醒脑开窍汤联合鼠神经生长因子注射治疗急性脑梗死患者的临床研究
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摘要
目的观察醒脑开窍汤联合鼠神经生长因子注射治疗急性脑梗死(ACI)患者疗效并探讨其作用机制。方法将124例患者按随机数字表法分为观察组和对照组各62例,均予基础治疗,在此基础上对照组给予鼠神经生长因子注射治疗,观察组在对照组基础上联合醒脑开窍汤治疗。比较两组中医证候积分、神经功能、日常生活能力、运动功能、临床疗效,检测组织型纤溶酶原激活物(t PA)、超敏C反应蛋白(hs-CRP)水平和血液流变学指标。结果治疗后两组中医证候积分、NIHSS评分、ADL、FMA、tPA、hs-CRP、血浆黏度、全血黏度高切值、红细胞压积、全血黏度低切值改善程度优于治疗前(P<0.05),且观察组优于对照组(P<0.05);观察组总有效率90.32%高于对照组75.81%(P<0.05)。结论醒脑开窍汤联合鼠神经生长因子能够有效改善ACI患者tPA、hs-CRP水平和血液流变性,提高临床疗效。
Objective: To explore the curative effect of Xingnao Kaiqiao Decoction combined with mouse nerve growth factor injection on patients with acute cerebral infarction(ACI),and to explore its mechanism. Methods:124 cases were divided into the observation group and the control group according to random number table method,62 cases in each. Both groups were given basic treatment,on the basis of which,the control group were given mouse nerve growth factor injection treatment,and the observation group were combined with Xingnao Kaiqiao Decoction on the basis of the control group. TCM symptom scores,neurological function,daily living ability,motor function and clinical efficacy were observed,and t PA,hs-CRP levels and blood rheology were detected.Results: After treatment,the TCM syndrome score,NIHSS score,ADL,FMA,t PA,hs-CRP,plasma viscosity,high viscosity of blood viscosity,hematocrit and whole blood viscosity were superior to those before treatment(P<0.05),and the observation group was superior to the control group(P<0.05),and the total effective rate of the observation group was 90.32%, higher than that of the control group(75.81%)(P<0.05). Conclusion: Xingnao Kaiqiao Decoction combined with mouse nerve growth factor injection can effectively improve t PA and hs-CRP levels and blood rheology of patients with ACI,and improve clinical efficacy.
Objective: To explore the curative effect of Xingnao Kaiqiao Decoction combined with mouse nerve growth factor injection on patients with acute cerebral infarction(ACI),and to explore its mechanism. Methods:124 cases were divided into the observation group and the control group according to random number table method,62 cases in each. Both groups were given basic treatment,on the basis of which,the control group were given mouse nerve growth factor injection treatment,and the observation group were combined with Xingnao Kaiqiao Decoction on the basis of the control group. TCM symptom scores,neurological function,daily living ability,motor function and clinical efficacy were observed,and t PA,hs-CRP levels and blood rheology were detected.Results: After treatment,the TCM syndrome score,NIHSS score,ADL,FMA,t PA,hs-CRP,plasma viscosity,high viscosity of blood viscosity,hematocrit and whole blood viscosity were superior to those before treatment(P<0.05),and the observation group was superior to the control group(P<0.05),and the total effective rate of the observation group was 90.32%, higher than that of the control group(75.81%)(P<0.05). Conclusion: Xingnao Kaiqiao Decoction combined with mouse nerve growth factor injection can effectively improve t PA and hs-CRP levels and blood rheology of patients with ACI,and improve clinical efficacy.
引文
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[14]衣春娜,毕朝晖.鼠神经生长因子对急性脑梗死患者认知功能及运动功能恢复的影响[J].中国医药导刊,2015,17(12):1274-1276.
[15]姜忠梅,卢冬喜,李红霞.鼠神经生长因子辅助治疗急性脑梗死疗效观察[J].山东医药,2015,55(34):106-107.
[16]杜丽娟.醒脑开窍汤联合中医护理对脑梗死恢复期患者神经损伤的影响[J].河南中医,2017,37(6):1002-1004.
[17]王成太.通窍活血汤加减治疗脑梗死急性期的疗效及对血液流变学的影响[J].实用临床医药杂志,2015,19(23):15-17,27.
[18]凌敬.通窍活血汤加减治疗急性脑梗死的疗效观察[J].世界中医药,2013,8(3):303-305.
[2]刘丹丹,靳洪波.鼠神经生长因子治疗急性老年脑梗死疗效观察[J].现代中西医结合杂志,2016,25(16):1780-1782.
[3]张军锋.醒脑开窍汤联合针刺对急性脑梗死血瘀证患者的神经保护作用[J].中医学报,2017,32(9):1782-1785.
[4]王新德.各类脑血管疾病诊断要点[J].中华神经科杂志,1996,29(6):379-380.
[5]国家中医药管理局脑病急症协作组.中风病诊断与疗效评定标准(试行)[J].北京中医药大学学报,1996,19(1):55-56.
[6]张磊,刘建民.美国国立卫生研究院卒中量表[J].中华神经外科杂志,2014,30(1):79.
[7]Lawton,Brody.Activity of daily living scale,ADL[S].1969.
[8]Springer.Fugl-Meyer Assessment[J].Springer New York,2011:1102.
[9]中华人民共和国卫生部.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:228-229.
[10]王继华,侯学寨,李建中,等.天麻熄风口服液治疗急性期脑梗死疗效观察及对血凝和血液流变学的影响[J].河北中医,2012,34(5):656-657,660.
[11]李淞,贾小影,张逊娟.人尿激肽原酶对急性脑梗死患者hs-CRP及t-PA的影响[J].中国老年学杂志,2010,30(23):3471-3473.
[12]项飞,张秀霞,蒋良福.血栓通辅助常规西药治疗对急性脑梗死患者hs-CRP、IL-6及D-二聚体的影响[J].中国中医急症,2014,23(12):2287-2289.
[13]师仰宏,霍艳艳,黄苗,等.银杏达莫对急性脑梗死患者tPA,Hcy,MMP-9的影响[J].现代生物医学进展,2017,17(20):3944-3947.
[14]衣春娜,毕朝晖.鼠神经生长因子对急性脑梗死患者认知功能及运动功能恢复的影响[J].中国医药导刊,2015,17(12):1274-1276.
[15]姜忠梅,卢冬喜,李红霞.鼠神经生长因子辅助治疗急性脑梗死疗效观察[J].山东医药,2015,55(34):106-107.
[16]杜丽娟.醒脑开窍汤联合中医护理对脑梗死恢复期患者神经损伤的影响[J].河南中医,2017,37(6):1002-1004.
[17]王成太.通窍活血汤加减治疗脑梗死急性期的疗效及对血液流变学的影响[J].实用临床医药杂志,2015,19(23):15-17,27.
[18]凌敬.通窍活血汤加减治疗急性脑梗死的疗效观察[J].世界中医药,2013,8(3):303-305.