化痰通络汤治疗痰瘀阻络型急性脑梗死
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摘要
目的:观察化痰通络汤治疗急性脑梗死痰瘀阻络证患者的临床疗效。方法:100例急性脑梗死患者按照随机数字表法分为对照组和观察组,每组各50例。对照组在常规治疗基础上给予丹参注射液,观察组患者在常规治疗基础上给予化痰通络汤。治疗后,比较两组患者临床疗效、中医证候积分、血液流变学、炎症因子、同型半胱胺酸及神经元特异性烯醇化酶水平。结果:观察组有效率为98%(49/50),对照组有效率为84%(42/50),两组有效率比较,差异有统计学意义(P <0. 05)。两组患者治疗后中医证候积分与治疗前比较,差异均有统计学意义(P <0. 01或P <0. 05);观察组治疗后中医证候积分显著低于对照组治疗后(P <0. 01或P <0. 05)。两组患者治疗后全血黏度、血浆黏度、纤维蛋白原(fibrinogen,FIB)、三酰甘油、胆固醇水平均低于治疗前,差异均有统计学意义(P <0. 05);观察组治疗后三酰甘油、胆固醇均低于对照组治疗后,差异均有统计学意义(P <0. 05)。两组患者治疗后超敏C反应蛋白、肿瘤坏死因子-α、白细胞介素-6水平均低于治疗前,差异均有统计学意义(P <0. 05);观察组治疗后以上指标均显著低于对照组,差异均有统计学意义(P <0. 05)。两组患者治疗后同型半胱胺酸、神经元特异性烯醇化酶均低于治疗前,差异均有统计学意义(P <0. 05);观察组治疗后以上指标均显著低于对照组,差异均有统计学意义(P <0. 05)。结论:化痰通络汤可以通过改善急性脑梗死患者血液流变学指标和神经功能缺损,减少炎症反应,降低血栓形成危险因子的水平,提高急性脑梗死的临床疗效。
Objective: To observe the clinical efficacy of Huatan Tongluo Decoction for acute cerebral infarction with phlegm and blood stasis blocking collaterals. Methods: 100 patients with acute cerebral infarction were divided into control group and observation group according to random number table method,50 cases in each group. The control group was given Salvia miltiorrhiza injection on the basis of routine treatment,while the observation group was given Huatan Tongluo Decoction on the basis of routine treatment. After treatment,the clinical efficacy,TCM syndrome score,hemorheology,inflammatory factors,homocysteine and neuron specific enolase levels were compared between the two groups. Results: The effective rate was 98%( 49/50) in the observation group and 84%( 42/50) in the control group. There was significant difference between the two groups( P < 0. 05). There were significant differences in TCM syndrome scores between the two groups after treatment and before treatment( P < 0. 01 or P <0. 05). TCM syndrome scores in the observation group after treatment were significantly lower than those in the control group after treatment( P < 0. 01 or P < 0. 05). After treatment,the blood viscosity,plasma viscosity,fibrinogen( FIB),triglyceride and cholesterol levels of the two groups were lower than those before treatment,and the difference was statistically significant( P < 0. 05).After treatment,the triglyceride and cholesterol levels of the observation group were lower than those of the control group,and the difference was statistically significant( P < 0. 05). The levels of hypersensitive C-reactive protein,tumor necrosis factor-α and interleukin-6 in the two groups after treatment were lower than those before treatment,and the difference was statistically significant( P < 0. 05). After treatment,the above indexes in the observation group were significantly lower than those in the control group,with statistical significance( P < 0. 05). The levels of homocysteine and neuron specific enolase in the two groups after treatment were lower than those before treatment,and the difference was statistically significant( P < 0. 05). The above indexes in the observation group were significantly lower than those in the control group after treatment,and the difference was statistically significant( P < 0. 05). Conclusion: Huatan Tongluo Decoction can improve the blood rheology index and neurological deficit of patients with acute cerebral infarction,reduce inflammation,reduce the level of risk factors for thrombosis,and improve the clinical efficacy of acute cerebral infarction.
Objective: To observe the clinical efficacy of Huatan Tongluo Decoction for acute cerebral infarction with phlegm and blood stasis blocking collaterals. Methods: 100 patients with acute cerebral infarction were divided into control group and observation group according to random number table method,50 cases in each group. The control group was given Salvia miltiorrhiza injection on the basis of routine treatment,while the observation group was given Huatan Tongluo Decoction on the basis of routine treatment. After treatment,the clinical efficacy,TCM syndrome score,hemorheology,inflammatory factors,homocysteine and neuron specific enolase levels were compared between the two groups. Results: The effective rate was 98%( 49/50) in the observation group and 84%( 42/50) in the control group. There was significant difference between the two groups( P < 0. 05). There were significant differences in TCM syndrome scores between the two groups after treatment and before treatment( P < 0. 01 or P <0. 05). TCM syndrome scores in the observation group after treatment were significantly lower than those in the control group after treatment( P < 0. 01 or P < 0. 05). After treatment,the blood viscosity,plasma viscosity,fibrinogen( FIB),triglyceride and cholesterol levels of the two groups were lower than those before treatment,and the difference was statistically significant( P < 0. 05).After treatment,the triglyceride and cholesterol levels of the observation group were lower than those of the control group,and the difference was statistically significant( P < 0. 05). The levels of hypersensitive C-reactive protein,tumor necrosis factor-α and interleukin-6 in the two groups after treatment were lower than those before treatment,and the difference was statistically significant( P < 0. 05). After treatment,the above indexes in the observation group were significantly lower than those in the control group,with statistical significance( P < 0. 05). The levels of homocysteine and neuron specific enolase in the two groups after treatment were lower than those before treatment,and the difference was statistically significant( P < 0. 05). The above indexes in the observation group were significantly lower than those in the control group after treatment,and the difference was statistically significant( P < 0. 05). Conclusion: Huatan Tongluo Decoction can improve the blood rheology index and neurological deficit of patients with acute cerebral infarction,reduce inflammation,reduce the level of risk factors for thrombosis,and improve the clinical efficacy of acute cerebral infarction.
引文
[1]张斌.急性脑梗死患者C反应蛋白与血清胱抑素C水平变化的临床意义[J].实用医药杂志,2018,35(1):1-3.
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[5]吴立国,马民凯,秦维.清热疏风通络方治疗急性脑梗死疗效观察[J].中国中医急症,2017,26(11):2049-2051.
[6]陈家红,杨勇杰.阿托伐他汀对急性脑梗死患者临床疗效血脂及血液流变学的影响[J].中国实用神经疾病杂志,2016,19(18):50-51.
[7]宋军营,吕靖,贾亚泉,等.痰瘀相关学说与络病[J].中医学报,2016,31(9):1328-1330.
[8]国家中医药管理局脑血管病急症科研协作组.中风病诊断与疗效评定标准[J].北京中医药大学学报,1996,19(1):55.
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[10]国第四届脑血管病学术会议.脑卒中患者临床神经功能缺损程度评分标准(1995)[J].中华神经科杂志,1996,29(6):381-383.
[11]卢志刚,王承明,李晓莉,等.季节变化对实验性脑梗死大鼠免疫炎性因子的影响[J].荆楚理工学院学报,2012,27(2):40.
[12]易继龙,卢志刚.长春西汀注射液对脑梗死并发慢性心力衰竭患者炎症因子的影响[J].医药导报,2014,33(2):210.
[13]黄会君.丹参药物临床应用研究现状[J].内蒙古中医药,2017,36(16):133.
[14]张文海.芎的药理作用及临床应用[J].中国卫生标准管理,2015,6(26):117-118.
[15]张明发,沈雅琴.半夏提取物抗菌抗炎及其抗肿瘤药理作用研究进展[J].抗感染药学,2017,14(6):1089-1094.
[16]裴昆,夏放高,陈海芳,等.陈皮、化橘红和枳壳研究概况[J].江西中医药,2015,46(1):71-74.
[17]何玉琴.中药鸡血藤研究现状[J].中西医结合心血管病杂志,2017,5(29):170.
[18]沈自强.黄芪的现代药理研究[J].内蒙古中医药,2011,30(19):117,122.
[19]张振强,宋军营,贾亚泉,等.脑缺血合并高脂血症模型大鼠脑组织的病理改变[J].中国组织工程研究,2013,17(33):5981-5987.
[20]庄志江.化痰通络汤对急性脑梗死风痰阻络证型患者NSE、HCY因子影响研究[D].广州:广州中医药大学,2017.
[21]李学军.急性脑梗死患者同型半胱氨酸水平变化及其治疗[J].临床医药文献电子杂志,2017,4(88):17290.
[22]胡淑云,陈丽,黄金华.依达拉奉联合巧风化疲通络汤对风疲阻络型急性脑梗死患者的疗效[J].中国当代医药,2017,24(2):144-146.
[2]许云鹤,刘永刚,赵小妹,等.丁苯酞注射液治疗急性脑梗的疗效及对血清s TRAIL、OPGTNF-α的影响[J].中国实用神经疾病杂志,2016,19(13):3-4.
[3]]张振强,贾亚泉,宋军营,等.高脂血症合并脑缺血对模型大鼠炎症因子的影响[J].中国实验方剂学杂志,2013,19(8):183-187.
[4]卢志刚,刘芸.醒脑静注射液对急性脑梗死血瘀证患者疗效及相关指标的影响[J].中国药房,2016,27(21):2898-2900.
[5]吴立国,马民凯,秦维.清热疏风通络方治疗急性脑梗死疗效观察[J].中国中医急症,2017,26(11):2049-2051.
[6]陈家红,杨勇杰.阿托伐他汀对急性脑梗死患者临床疗效血脂及血液流变学的影响[J].中国实用神经疾病杂志,2016,19(18):50-51.
[7]宋军营,吕靖,贾亚泉,等.痰瘀相关学说与络病[J].中医学报,2016,31(9):1328-1330.
[8]国家中医药管理局脑血管病急症科研协作组.中风病诊断与疗效评定标准[J].北京中医药大学学报,1996,19(1):55.
[9]全国第四届脑血管病学术会议.各类脑血管疾病诊断要点(1995)[J].中华神经杂志,1996,29(6):379.
[10]国第四届脑血管病学术会议.脑卒中患者临床神经功能缺损程度评分标准(1995)[J].中华神经科杂志,1996,29(6):381-383.
[11]卢志刚,王承明,李晓莉,等.季节变化对实验性脑梗死大鼠免疫炎性因子的影响[J].荆楚理工学院学报,2012,27(2):40.
[12]易继龙,卢志刚.长春西汀注射液对脑梗死并发慢性心力衰竭患者炎症因子的影响[J].医药导报,2014,33(2):210.
[13]黄会君.丹参药物临床应用研究现状[J].内蒙古中医药,2017,36(16):133.
[14]张文海.芎的药理作用及临床应用[J].中国卫生标准管理,2015,6(26):117-118.
[15]张明发,沈雅琴.半夏提取物抗菌抗炎及其抗肿瘤药理作用研究进展[J].抗感染药学,2017,14(6):1089-1094.
[16]裴昆,夏放高,陈海芳,等.陈皮、化橘红和枳壳研究概况[J].江西中医药,2015,46(1):71-74.
[17]何玉琴.中药鸡血藤研究现状[J].中西医结合心血管病杂志,2017,5(29):170.
[18]沈自强.黄芪的现代药理研究[J].内蒙古中医药,2011,30(19):117,122.
[19]张振强,宋军营,贾亚泉,等.脑缺血合并高脂血症模型大鼠脑组织的病理改变[J].中国组织工程研究,2013,17(33):5981-5987.
[20]庄志江.化痰通络汤对急性脑梗死风痰阻络证型患者NSE、HCY因子影响研究[D].广州:广州中医药大学,2017.
[21]李学军.急性脑梗死患者同型半胱氨酸水平变化及其治疗[J].临床医药文献电子杂志,2017,4(88):17290.
[22]胡淑云,陈丽,黄金华.依达拉奉联合巧风化疲通络汤对风疲阻络型急性脑梗死患者的疗效[J].中国当代医药,2017,24(2):144-146.