丹参川芎嗪注射液治疗脑血栓患者的临床疗效及对SOD、MDA、LPA和内皮素的作用分析
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摘要
目的:研究丹参川芎嗪注射液治疗脑血栓患者的临床疗效及对超氧化物歧化酶(SOD)、丙二醛(MDA)、溶血磷脂酸(LPA)和内皮素的作用分析。方法:回顾性抽取2016年3月至2017年6月陕西中医药大学附属医院收治的脑血栓患者127例作为研究对象,依据不同的治疗方案分为丹参组(n=66)和肝素组(n=61),丹参组患者接受丹参川芎嗪注射液联合常规西药治疗;肝素组患者由单纯接受常规西药治疗。经过14 d的临床治疗,组间比较各项指标优势。结果:1)血清SOD、MDA、LPA和内皮素检测:丹参组患者治疗后SOD(6. 93±1. 25) nmol/m L、MDA(3. 79±0. 81) n U/m L、LPA(4. 10±0. 23)μmol/L和ET(85. 31±6. 35) ng/L;肝素组患者治疗后SOD(5. 14±0. 89) nmol/m L、MDA(6. 08±1. 13) n U/m L、LPA(7. 82±1. 73)μmol/L和ET(122. 86±10. 54) ng/L。2)血流变化指标检测:治疗14 d后,检测丹参组全血高切黏度(5. 26±0. 74) m Pa·s、全血低切黏度(18. 24±1. 09) m Pa·s、血浆比黏度(1. 45±0. 26) m Pa·s、以及纤维蛋白含量(3. 35±0. 32) m Pa·s;相同时间检测肝素组全血高切黏度(5. 85±0. 91) m Pa·s、全血低切黏度(21. 66±1. 27) m Pa·s、血浆比黏度(1. 82±0. 28) m Pa·s、以及纤维蛋白含量(6. 05±0. 92) m Pa·s。3)统计组间中医证候变化:治疗前丹参组总积分(12. 10±0. 46)分与肝素组总积分(12. 40±0. 39)分,治疗后参组总积分(3. 93±0. 27)分与肝素组总积分(6. 74±0. 33)分。4)神经功能缺损治疗效果检测:66例丹参组患者中有22例评分改善> 90%,17例90%≥评分改善> 45%,和19例45%≥评分改善> 17%,共计58例患者治疗效果明显,总有效率为87. 88%。61例肝素组患者中有10例评分改善> 90%,12例90%≥评分改善> 45%,和20例45%≥评分改善> 17%,共计42例患者治疗效果明显,总有效率为68. 85%。结论:丹参川芎嗪注射液治疗脑血栓患者的临床疗效显著,与常规西药联合服用,促进SOD含量增长的同时对MDA、LPA和ET含量有明显抑制作用。
Objective: To study the clinical effects of the Salvia miltiorrhiza and Ligustrazine injection on patients with cerebral thrombosis and its effects on SOD,MDA,LPA and Endothelin. Methods: A total of 127 patients with cerebral thrombosis treated in Affiliated Hospital of Shaanxi University of Chinese Medicine from March 2016 to June 2017 were selected retrospectively as study object. According to different treatment schemes,they were divided into two groups: the Salvia miltiorrhiza group,made up of 66 patients receiving treatment of the combination of Salvia miltiorrhiza and Ligustrazine injection and conventional Western medicine;the heparin group,61 patients receiving conventional Western medicine. After 14 days of clinical treatment,the advantages of various indexes were compared between groups. Results: 1) Detection of serum SOD,MDA,LPA and endothelin. After the treatment,in the Salvia miltiorrhiza group: SOD( 6. 93 ± 1. 25) nmol/m L,MDA( 3. 79 ± 0. 81) n U/m L,LPA( 4. 10 ± 0. 23) μmol/L and ET( 85. 31 ± 6. 35) ng/L. In the heparin group,SOD( 5. 14 ± 0. 89) nmol/m L,MDA( 6. 08 ± 1. 13) n U/m L,LPA( 7. 82 ± 1. 73) μmol/L and ET( 122. 86 ± 10. 54) ng/L. 2) Determination of blood flow index. After 14 days of treatment,in the Salvia miltiorrhiza group:high shear viscosity( 5. 26 ± 0. 74) m Pa · s,low shear viscosity( 18. 24 ± 1. 09) m Pa · s and plasma specific viscosity( 1. 45 ±0. 26) m Pa s,and fibrin content( 3. 35 ± 0. 32) m Pa s; in the Salvia miltiorrhiza group( 1. 45 ± 0. 26) m Pa · s,fibrin content( 3. 35 ± 0. 32) m Pa·s. At the same time,in heparin group,the whole blood high shear viscosity( 5. 85 ± 0. 91) m Pa·s,low shear viscosity( 21. 66 ± 1. 27) m Pa·s,plasma specific viscosity( 1. 82 ± 0. 28) m Pa·s and fibrin( 6. 05 ± 0. 92) m Pa·s. 3) The changes of TCM syndromes were detected: the total score of the Salvia miltiorrhiza group before treatment was( 12. 10 ± 0. 46),and that of the heparin group was( 12. 40 ± 0. 39); after the treatment,the total score of the Salvia miltiorrhiza group was( 3. 93 ± 0. 27) and that of the heparin group was( 6. 74 ± 0. 33). 4) The effect of nerve function. the improvement scores in 66 cases of the Salvia miltiorrhiza group: 22 cases > 90%,90% ≥ 17 cases > 45%,45% ≥ 19 cases > 17%. The effect was significant in 58 cases. The total effective rate was 87. 88%. In 61 cases of the heparin group,10 cases > 90%,90% ≥ 12 cases > 45%,45% ≥ 20 cases > 17%. A total of 42 cases witnessed obvious curative effect,and the total effective rate was 68. 85%. Conclusion: The Salvia miltiorrhiza and Ligustrazine injection is significantly effective in the treatment of patients with cerebral thrombosis. When combined with conventional Western medicine,it can increase the level of SOD and significantly inhibit the levels of MDA,LPA and ET.
Objective: To study the clinical effects of the Salvia miltiorrhiza and Ligustrazine injection on patients with cerebral thrombosis and its effects on SOD,MDA,LPA and Endothelin. Methods: A total of 127 patients with cerebral thrombosis treated in Affiliated Hospital of Shaanxi University of Chinese Medicine from March 2016 to June 2017 were selected retrospectively as study object. According to different treatment schemes,they were divided into two groups: the Salvia miltiorrhiza group,made up of 66 patients receiving treatment of the combination of Salvia miltiorrhiza and Ligustrazine injection and conventional Western medicine;the heparin group,61 patients receiving conventional Western medicine. After 14 days of clinical treatment,the advantages of various indexes were compared between groups. Results: 1) Detection of serum SOD,MDA,LPA and endothelin. After the treatment,in the Salvia miltiorrhiza group: SOD( 6. 93 ± 1. 25) nmol/m L,MDA( 3. 79 ± 0. 81) n U/m L,LPA( 4. 10 ± 0. 23) μmol/L and ET( 85. 31 ± 6. 35) ng/L. In the heparin group,SOD( 5. 14 ± 0. 89) nmol/m L,MDA( 6. 08 ± 1. 13) n U/m L,LPA( 7. 82 ± 1. 73) μmol/L and ET( 122. 86 ± 10. 54) ng/L. 2) Determination of blood flow index. After 14 days of treatment,in the Salvia miltiorrhiza group:high shear viscosity( 5. 26 ± 0. 74) m Pa · s,low shear viscosity( 18. 24 ± 1. 09) m Pa · s and plasma specific viscosity( 1. 45 ±0. 26) m Pa s,and fibrin content( 3. 35 ± 0. 32) m Pa s; in the Salvia miltiorrhiza group( 1. 45 ± 0. 26) m Pa · s,fibrin content( 3. 35 ± 0. 32) m Pa·s. At the same time,in heparin group,the whole blood high shear viscosity( 5. 85 ± 0. 91) m Pa·s,low shear viscosity( 21. 66 ± 1. 27) m Pa·s,plasma specific viscosity( 1. 82 ± 0. 28) m Pa·s and fibrin( 6. 05 ± 0. 92) m Pa·s. 3) The changes of TCM syndromes were detected: the total score of the Salvia miltiorrhiza group before treatment was( 12. 10 ± 0. 46),and that of the heparin group was( 12. 40 ± 0. 39); after the treatment,the total score of the Salvia miltiorrhiza group was( 3. 93 ± 0. 27) and that of the heparin group was( 6. 74 ± 0. 33). 4) The effect of nerve function. the improvement scores in 66 cases of the Salvia miltiorrhiza group: 22 cases > 90%,90% ≥ 17 cases > 45%,45% ≥ 19 cases > 17%. The effect was significant in 58 cases. The total effective rate was 87. 88%. In 61 cases of the heparin group,10 cases > 90%,90% ≥ 12 cases > 45%,45% ≥ 20 cases > 17%. A total of 42 cases witnessed obvious curative effect,and the total effective rate was 68. 85%. Conclusion: The Salvia miltiorrhiza and Ligustrazine injection is significantly effective in the treatment of patients with cerebral thrombosis. When combined with conventional Western medicine,it can increase the level of SOD and significantly inhibit the levels of MDA,LPA and ET.
引文
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[7]侯军.72例脑血栓患者中医治疗分析[J].中医临床研究,2015,28(5):91-92.
[8]Li Q,Fan JY,Han JY.Chinese herbal remedies affecting thrombosis and hemostasis:A review[J].World J Tradit Chin Med,2015,1(2):38-49.
[9]曹光德.中医中药治疗脑血栓疗效分析[J].中国卫生标准管理,2015,6(10):241-242.
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[11]Wang Z,Zhang J,Ren T,et al.Targeted metabolomic profiling of cardioprotective effect of Ginkgo biloba L.extract on myocardial ischemia in rats[J].Phytomedicine,2016,23(6):621-631.
[12]熊明松,李玉明.缺血性脑血管合并心血管疾病患者介入治疗血浆中ET-1、v WF和NO水平的变化研究[J].国际心血管病杂志,2017,44(1):75-76.
[13]兰丹.低分子肝素治疗常见心脑血管疾病的临床分析[J].当代医学,2015,21(15):130-131.
[14]刘爱霞,赵淑清,郑大勇,等.低分子肝素治疗急性缺血性脑血管病临床研究[J].中风与神经疾病杂志,2001,18(3):136.
[15]王心珉.低分子肝素钙对缺血性脑血管病患者神经功能恢复的影响与不良反应观察[J].中国医药指南,2017,15(34):102-103.
[16]范婷.脑血栓应用丹参川芎嗪注射液治疗的效果观察及评估[J].北方药学,2017,14(7):78-79.
[17]高原.丹参川芎嗪注射液治疗脑血栓椎基底动脉系统供血不足临床疗效分析[J].临床医药文献(连续型电子期刊),2015,(25):5296-5296.
[18]靳丽丽.两种中药注射液联合治疗脑血栓的疗效观察[J].中西医结合心血管病(连续型电子期刊),2015(11):25-25,27.
[19]卢中莲.丹参川芎嗪注射液联合低分子肝素治疗后循环缺血疗效观察[J].陕西中医,2017,38(7):846-848.
[2]张小雪,张京芬.国内急性期缺血性脑卒中的溶栓治疗现状分析[J].中华老年心脑血管病杂志,2015,17(2):222-224.
[3]李双涛,于长春,张晶,等.急性脑梗死患者血栓弹力图与凝血功能相关性研究[J].中国临床医生杂志,2015,43(4):52-55.
[4]杜辉,蔡毅,王晓曦,等.老年男性高血压病患者缺血性脑血管病患病率及与血压达标的相关性研究[J].中华保健医学杂志,2016,18(2):96-99.
[5]王全懂,秦佩媛,李松,等.应用血栓弹力图预测短暂性脑缺血发作患者进展为脑梗死的临床研究[J].中华老年心脑血管病杂志,2015,17(12):1292-1294.
[6]李利,张玉芹.78例老年脑血栓患者的临床护理体会与分析[J].中国医药指南,2015,13(29):260-261.
[7]侯军.72例脑血栓患者中医治疗分析[J].中医临床研究,2015,28(5):91-92.
[8]Li Q,Fan JY,Han JY.Chinese herbal remedies affecting thrombosis and hemostasis:A review[J].World J Tradit Chin Med,2015,1(2):38-49.
[9]曹光德.中医中药治疗脑血栓疗效分析[J].中国卫生标准管理,2015,6(10):241-242.
[10]Poisson LM,Munkarah A,Madi H,et al.A metabolomic approach to identifying platinum resistance in ovarian cancer[J].J Ovarian Res,2015,8:13.
[11]Wang Z,Zhang J,Ren T,et al.Targeted metabolomic profiling of cardioprotective effect of Ginkgo biloba L.extract on myocardial ischemia in rats[J].Phytomedicine,2016,23(6):621-631.
[12]熊明松,李玉明.缺血性脑血管合并心血管疾病患者介入治疗血浆中ET-1、v WF和NO水平的变化研究[J].国际心血管病杂志,2017,44(1):75-76.
[13]兰丹.低分子肝素治疗常见心脑血管疾病的临床分析[J].当代医学,2015,21(15):130-131.
[14]刘爱霞,赵淑清,郑大勇,等.低分子肝素治疗急性缺血性脑血管病临床研究[J].中风与神经疾病杂志,2001,18(3):136.
[15]王心珉.低分子肝素钙对缺血性脑血管病患者神经功能恢复的影响与不良反应观察[J].中国医药指南,2017,15(34):102-103.
[16]范婷.脑血栓应用丹参川芎嗪注射液治疗的效果观察及评估[J].北方药学,2017,14(7):78-79.
[17]高原.丹参川芎嗪注射液治疗脑血栓椎基底动脉系统供血不足临床疗效分析[J].临床医药文献(连续型电子期刊),2015,(25):5296-5296.
[18]靳丽丽.两种中药注射液联合治疗脑血栓的疗效观察[J].中西医结合心血管病(连续型电子期刊),2015(11):25-25,27.
[19]卢中莲.丹参川芎嗪注射液联合低分子肝素治疗后循环缺血疗效观察[J].陕西中医,2017,38(7):846-848.