研究 

分 类 号：R255.2[医药卫生—中医内科学]