摘要
目的探讨清热熄风活血汤合葛根素注射液治疗急性脑梗死风阳上扰证疗效及对实验室指标水平的影响。方法选取平煤神马医疗集团总医院2016年5月至2018年5月收治急性脑梗死风阳上扰证病人共116例,以随机抽签法分为对照组(58例)和观察组(58例),对照组单纯西医方案:采用阿司匹林100 mg/d口服和阿托伐他汀20 mg/d口服为主的包括降低颅内压、抗血小板、降血糖、稳定血压及稳定斑块等治疗措施;观察组则在此基础上辅以清热熄风活血汤合葛根素注射液治疗,包括:①清热熄风活血汤[组分:石决明(先煎)、夜交藤、茯神等]煎汁,分早晚2次服用;②葛根素注射液400毫克/次,1次/天;两组疗程均为14 d。比较两组近期疗效、远期改良RANKIN量表(mRS)评分良好率、治疗前后中医证候积分、美国国立卫生研究院卒中量表(NIHSS)评分、缺血半暗带体积、工具性日常生活活动能力(IADL)评分、血脂指标水平、血液流变学指标、血管内皮生长因子(VEGF)、血管紧张素Ⅰ(Ang⁃I)及过氧化氢酶(CAT)水平。结果观察组近期疗效和远期mRS评分良好率均优于对照组(P<0.05);观察组治疗后中医证候积分、NIHSS评分、缺血半暗带体积及IADL评分均优于对照组及治疗前(P<0.05);中医症候积分包括:偏身瘫痪[(1.09±0.12)比(1.53±0.40)比(4.21±1.10)分];舌强语謇[(1.12±0.17)比(1.67±0.32)比(4.30±0.92)分];口眼斜[(0.97±0.19)比(4.12±0.94)比(1.44±0.37)分];耳鸣目眩[(0.93±0.20)比(1.35±0.32)比(3.90±0.82)分];NIHSS评分:(9.15±1.37)比(12.80±1.80)比(20.90±2.65)分;缺血半暗带体积:(21.92±4.65)比(33.60±6.80)比(83.90±14.98)mL;IADL评分:(19.15±4.79)比(15.80±3.44)比(5.30±1.05)分;观察组治疗后血脂指标和血液流变学指标水平均低于对照组及治疗前(P<0.05);血脂指标包括:总胆固醇(TC)[(3.97±0.51)比(4.51±0.64)比(5.59±0.83)mmol/L];三酰甘油(TG)[(1.19±0.30)比(1.54±0.45)比(2.11±0.68)m
Objective To investigate the clinical effects of Qingre Xifeng Huoxue Decoction combined with Puerarin injection in the treatment of patients with acute cerebral infarction for Fengyang Shangzu syndrome and influence on laboratory index.Meth⁃ods 116 patients with acute cerebral infarction for Fengyang Shangzu syndrome were chosen from May 2016 to May 2018 in Gen⁃eral Hospital of Pingmei Shenma Medical Group and randomly divided into 2 groups including control group(58 patients)with western medicine used alone and observation group(58 patients)with Qingre Xifeng Huoxue Decoction combined with Puerarin in⁃jection on the basis of control group including:①Qingre Xifeng Huoxue Decoction Shijueming for 20 g(decocting first),Nightin⁃gale,Tuckahen,etc.,taken twice in the morning and evening;②Puerarin injection 400 mg/time,1 time/day;and the short⁃term clinical efficacy,long⁃term good rate of modifed Rankin Scale(MRS)score,TCM syndrome score,National Institutes of Health Stroke Scale(NIHSS)score,ischemic penumbra volume,instrumental activities of daily living(IADL)score,the levels of blood lipid index,hemorheology index,vascular endothelial growth factor(VEGF),Angiotensin I(Ang⁃I)and Catalase(Cat)before and af⁃ter treatment of 2 groups were compared.Results The clinical effects for short⁃term and good and excellent rate of mRS score for long⁃term of observation group was significantly better than control group(P<0.05).The TCM syndrome score,NIHSS score,isch⁃emic penumbra volume and IADL score of observation group after treatment were significantly improved than control group and be⁃fore treatment(P<0.05).[TCM syndrome score:(1.09±0.12)points vs.(1.53±0.40)points,(4.21±1.10)points;(1.12±0.17)points vs.(1.67±0.32)points,(4.30±0.92)points;(0.97±0.19)points vs.(1.44±0.37)points,(4.12±0.94)points;(0.93±0.20)points vs.(1.35±0.32)points,(3.90±0.82)points;NIHSS scores:(9.15±1.37)points vs.(12.80±1.80)points,(20.90±2.65)points;ischemic pen⁃umbra volume:(21.92±4.65)ml vs.(33.60±6.80)ml
作者
牛永义
王芸生
NIU Yongyi;WANG Yunsheng(Department of Traditional Chinese Medicine,General Hospital of Pingmei Shenma Medical Group,Pingdingshan,Henan 467000,China)
出处
《安徽医药》
CAS
2020年第1期27-32,共6页
Anhui Medical and Pharmaceutical Journal
关键词
脑梗死
疏风清热
活血
葛根素
内皮生长因子
血管紧张素Ⅰ
过氧化氢酶
血液黏度
血细胞比容
纤维蛋白
清热熄风活血汤
风阳上扰
Brain infarction
Dispelling wind clearing heat
Activating blood
Puerarin
Endothelial growth factors
Angiotensin I
Catalase
Blood viscosity
Hematocrit
Fibrin
Qingre Xifeng Huoxue Decoction
Fengyang Shangzu
