补阳还五汤联合脑血管二级预防对脑卒中神经功能恢复的疗效观察
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摘要
目的:通过观察补阳还五汤联合脑血管二级预防对脑卒中患者神经功能恢复的临床疗效,探讨联合疗法对脑卒中患者的预后影响。方法:选取自2012年3月~2014年12月入我院治疗的脑卒中后患者117例,根据其入院治疗时间分为观察组57例,联合治疗组60例。观察组给予常规西医治疗,主要目的为改善微循环、控制脑部水肿、扩张血管、营养脑细胞以及抗血管痉挛等。联合治疗组在观察组治疗基础上,以补阳还五汤为主方,采用中药颗粒制剂,同时联合脑血管相关二级预防为治疗手段,以10天为1个疗程,连续治疗3个疗程。记录两组各自有效率,同时应用神经功能缺损程度评分(NDS)、功能综合评定量表(FCA)和改良巴氏指数(BI)的参数指标评定神经功能改善情况,对两组患者治疗前、治疗后15天以及治疗后30天(M0、M1、M3)的临床疗效进行分析。结果:联合治疗组较观察组疗效明显增强(P<0.05),差异有统计学意义;联合治疗组M1、M3的BI、FCA增高及NDS降低均较观察组明显。两组患者M1、M3的BI、FCA均较M0有所增高(P<0.05),DNS有所降低(P<0.01),差异有统计学意义,联合治疗组治疗一周后血清hs-CRP及WBC水平显著低于观察组,差异有统计学意义(P<0.05)。结论:补阳还五汤联合脑血管二级预防与传统的常规西医治疗均可促进脑卒中患者的神经功能恢复,但补阳还五汤联合脑血管二级预防在脑卒中患者神经功能改善、修复方面的优势更为明显,临床中可作为脑卒中患者神经功能修复的辅助治疗手段而予以推广应用。
Objective: Observing the effect of Buyang Huanwu Decoction combined with cerebrovascular secondary prevention for neural functional recovery in patients with cerebral apoplexy,and to study the effect of the combination therapy on the prognosis of patients with cerebral apoplexy. Methods: Selecting 117 cases patients after stroke in our hospital from March 2012 to December 2014,according to the hospitalized time divided into observation group and controlled group,57 cases were in the obserbation group and 60 cases in the combined treatment group. The observation group was given conventional western medicine treatment,the main purpose for improving microcirculation,controlling brain edema,dilating blood vessels,brain cells and nutrition vasospasm,etc. The combined treatment group was given Buyang Huanwu Decoction,the formulas for traditional Chinese medicine granules,joint cerebrovascular related secondary prevention for treatment at the same time,in a month for a period of treatment,treatment of three consecutive period of treatment. Two groups of individual efficiently,and at the same time the application degree of nerve function defect score( NDS),functional comprehensive assessment scale( FCA) and the parameters of the improved pap index( BI) assess neurologic improvement,before and after treatment in patients with two groups of 1 month and 3 months after treatment( M0,M1,M3) of clinical efficacy were analyzed. The levels of serum hs-CRP and WBC in the combined treatment group were significantly lower than those in the observation group after treatment,the difference was statistically significant( P<0. 05). Results: The curative effect of the combined treatment group obviously increased compared with the observation group( P<0. 05),the difference was statistically significant; The combined treatment group increased BI,FCA of M1,M3 and NDS reduced obviously in the observation group. Two groups of patients with M1,M3 BI,FCA than M0 increase significantly( P<0. 05),the DNS had decreased( P<0. 01),the difference was statistically significant. Conclusion: Buyang Huanwu Decoction combined with cerebrovascular secondary prevention and traditional routine western medicine treatment both can promote neural functional recovery in patients with cerebral apoplexy,but the combined treatment group has more better effect than the ovbervation group,can be used as in clinical neural function repair of auxiliary treatment approaches for patients with cerebral apoplexy and popularization and application.
Objective: Observing the effect of Buyang Huanwu Decoction combined with cerebrovascular secondary prevention for neural functional recovery in patients with cerebral apoplexy,and to study the effect of the combination therapy on the prognosis of patients with cerebral apoplexy. Methods: Selecting 117 cases patients after stroke in our hospital from March 2012 to December 2014,according to the hospitalized time divided into observation group and controlled group,57 cases were in the obserbation group and 60 cases in the combined treatment group. The observation group was given conventional western medicine treatment,the main purpose for improving microcirculation,controlling brain edema,dilating blood vessels,brain cells and nutrition vasospasm,etc. The combined treatment group was given Buyang Huanwu Decoction,the formulas for traditional Chinese medicine granules,joint cerebrovascular related secondary prevention for treatment at the same time,in a month for a period of treatment,treatment of three consecutive period of treatment. Two groups of individual efficiently,and at the same time the application degree of nerve function defect score( NDS),functional comprehensive assessment scale( FCA) and the parameters of the improved pap index( BI) assess neurologic improvement,before and after treatment in patients with two groups of 1 month and 3 months after treatment( M0,M1,M3) of clinical efficacy were analyzed. The levels of serum hs-CRP and WBC in the combined treatment group were significantly lower than those in the observation group after treatment,the difference was statistically significant( P<0. 05). Results: The curative effect of the combined treatment group obviously increased compared with the observation group( P<0. 05),the difference was statistically significant; The combined treatment group increased BI,FCA of M1,M3 and NDS reduced obviously in the observation group. Two groups of patients with M1,M3 BI,FCA than M0 increase significantly( P<0. 05),the DNS had decreased( P<0. 01),the difference was statistically significant. Conclusion: Buyang Huanwu Decoction combined with cerebrovascular secondary prevention and traditional routine western medicine treatment both can promote neural functional recovery in patients with cerebral apoplexy,but the combined treatment group has more better effect than the ovbervation group,can be used as in clinical neural function repair of auxiliary treatment approaches for patients with cerebral apoplexy and popularization and application.
引文
[1]王顺吉,冶尕西,刘秀芬,等.补阳还五汤加减配合回医烙灸对脑卒中气虚血瘀证患者神经功能的影响简[J].宁夏医科大学学报,2016,38(8):853~855
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[12]侯菊花,刘圆月,李灿,等.补阳还五汤对卒中后抑郁大鼠海马区Cyclin D1与Cdk2的影响[J].中华行为医学与脑科学杂志,2015,24(8):680~683
[13]罗银河,葛金文,刘林.补阳还五汤治疗缺血性中风临床应用进展[J].中西医结合心脑血管病杂志,2016,14(3):278~281
[2]王振清.缺血性脑卒中患者应用尼莫地平联合针刺及补阳还五汤治疗方案的临床效果[J].血栓与止血学,2016,22(5):538~541
[3]谢佳宏,杨志新,韩淑丽.补阳还五汤治疗缺血性脑卒中恢复期的系统评价[J].中医药导报,2015,17(20):78~82
[4]潘锐焕,周明超,杨志敬,等.补阳还五汤加减结合现代康复治疗对气虚型脑卒中患者的疗效观察[J].辽宁中医杂志,2016,15(6):1202~1204
[5]刘涓,刘宏祥,覃亮,等.穴位电刺激加补阳还五汤对脑卒中后抑郁症的治疗研究[J].河北医药,2016,38(10):1570~1572
[6]谢晋萌.疏经通督推拿联合加味补阳还五汤在脑卒中恢复期的应用观察[J].四川中医,2017(1):189~191
[7]毛光兰,贾奎.加味补阳还五汤联合针刺养老穴治疗脑卒中后肩-手综合征疗效观察[J].新乡医学院学报,2015,32(1):62~64
[8]任麦存,马居里.补阳还五汤加味内服对脑卒中病人MMP-2、MMP-8的影响[J].中西医结合心脑血管病杂志,2016,14(23):2815~2817
[9]宁静,王涛,张小霞.补阳还五汤加减内服外洗配合西医常规治疗脑卒中64例[J].陕西中医,2016,37(7):816~817
[10]赵正泰,唐仕欢,马月香.补阳还五汤治疗气虚血瘀型脑卒中研究进展[J].山东中医杂志,2017,36(1):71~73
[11]周曾璇,陈雪梅,易健,等.补阳还五汤治疗脑卒中后抑郁的疗效和安全性系统评价[J].中国中医急症,2015,24(7):1142~1143
[12]侯菊花,刘圆月,李灿,等.补阳还五汤对卒中后抑郁大鼠海马区Cyclin D1与Cdk2的影响[J].中华行为医学与脑科学杂志,2015,24(8):680~683
[13]罗银河,葛金文,刘林.补阳还五汤治疗缺血性中风临床应用进展[J].中西医结合心脑血管病杂志,2016,14(3):278~281