摘要
目的观察补阳还五汤治疗气虚血瘀证急性缺血性脑卒中的临床疗效并探讨其可能的作用机制。方法选择气虚血瘀证急性缺血性脑卒中患者80例,按照随机数字表法分为试验组和对照组各40例,对照组采用西医常规治疗,试验组采用西医常规治疗加补阳还五汤。治疗7天后,观察比较两组治疗前后美国国立卫生院卒中量表(NIHSS)评分及NIHSS评分差值;改良Rankin量表(mRS)评分及mRS评分差值;血清缺氧转录因子-1α(HIF-1α)和B淋巴细胞瘤-2(Bcl-2)水平;评定两组中医证候积分及疗效。结果两组治疗后NIHSS和mRS评分较治疗前均降低(P<0.05);治疗后两组NIHSS、mRS评分均较治疗前降低(P<0.05),两量表评分治疗前后差值试验组均高于对照组(P<0.05);两组治疗后HIF-1α、Bcl-2水平较治疗前均升高(P<0.05),试验组治疗后HIF-1α值低于对照组(P<0.05),Bcl-2水平高于对照组(P<0.05);两组治疗后中医证候积分均低于治疗前,试验组治疗后中医证候积分低于对照组(P<0.05);试验组总有效率(80.0%)高于对照组(57.5%,P<0.05)。结论补阳还五汤能够改善气虚血瘀证急性缺血性脑卒中患者的神经功能缺损症状,降低中医证候积分,提高治疗总有效率,其机制可能是通过HIF-1α表达下调和Bcl-2表达上调改善脑供血和启动抗凋亡。
Objective To observe the clinical effect of Buyang Huanwu Decoction(BYHWD)on acute ischemic stroke patients with qi deficiency blood stasis syndrome(QDBSS),and to explore its possible mechanism.Methods Totally 80 acute ischemic stroke patients with QDBSS admitted were assigned to the experimental group and the control group by random digit table,40 in each group.Patients in the control group received routine Western medicine treatment,while those in the control group additionally took BYHWD.After 7 days treatment,National Institutes of Health Stroke Scale(NIHSS)score and NIHSS score differences between before and after treatment in the two groups,Modified Rankin scale(mRS)score and the difference of mRS score between before and after treatment in the two groups,the expressions of hypoxia transcription factor-1α(HIF-1α)and B-cell lymphoma-2(Bcl-2)in the two groups were observed and compared.The symptoms scores of traditional Chinese medicine and curative effects in the two groups were evaluated.Results The NIHSS and mRS scores in the two groups were lower after treatment than before treatment(P<0.05).The post-/pre-treatment differences in NIHSS and mRS scores were higher in the experimental group than in the control group(P<0.05).HIF-1αand Bcl-2 levels were higher in the two groups after treatment than before treatment(P<0.05).The HIF-1αafter treatment was lower in the experimental group than in the control group(P<0.05).Bcl-2 level was higher in the experimental group than in the control group(P<0.05).TCM syndromes scores of the two groups after treatment were lower than those before treatment,and TCM syndromes scores of the experimental group after treatment were lower than those of the control group(P<0.05).The total effective rate of the experimental group(80.0%)was higher than that of the control group(57.5%,P<0.05).Conclusions BYHWD improved the symptoms of neurological deficit in acute ischemic stroke patients with QDBSS,reduced TCM syndromes scores,and improved the total effective rate.It might down-re
作者
黄志强
曹朝霞
崔晓娟
何其胜
邓志
王龙海
段杰
HUANG Zhi-qiang;CAO Zhao-xia;CUI Xiao-juan;HE Qi-sheng;DEND Zhi;WANG Long-hai;DUAN Jie(Department of Neurology,Dazhou Hospital of Integrated Traditional Chinese and Western Medicine,Sichuan(635000);Department of Endocrinology,Dazhou Hospital of Integrated Traditional Chinese and Western Medicine,Sichuan(635000);Laboratory Center,Dazhou Hospital of Integrated Traditional Chinese and Western Medicine,Sichuan(635000))
出处
《中国中西医结合杂志》
CAS
CSCD
北大核心
2022年第1期24-28,共5页
Chinese Journal of Integrated Traditional and Western Medicine
基金
四川省达州市卫计委科研课题(No.2018010)。
