当归四逆汤治疗脑梗死临床研究  

Clinical Study on the Treatment of Cerebral Infarction with Chinese Angelica Frigid Extremities Decoction

作　　者：朱慧 ZHU Hui(Jinan Hospital of Integrated Traditional Chinese and Western Medicine,Jinan,Shandong,China,271100)

机构地区：[1]济南市中西医结合医院,山东济南271100

出　　处：《河南中医》2025年第4期490-495,共6页Henan Traditional Chinese Medicine

基　　金：山东省自然科学基金项目(Zk202203011115)。

摘　　要：目的:观察当归四逆汤治疗脑梗死的临床疗效。方法:选择2022年11月至2023年11月济南市中西医结合医院收治的68例脑梗死患者为研究对象,按照随机数字表法分为对照组32例和观察组36例。对照组给予常规治疗,观察组在对照组治疗的基础上加用当归四逆汤。比较两组患者治疗前后临床症状积分、心功能生物标志物[肌酸激酶(creatine kinase,CK)、肌酸激酶同工酶(creatine kinase isoe-nzyme,CK-MB)、脑钠肽(brain natriuretic peptide,BNP)]、内皮功能[一氧化氮(nitric oxide,NO)、内皮素(endothelin,ET)]及脑血流参数变化情况。结果:两组患者治疗后临床症状积分低于本组治疗前,治疗后观察组言语不清、肢体麻木、视物模糊等积分分别为(1.98±0.49)分、(2.35±0.50)分、(2.45±0.60)分,均低于对照组治疗后,差异具有统计学意义(P<0.05)。两组患者治疗后CK、CK-MB高于本组治疗前,BNP水平低于本组治疗前,治疗后观察组CK为(105.90±19.07) IU·L^(-1)、CK-MB为(23.91±5.26) IU·L^(-1),高于对照组治疗后,治疗后观察组BNP为(87.85±11.90) ng·L^(-1),低于对照组治疗后,差异具有统计学意义(P<0.05)。两组患者治疗后NO、ET水平低于本组治疗前,治疗后观察组NO水平为(59.87±11.23)μmol·L^(-1)、ET为(35.16±7.52) mg·L^(-1),均低于对照组治疗后,差异具有统计学意义(P<0.05)。两组患者治疗后脑血管搏动指数、大脑中动脉血流速度、大脑后动脉血流速度低于本组治疗前,治疗后观察组血管搏动指数为(0.80±0.18),大脑中动脉血流速度为(105.38±18.20) cm·s^(-1),大脑后动脉血流速度为(53.75±8.12) cm·s^(-1),均低于对照组治疗后,差异具有统计学意义(P<0.05)。结论:当归四逆汤治疗脑梗死,可改善患者的临床症状,作用机制可能与调节心功能生物标志物水平及内皮功能,改善脑血流参数等有关。Objective:To observe the clinical efficacy of Chinese Angelica Frigid Extremities Decoction on cerebral infarction.Methods:A total of 78 patients with cerebral infarction admitted to Jinan Hospital of Integrated Traditional Chinese and Western Medicine from November 2022 to November 2023 were selected as the research subjects and randomly divided into the control group with 32 cases and the observation group with 36 cases according to the random number table method.The control group was given conventional treatment,while the observation group was treated with Chinese Angelica Frigid Extremities Decoction on the basis of the treatment of the control group.The changes in clinical symptom scores,cardiac function biomarkers [such as creatine kinase(CK),creatine kinase isoenzyme(CK-MB),brain natriuretic peptide(BNP)],endothelial function [nitric oxide(NO),endothelin(ET)],and cerebral blood flow parameters before and after treatment were compared between the two groups.Results:After treatment,the clinical symptom scores of both groups were lower than those before treatment in the same group;the scores of speech impairment,limb numbness and blurred vision in the observation group were(1.98±0.49) points,(2.35±0.50) points and(2.45±0.60) points respectively,which were all lower than those in the control group,and the differences were statistically significant(P<0.05);the levels of CK and CK-MB in both groups were higher than those before treatment in the same group,while the BNP levels were lower than those before treatment in the same group;the CK level in the observation group was(105.90±19.07) IU·L^(-1) and the CK-MB level was(23.91±5.26) IU·L^(-1),which were both higher than those in the control group;the BNP level in the observation group was(87.85±11.90) ng·L^(-1),which was lower than that in the control group,and all the differences were statistically significant(P<0.05);the levels of NO and ET in both groups were lower than those before treatment in the same group;the NO level in the observation group was

关 键 词：脑梗死 当归四逆汤 症状积分 心功能生物标志物 内皮功能 脑血流参数 《伤寒论》 张仲景 

分 类 号：R277.743.33[医药卫生—中医学]