补阳还五汤加减联合丁苯酞软胶囊治疗中风病恢复期临床疗效及作用机制
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摘要
目的:探讨补阳还五汤加减联合丁苯酞软胶囊治疗门诊中风病恢复期临床疗效及作用机制。方法:选取2016年3月—2018年3月于我院收治的中风病恢复期患者112例,采用随机字母表法将所有患者分为观察组与对照组,对照组应用丁苯酞软胶囊治疗,观察组在对照组基础上联合补阳还五汤加减治疗,观察两组患者治疗效果、血液流变学指标变化,身体各功能恢复情况以及不良反应。结果:观察组患者治疗总有效率为96.43%显著高于对照组80.36%且差异有统计学意义(P<0.05);经治疗后,观察组患者全血黏度高切、全血黏度低切、血浆黏度(PV)与红细胞压积(HCT)水平均显著低于对照组且差异有统计学意义(P<0.05);观察组平衡能力评分(BBS)、日常生活活动能力评分(ADL)、肢体运动能力评分(FM)均显著高于对照组,神经功能缺损评分(CSS)显著低于对照组且差异有统计学意义(P<0.05);观察组患者不良反应发生率为5.36%显著低于对照组21.43%且差异有统计学意义(P<0.05)。结论:补阳还五汤加减与丁苯酞软胶囊治疗中风病恢复期患者具有积极作用,降低全血黏度高切、全血黏度低切、PV以及HCT水平,促进患者神经、运动、平衡等功能恢复,不良反应较少,为临床工作提供一定的参考意义。
Objective:To explore the clinical efficacy and mechanism of modified Buyang Huanwu Decoction combined with Butylphthalide Soft Capsules in recovery period of apoplexy patients in outpatient clinic. Methods:112 patients with apoplexy in the recovery period treated in our hospital from March 2016 to March 2018 were divided into the observation group and the control group by random alphabet method,the control group was treated with Butylphthalide Soft Capsules,the observation group was treated with modified Buyang Huanwu Decoction on the basis of the control group,observed the curative effect,hemorheological indexes changes,the recovery of various functions of the body and adverse reactions of two groups of patients.Results:The total effective rate of the observation group was 96.43%,which was significantly higher than80.36% of the control group,and the difference was statistically significant(P<0.05);after treatment,the levels of high shear whole blood viscosity,low shear whole blood viscosity,plasma viscosity(PV)and hematocrit(HCT)in the observation group were significantly lower than those in the control group(P<0.05);the Berg balance scale(BBS)score,activity of daily living(ADL)score and limb movement ability(FM)score in the observation group were significantly lower than those in the control group,the China stroke scale(CSS)score was significantly lower than that in the control group,and the difference was statistically significant(P<0.05);the incidence rate of adverse reactions in the observation group was5.36%,which was significantly lower than 21.43% in the control group,and the difference was statistically significant(P<0.05). Conclusion:Modified Buyang Huanwu Decoction combined with Butylphthalide Soft Capsules has a positive effect in the treatment of stroke patients in recovery stage,can reduce the high shear whole blood viscosity,low shear whole blood viscosity,PV and HCT levels,promote the recovery of nerve,movement,balance and other functions of patients,with less adverse reaction,it provides a certain reference for clinical work.
Objective:To explore the clinical efficacy and mechanism of modified Buyang Huanwu Decoction combined with Butylphthalide Soft Capsules in recovery period of apoplexy patients in outpatient clinic. Methods:112 patients with apoplexy in the recovery period treated in our hospital from March 2016 to March 2018 were divided into the observation group and the control group by random alphabet method,the control group was treated with Butylphthalide Soft Capsules,the observation group was treated with modified Buyang Huanwu Decoction on the basis of the control group,observed the curative effect,hemorheological indexes changes,the recovery of various functions of the body and adverse reactions of two groups of patients.Results:The total effective rate of the observation group was 96.43%,which was significantly higher than80.36% of the control group,and the difference was statistically significant(P<0.05);after treatment,the levels of high shear whole blood viscosity,low shear whole blood viscosity,plasma viscosity(PV)and hematocrit(HCT)in the observation group were significantly lower than those in the control group(P<0.05);the Berg balance scale(BBS)score,activity of daily living(ADL)score and limb movement ability(FM)score in the observation group were significantly lower than those in the control group,the China stroke scale(CSS)score was significantly lower than that in the control group,and the difference was statistically significant(P<0.05);the incidence rate of adverse reactions in the observation group was5.36%,which was significantly lower than 21.43% in the control group,and the difference was statistically significant(P<0.05). Conclusion:Modified Buyang Huanwu Decoction combined with Butylphthalide Soft Capsules has a positive effect in the treatment of stroke patients in recovery stage,can reduce the high shear whole blood viscosity,low shear whole blood viscosity,PV and HCT levels,promote the recovery of nerve,movement,balance and other functions of patients,with less adverse reaction,it provides a certain reference for clinical work.
引文
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[2]莫海婷,李弼仁,林泽辉.补阳还五汤联合阿司匹林治疗缺血性脑中风临床观察[J].湖北中医药大学学报,2016,18(4):58-61.
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[6]Mahoney F I,Barthel D W. Functional Evaluation:The Barthel Index[J].Md State Med J,1965,14(14):61-65.
[7]Fugl-Meyer A R. Post-stroke hemiplegia assessment of physical properties[J]. Scand J Rehabil Med Suppl,1980,7(7):85-93.
[8]陈清棠.脑卒中患者临床神经功能缺损程度评分标准(1995)[J].中华神经外科杂志,1996,29(6):381.
[9]吕昕,杨飞,齐武强.脑塞通丸治疗中风病恢复期的临床研究[J].中西医结合心脑血管病杂志,2016,14(5):551-552.
[10]董洪坦,李令康,贺立娟,等.缺血性中风病气虚血瘀证研究进展[J].世界中西医结合杂志,2016,11(1):131-135.
[11]武星,王珅,方庆娟,等.丁苯酞软胶囊对急性缺血性脑血管病的治疗效果[J].宁夏医科大学学报,2017,39(5):576-578.
[12]杨江胜,王达鹏,高志强,等.丁苯酞软胶囊联合曲唑酮治疗缺血性卒中后抑郁的效果评价[J].中西医结合心脑血管病杂志,2016,14(21):2557-2558.
[13]韩家密,黄良文.出血性中风恢复期机体气机失常与对策[J].中国中医基础医学杂志,2016,22(11):1491-1492.
[14]盖引莉,李振斌,樊继康.补阳还五汤加减配合针灸治疗中风偏瘫疗效观察[J].陕西中医,2017,38(8):995-996.
[15]银蔷蔷,海英.针药结合治疗风痰阻络型缺血性中风恢复期吞咽障碍临床观察[J].辽宁中医药大学学报,2018,20(1):219-222.
[16]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,2017,35(1):189-191.
[17]刘晓宇.补阳还五汤加减联合丹红注射液对脑梗塞恢复期偏瘫患者血液流变学的影响[J].辽宁中医杂志,2017,44(7):1421-1424.
[18]袁磊,杨进平,闻瑛,等.补阳还五汤治疗缺血性中风恢复期(气虚血瘀)的临床疗效及对Hcy影响的临床研究[J].中华中医药学刊,2016,34(1):195-197.
[2]莫海婷,李弼仁,林泽辉.补阳还五汤联合阿司匹林治疗缺血性脑中风临床观察[J].湖北中医药大学学报,2016,18(4):58-61.
[3]中华神经科学会.各类脑血管疾病诊断要点[J].中华神经外科杂志,1996,29(6):379-380.
[4]郑筱萸.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002:99.
[5]金冬梅,燕铁斌.Berg平衡量表及其临床应用[J].中国康复理论与实践,2002,8(3):155-157.
[6]Mahoney F I,Barthel D W. Functional Evaluation:The Barthel Index[J].Md State Med J,1965,14(14):61-65.
[7]Fugl-Meyer A R. Post-stroke hemiplegia assessment of physical properties[J]. Scand J Rehabil Med Suppl,1980,7(7):85-93.
[8]陈清棠.脑卒中患者临床神经功能缺损程度评分标准(1995)[J].中华神经外科杂志,1996,29(6):381.
[9]吕昕,杨飞,齐武强.脑塞通丸治疗中风病恢复期的临床研究[J].中西医结合心脑血管病杂志,2016,14(5):551-552.
[10]董洪坦,李令康,贺立娟,等.缺血性中风病气虚血瘀证研究进展[J].世界中西医结合杂志,2016,11(1):131-135.
[11]武星,王珅,方庆娟,等.丁苯酞软胶囊对急性缺血性脑血管病的治疗效果[J].宁夏医科大学学报,2017,39(5):576-578.
[12]杨江胜,王达鹏,高志强,等.丁苯酞软胶囊联合曲唑酮治疗缺血性卒中后抑郁的效果评价[J].中西医结合心脑血管病杂志,2016,14(21):2557-2558.
[13]韩家密,黄良文.出血性中风恢复期机体气机失常与对策[J].中国中医基础医学杂志,2016,22(11):1491-1492.
[14]盖引莉,李振斌,樊继康.补阳还五汤加减配合针灸治疗中风偏瘫疗效观察[J].陕西中医,2017,38(8):995-996.
[15]银蔷蔷,海英.针药结合治疗风痰阻络型缺血性中风恢复期吞咽障碍临床观察[J].辽宁中医药大学学报,2018,20(1):219-222.
[16]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,2017,35(1):189-191.
[17]刘晓宇.补阳还五汤加减联合丹红注射液对脑梗塞恢复期偏瘫患者血液流变学的影响[J].辽宁中医杂志,2017,44(7):1421-1424.
[18]袁磊,杨进平,闻瑛,等.补阳还五汤治疗缺血性中风恢复期(气虚血瘀)的临床疗效及对Hcy影响的临床研究[J].中华中医药学刊,2016,34(1):195-197.