蛭蛇通络胶囊联合西药治疗缺血性脑卒中恢复期78例临床观察
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摘要
目的观察蛭蛇通络胶囊联合西药治疗缺血性脑卒中恢复期气虚血瘀证患者的临床疗效。方法将156例缺血性脑卒中恢复期气虚血瘀证患者随机分为对照组和治疗组各78例。对照组采用基础规范治疗和脑卒中的三级康复治疗方案,治疗组在对照组基础上加用蛭蛇通络胶囊,每次4粒(每粒0.5 g),每日3次,两组患者均用药8周。观察两组患者治疗前后总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)水平,并在治疗前和治疗后2、4、8周分别进行中医证候积分、美国国立卫生研究院卒中量表(NIHSS)评分和改良Rankin量表评分,并判定临床疗效。结果治疗组临床总有效率为79.22%,对照组为67.11%,治疗组优于对照组(P<0.05)。两组治疗后TC、TG、LDL-C水平均较治疗前降低,HDL-C水平升高(P<0.05或P<0.01)。治疗组治疗后LDL-C水平降低和HDL-C水平升高较对照组显著(P<0.05)。与治疗前比较,治疗组在治疗后4、8周中医证候积分、NIHSS评分和改良Rankin量表评分均降低(P<0.05或P<0.01);对照组治疗后8周中医证候积分、NIHSS评分和改良Rankin量表评分均降低(P<0.05)。与对照组治疗后同时间比较,治疗组治疗后4周和8周中医证候积分、NIHSS评分均降低(P<0.05)。治疗组治疗后8周改良Rankin量表评分较对照组同时间降低更明显(P<0.05)。结论蛭蛇通络胶囊联合西药治疗缺血性脑卒中恢复期气虚血瘀证患者可有效降低血脂,改善临床症状,恢复神经功能和日常生活能力。
Objective To observe the clinical effect of Zhishe Tongluo Capsule combined with west medicine treating ischemic stroke convalescence phase patients of Qi deficiency and blood stasis syndrome. Methods Totally156 ischemic stroke convalescence phase patients of Qi deficiency and blood stasis syndrome were randomly divided into control group and treatment group,each of 78 cases. Control group were given basic standard treatment and thirdlevel rehabilitation program. Treatment group were added oral Zhishe Tongluo Capsule,4 capsules each time( 0. 5 g each capsules),3 times a day. Both groups were treated for 8 weeks. Observe blood lipid including total cholesterol( TC),triglyceride( TG),high density lipoprotein cholesterol( HDL-C) and low density lipopro tein cholesterol( LDL-C) level in both groups before and after treatment. Evaluate therapeutic effect adopting Chinese medicine syndrome scores,National Institute of Health stroke scale( NIHSS) and Modified Rankin Scale before treatment and 2,4,8 weeks after treatment. Results Total effective rate in treatment group was 79. 22%,67. 11% in control group( P < 0. 05). TC,TG and LDL-C in both groups were decreased after treatment,while HDL-C increased( P < 0. 05 or P < 0. 01). The decrease of LDL-C and increase of HDL-C in treatment group was significant compared with that in control group after treatment( P < 0. 05). Scores of Chinese medicine syndrome,NIHSS and Modified Rankin Scale in treatment group were decreased after 4 and 8 weeks treatment( P < 0. 05 or P < 0. 01). Scores in control group were decreased after 8 weeks treatment( P < 0. 05). Scores of Chinese medicine syndrome and NIHSS in treatment group were lower than those in control group after 4 and 8 weeks treatment( P < 0. 05). Scores of Modified Rankin Scale in treatment group decreased more significantly than those in control group after 8 weeks treatment( P < 0. 05).Conclusion Zhishe Tongluo Capsule combined with west medicine could decrease blood lipid effectively,improve clinical symptoms and recover nerves function and activities of daily living of ischemic stroke convalescence phase patients of Qi deficiency and blood stasis syndrome.
Objective To observe the clinical effect of Zhishe Tongluo Capsule combined with west medicine treating ischemic stroke convalescence phase patients of Qi deficiency and blood stasis syndrome. Methods Totally156 ischemic stroke convalescence phase patients of Qi deficiency and blood stasis syndrome were randomly divided into control group and treatment group,each of 78 cases. Control group were given basic standard treatment and thirdlevel rehabilitation program. Treatment group were added oral Zhishe Tongluo Capsule,4 capsules each time( 0. 5 g each capsules),3 times a day. Both groups were treated for 8 weeks. Observe blood lipid including total cholesterol( TC),triglyceride( TG),high density lipoprotein cholesterol( HDL-C) and low density lipopro tein cholesterol( LDL-C) level in both groups before and after treatment. Evaluate therapeutic effect adopting Chinese medicine syndrome scores,National Institute of Health stroke scale( NIHSS) and Modified Rankin Scale before treatment and 2,4,8 weeks after treatment. Results Total effective rate in treatment group was 79. 22%,67. 11% in control group( P < 0. 05). TC,TG and LDL-C in both groups were decreased after treatment,while HDL-C increased( P < 0. 05 or P < 0. 01). The decrease of LDL-C and increase of HDL-C in treatment group was significant compared with that in control group after treatment( P < 0. 05). Scores of Chinese medicine syndrome,NIHSS and Modified Rankin Scale in treatment group were decreased after 4 and 8 weeks treatment( P < 0. 05 or P < 0. 01). Scores in control group were decreased after 8 weeks treatment( P < 0. 05). Scores of Chinese medicine syndrome and NIHSS in treatment group were lower than those in control group after 4 and 8 weeks treatment( P < 0. 05). Scores of Modified Rankin Scale in treatment group decreased more significantly than those in control group after 8 weeks treatment( P < 0. 05).Conclusion Zhishe Tongluo Capsule combined with west medicine could decrease blood lipid effectively,improve clinical symptoms and recover nerves function and activities of daily living of ischemic stroke convalescence phase patients of Qi deficiency and blood stasis syndrome.
引文
[1]中华预防医学会卒中预防与控制专业委员会介入组,急性缺血性脑卒中血管内治疗中国专家共识组.急性缺血性脑卒中血管内治疗中国专家共识[J].中华医学杂志,2014,94(27):2097-2102.
[2]Rha JH,Saver JL.The impact of recanalization on ischemic stroke outcome:a meta-analysis[J].Stroke,2007,38(3):967-973.
[3]陈薇,胡玉英.中医药治疗缺血性中风研究进展[J].中西医结合心脑血管病杂志,2012,10(4):474-476.
[4]罗诗,王净净.中药复方治疗脑出血与脑梗死恢复期的用药规律分析[J].湖南中医药大学学报,2014,34(3):61-64.
[5]中华医学会神经病学分会脑血管病学组急性缺血性脑卒中诊治指南撰写组.中国急性缺血性脑卒中诊治指南2010[J].中华神经科杂志,2010,43(2):1-8.
[6]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.
[7]Brott T,Adams HP,Olinger CP,et al.Measurements of acute cerebral infarction:a clinical examination scale[J].Stroke,1989,20(7):864-870.
[8]中华医学会神经病学分会神经康复学组,中华医学会神经病学分会脑血管病学组,卫生部脑卒中筛查与防治工程委员会.中国脑卒中康复治疗指南(2011完全版)[J].中国康复理论与实践,2012,18(4):301-308.
[9]王永刚,郑刚.优势病种:中西医结合诊疗方案[M].西安:陕西科学技术出版社,2013:43-49.
[10]Quinn TJ,Lees KR,Hardemark HG,et al.Initial Experience of a Digital Training Resource for Modified Rankin Scale Assessment in Clinical Trials[J].Stroke,2007,38(8):2257-2261.
[11]刘绪银,张宏伟.国医大师张学文临床经验传承集[M].北京:人民卫生出版社,2014:3-77.
[12]李军.玉鼎集:国医大师张学文学术思想鉴赏[M].西安:第四军医大学出版社,2014:217-220.
[13]高红莉,王德才,曲晓兰,等.黄芪丹参配伍对局灶性脑缺血再灌注大鼠脑组织VEGF和b FGFmRNA表达的影响[J].中药药理与临床,2013,29(5):95-98.
[14]李美娇,郭虹,刘青青,等.丹红注射液对脑缺血缺氧损伤的保护作用[J].中国实验方剂学杂志,2013,19(17):221-224.
[15]黄剑,陈喜德,李少鹏,等.川芎嗪注射液对鼠脑损伤后神经细胞的保护及功能恢复作用[J].国际医药卫生导报,2014,20(9):1232-1235.
[16]王希,武建卓,宋淑亮,等.水蛭多肽对局灶大鼠脑缺血再灌注损伤保护作用[J].中国生化药物杂志,2010,31(1):42-46.
[2]Rha JH,Saver JL.The impact of recanalization on ischemic stroke outcome:a meta-analysis[J].Stroke,2007,38(3):967-973.
[3]陈薇,胡玉英.中医药治疗缺血性中风研究进展[J].中西医结合心脑血管病杂志,2012,10(4):474-476.
[4]罗诗,王净净.中药复方治疗脑出血与脑梗死恢复期的用药规律分析[J].湖南中医药大学学报,2014,34(3):61-64.
[5]中华医学会神经病学分会脑血管病学组急性缺血性脑卒中诊治指南撰写组.中国急性缺血性脑卒中诊治指南2010[J].中华神经科杂志,2010,43(2):1-8.
[6]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.
[7]Brott T,Adams HP,Olinger CP,et al.Measurements of acute cerebral infarction:a clinical examination scale[J].Stroke,1989,20(7):864-870.
[8]中华医学会神经病学分会神经康复学组,中华医学会神经病学分会脑血管病学组,卫生部脑卒中筛查与防治工程委员会.中国脑卒中康复治疗指南(2011完全版)[J].中国康复理论与实践,2012,18(4):301-308.
[9]王永刚,郑刚.优势病种:中西医结合诊疗方案[M].西安:陕西科学技术出版社,2013:43-49.
[10]Quinn TJ,Lees KR,Hardemark HG,et al.Initial Experience of a Digital Training Resource for Modified Rankin Scale Assessment in Clinical Trials[J].Stroke,2007,38(8):2257-2261.
[11]刘绪银,张宏伟.国医大师张学文临床经验传承集[M].北京:人民卫生出版社,2014:3-77.
[12]李军.玉鼎集:国医大师张学文学术思想鉴赏[M].西安:第四军医大学出版社,2014:217-220.
[13]高红莉,王德才,曲晓兰,等.黄芪丹参配伍对局灶性脑缺血再灌注大鼠脑组织VEGF和b FGFmRNA表达的影响[J].中药药理与临床,2013,29(5):95-98.
[14]李美娇,郭虹,刘青青,等.丹红注射液对脑缺血缺氧损伤的保护作用[J].中国实验方剂学杂志,2013,19(17):221-224.
[15]黄剑,陈喜德,李少鹏,等.川芎嗪注射液对鼠脑损伤后神经细胞的保护及功能恢复作用[J].国际医药卫生导报,2014,20(9):1232-1235.
[16]王希,武建卓,宋淑亮,等.水蛭多肽对局灶大鼠脑缺血再灌注损伤保护作用[J].中国生化药物杂志,2010,31(1):42-46.