任督通脉益脑方对缺血性卒中恢复期患者脑血流动力学及预后的影响  

Effect of Rendu Tongmai Yinao Prescription on cerebral hemodynamics and prognosis of patients with ischemic stroke during the recovery period

作　　者：杨建波[1] 杨娜[2] 王晓阳 林雪[2] YANG Jianbo;YANG Na;WANG Xiaoyang;LIN Xue(Second Department of Encephalopathy,the Fourth Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang 830000;Department of Hypertension,the Fourth Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang 830000;Second Department of Spine,the Fourth Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang 830000)

机构地区：[1]新疆医科大学第四附属医院脑病二科,新疆乌鲁木齐830000 [2]新疆医科大学第四附属医院高血压科,新疆乌鲁木齐830000 [3]新疆医科大学第四附属医院脊柱二科,新疆乌鲁木齐830000

出　　处：《河北中医》2025年第3期386-390,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：自治区科技支疆项目计划(指令性)项目(编号:2021E02066)。

摘　　要：目的探讨任督通脉益脑方对缺血性脑卒中(IS)恢复期患者脑血流动力学及预后的影响。方法将84例IS恢复期患者按随机数字表法分为治疗组(n=42)和对照组(n=42)。对照组给予常规西医治疗,治疗组在此基础上加用任督通脉益脑方治疗,2组均治疗4周。比较2组治疗前后中医证候评分、脑血流动力学[峰值流速(Vs)、平均流速(Vm)、阻力指数(RI)、搏动指数(PI)]、血液流变学指标[全血黏度(高切)(WBHSV)、全血黏度(低切)(WBLSV)、血浆黏度(PV)、血细胞比容(HCT)]、神经细胞因子[S-100B蛋白、脑源性神经营养因子(BDNF)、神经元特异性烯醇化酶(NSE)]及神经功能[美国国立卫生研究院卒中量表(NIHSS)],统计2组90 d预后及不良反应情况。结果治疗后,2组各中医证候评分均较治疗前降低,且治疗组更低(P<0.05)。治疗后,2组Vs、Vm均较治疗前升高,RI、PI均较治疗前降低,且治疗组Vs、Vm更高,RI、PI更低(P<0.05)。治疗后,2组WBHSV、WBLSV、PV、HCT较治疗前降低,且治疗组更低(P<0.05)。治疗后,2组S-100B、NSE均较治疗前降低,BDNF较治疗前升高,且治疗组S-100B、NSE更低,BDNF更高(P<0.05)。治疗后,2组NIHSS评分均较治疗前降低,且治疗组低于对照组(P<0.05)。治疗组预后良好率高于对照组(P<0.05)。2组均未见明显不良反应。结论任督通脉益脑方可有效缓解IS恢复期患者临床症状,降低其血液黏稠度,改善血流动力学,调节神经细胞因子水平,促进神经功能恢复,从而改善患者预后。Objective To explore the effect of Rendu Tongmai Yinao Prescription on cerebral hemodynamics and prognosis of patients with ischemic stroke(IS)during the recovery period.Methods Eighty-four patients with IS during the recovery period were assigned into a treatment group(n=42)and a control group(n=42)using a random number table.All patients were managed by conventional Western medicine,those in the treatment group were additionally received Rendu Tongmai Yinao Prescription for 4 weeks.The traditional Chinese medicine(TCM)syndrome scores,cerebral hemodynamics including peak flow velocity(Vs),mean flow velocity(Vm),resistance index(RI),pulsatility index(PI),hemorheological including whole blood high/low shear viscosity(WBHSV/WBLSV),plasma viscosity(PV),hematocrit(HCT),neurocytokines including S-100B protein,brain-derived neurotrophic factor(BDNF),neuron specific enolase(NSE),as well as neurological function including National Institutes of Health Stroke Scale(NIHSS)before and after treatment were compared between groups.The 90-day prognosis and adverse reactions were calculated.Results After treatment,the both groups showed significantly decreased TCM syndrome scores,elevated Vs and Vm,decreased RI and PI,lower WBHSV,WBLSV,PV,HCT,NIHSS scores,down-regulated S-100B,NSE,up-regulated BDNF than those before treatment(all P<0.05),the treatment group was superior to the control group for the above indexes(all P<0.05).The rate of good prognosis in the treatment group was significantly higher than that of the control group(P<0.05).The incidence of adverse reactions was comparable between the two groups.Conclusion Rendu Tongmai Yinao Prescription can effectively alleviate clinical symptoms,reduce blood viscosity,improve hemodynamics,regulate neurocytokines,promote neurological function recovery,and thus improve prognosis of IS patient during the recovery period.

关 键 词：缺血性卒中 恢复期 扶阳 植物药疗法 脑血流动力学 神经康复 

分 类 号：R743.330.531[医药卫生—神经病学与精神病学]