摘要
目的:观察蛭龙溶栓汤对风痰瘀阻型急性脑梗死者脑代谢产物影响,并采用磁共振波谱(MRS)定量分析进行疗效评价。方法:符合纳入标准的80例急性脑梗死患者按照随机数表法分为观察组和对照组,各40例。对照组采用常规基础治疗,观察组在常规基础治疗的同时采用蛭龙溶栓汤治疗。治疗2周后,采用磁共振波谱定量检测脑梗死组织代谢物N-乙酰天门冬氨酸(NAA),胆碱(Cho),肌酸(Cr)及乳酸(Lac)的含量,计算出Cho/Cr、NAA/Cr和Lac/Cr比值;检测血浆同型半胱氨酸(HCY)、血管性假血友病因子(VWF)和α颗粒膜蛋白-140(GMP-140)等血栓相关因子水平;采用NIHSS评定患者神经功能,采用Barthel指数评定患者日常生活能力。结果:治疗后,观察组患者NAA/Cr比值较治疗前明显升高(P <0. 05),观察组患者NAA/Cr和Lac/Cr比值较治疗前明显降低(P <0. 05),且改变程度明显优于对照组(P <0. 05);观察组患者Hcy、VWF和GMP-140血栓相关因子水平均降低(P <0. 05),观察组患者NIHSS积分和BI积分较治疗前明显改善,且改善程度优于对照组(P <0. 05)。两组均未见明显不良反应。结论:采用蛭龙溶栓汤治疗风痰瘀阻型急性脑梗死能够明显改善患者梗死周围区脑细胞的代谢,具有保护神经细胞的作用,挽救缺血半暗带,降低血栓相关因子水平,并减轻脑组织损伤和神经功能缺损。
Objective ： To observe the effect of Zhilong Rongshuan Decoction on cerebral metabolites in patients with acute cerebral infaretion due to wind -phlegm obstruction, and to evaluate the therapeutic effect by quantitative analysis of MRI. Methods： 80 patients with acute cerebral infal^tion were randomly divided into the observation group （n = 40 ） and the control group （n = 40 ）. The control group was given conventional basic treatment ; on which basis, the observation group was also treated with Zhilong Rongshuan Decoction. After 2 weeks of treatment, the contents of NAA, Cho, Cr and Lac in cerebral infaretion tissue were detected by quantitative analysis of MRI. Cho/Cr, NAA/Cr and Lac/Cr were measured. Thrombus - related factors, such as HCY, VWF and GMP- 140, were tested. NIHSS was used to assess neurological function and Barthel index was used to assess the daily living ability. Results： After treatment, NAA/Cr value was significantly in-creased, and Lac/Cr value was significantly decreased in the observation group （P 〈 0.05 ） ; the changes of the observation group were more obvious than those of the control group（P 〈0.05）. The levels of Hey, VWF and GMP - 140 were significantly lowered, and seoris of NIHSS and BI were gl^atly improved in the observa- tion group （P 〈 0.05 ） ; the improvements of the observation group were significantly better than those of the control group （ P 〈 0. 05 ）. No obvious adverse reactions and side effects were observed in both groups. Conclusion： Zhilong Rongshuan Decoction can improve brain metabolism and protect neurocyte around the infarcted area, save the ischemic penumbra, lower the level of thrombosis - related factors, and reduce the dam- age of brain tissue and neurological deficits in treatment of acute cerebral infarction due to wind - phlegm obstruction.
作者
张金凤
李光
苏果
陈飞
ZHANG Jinfeng;LI Guang;SU Guo;CHEN Fei(Zhumadian Second Hospital of TCM,Zhumadian 463000,China)
出处
《中医药信息》
2018年第5期73-76,共4页
Information on Traditional Chinese Medicine
基金
河南省科技攻关计划项目(No.162102310115)
