摘要
目的:研究通窍活血汤联合丁苯酞软胶囊口服治疗急性缺血性卒中(acute ischemic stroke,AIS)的疗效及对血清血管内皮生长因子(VEGF)的影响。方法:纳入本次研究的AIS患者共76例,分为对照组和观察组各38例。所有患者采用本病常规治疗方法,对照组在此基础上予丁苯酞软胶囊口服,0.2 g/次,3次/d,观察组在口服丁苯酞软胶囊基础上予通窍活血汤加减,每日1剂,分早晚两次口服。所有患者治疗20 d为1个疗程,比较两组临床疗效,治疗前后的侧枝循环开放率、NIHSS、MoCA及MMSE评分、血液流变学指标(血浆黏度、纤维蛋白原及全血高、低切黏度)、VEGF水平以及不良反应发生情况。结果:两组有效率比较,差异具有统计学意义(P<0.05)。观察组侧枝循环开放率与对照组比较,差异具有统计学意义(P<0.05)。观察组治疗后MoCA、MMSE评分及VEGF水平较治疗前及对照组均有明显升高,差异具有统计学意义(P<0.05),NIHSS评分、血液流变学指标较治疗前及对照组均改善,差异具有统计学意义(P<0.05)。结论:通窍活血汤联合丁苯酞软胶囊口服能明显改善AIS患者侧枝循环、血液流变学、神经及认知功能,其机制可能与提高VEGF水平,促进新生血管形成有关。
Objective:To study the effect of Tongqiao Huoxue Decoction combined with butylphthalide on acute ischemic stroke and its effect on serum vascular endothelial growth factor(VEGF).Methods:There are 76 patients with acute ischemic stroke(Acute Ischemic Stroke,AIS),with 38 cases in the control group and 38 cases in the observation group.All patients were treated with conventional treatment methods for this disease.On this basis,the control group was given butylphthalide soft capsules orally,0.2 g/time,3 times per day,while the observation group was given Tongqiao Huoxue Decoction combined with oral butylphthalide soft capsules,one dose per day,two times in the morning and evening.All patients were treated for 20 days.The clinical efficacy,the collateral circulation rate before and after treatment,NIHSS,MoCA,MMSE,hemorheology(plasma viscosity,fibrinogen,whole blood high and low shear viscosity),VEGF levels and the occurrence of adverse reactions were compared between two groups.Results:The effective rate was 92.1%in the observation group and 73.7%in the control group,with significant difference(P<0.05).The collateral circulation rate was 86.8%in the observation group while 57.9%in the control group,with significant difference(P<0.05).After treatment,the MoCA,MMSE scores and VEGF levels of the observation group were significantly higher than those before the treatment and in the control group(P<0.05).The NIHSS score and hemorheology were improved compared with those before the treatment and in the control group(P<0.05).Conclusion:Tongqiao Huoxue Decoction combined with butylphthalide soft capsules can significantly improve collateral circulation,hemorheology,neurological and cognitive functions in patients with acute ischemic stroke.The mechanism may be related to the increase of VEGF levels and the acceleration of neovascularization.
作者
陈新
熊英琼
程绍民
CHEN Xin;XIONG Ying-qiong;CHENG Shao-min(Jiangxi University of Traditional Chinese Medicine, Nanchang 330004, Jiangxi Province, China;Department of Neurology, the First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China)
出处
《海南医学院学报》
CAS
2021年第2期105-110,共6页
Journal of Hainan Medical University
基金
江西省卫生计生委科技计划(20195025)
国家中医药管理局中医药重点学科中医诊断学(1242000309)。
关键词
通窍活血汤
丁苯酞
急性缺血性卒中
疗效
VEGF
Tongqiao Huoxue Decoction
Butylphthalide
Acute ischemic stroke
Efficacy
VEGF
