摘要
目的观察加减枳实大黄汤治疗急性缺血性脑卒中患者的临床疗效,以及对脑肠肽Ghrelin、Nesfatin-1、炎症因子的影响。方法将60例脑梗死急性期住院患者分为治疗组与对照组各30例。对照组患者积极进行常规治疗,治疗组在常规治疗的基础上予加减枳实大黄汤,疗程为2周。比较两组治疗前后美国国立卫生研究院脑卒中量表(NIHSS)评分及Barthel指数(BI)量表、中医证候量表评分、脑肠肽Ghrelin、Nesfatin-1含量,以及抗炎因子白细胞介素-4(IL-4)、转化生长因子-β(TGF-β),促炎因子白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)含量。结果两组治疗后,NIHSS评分、中医证候评分均显著降低,BI评分显著增加,观察组优于对照组(P<0.05)。脑肠肽Ghrelin、Nesfatin-1均增高,治疗组增高程度优于对照组(P<0.05);两组治疗后,抗炎因子TGF-β、IL-4均较治疗前升高,TGF-β治疗组升高程度大于对照组(P<0.05),IL-4两组升高程度无明显差异(P>0.05);治疗组促炎因子TNF-α、IL-6均治疗前降低,治疗组降低程度大于对照组(P<0.05)。结论加减枳实大黄汤可通过调控急性缺血性脑卒中患者脑肠肽Ghrelin、Nesfatin-1的表达,调节炎症因子的水平,优化患者神经缺损症状,提高自主生活能力,改善痰热腑实症状。
Objective:To explore the clinical efficacy of Modified Zhishi Dahuang Decoction on patients with acute ischemic stroke,and its effect on brain intestinal peptide Ghrelin,Nesfatin-1 and inflammatory indexes.Methods:A total of 60 hospitalized patients with acute cerebral infarction were divided into a treatment group(n=30)and a control group(n=30).After grouping,patients in the control group were actively treated conventionally;in the treatment group,on the basis of conventional treatment,Modified Zhishi Dahuang Decoction was administered orally.The treatment period was set to two weeks in both the treatment and control groups.The scores of the National Institutes of Health Stroke Scale(NIHSS),Barthel Index(BI),the score of TCM syndromes,as well as the levels of the brain intestinal peptide Ghrelin,Nesfatin-1,anti-inflammatory factors IL-4 and TGF-β,and proinflammatory factors IL-6 and TNF-α were compared between the two groups before and after treatment.Results:After treatment,the NIHSS score and TCM syndrome score of the two groups were significantly reduced,the BI score was significantly increased,and the observation group was better than the control group(P<0.05).The brain intestinal peptides Ghrelin and Nesfatin-1 were all higher than before treatment,and the increase was greater in the treatment group than in the control group(P<0.05).After treatment,the anti-inflammatory factor TGF-β,IL-4 were higher than those before treatment in both groups,and increase degree of TGF-β in the treatment group was greater than that of the control group(P<0.05),and there was no significant difference in the increase degree of IL-4 between the two groups(P>0.05);the pro-inflammatory factors TNF-α and IL-6 were lower in the treatment group than before treatment,and the degree of decrease was greater in the treatment group than in the control group(P<0.05).Conclusion:Modified Zhishi Dahuang Decoction can promote the expression of brain intestinal peptides after acute ischemic stroke,and improve the symptoms of neurological
作者
曹凤娇
吕双
颜雨晴
张越
张敬华
Fengjiao;Li Shuang;Yan Yuqing;Zhang Yue;Zhang Jinghua(Jiangyin Hospital of Traditional Chinese Medicine,Jiangsu,Jiangyin 214400,China)
出处
《中国中医急症》
2023年第9期1614-1617,共4页
Journal of Emergency in Traditional Chinese Medicine
基金
江苏省卫生健康发展研究中心基金项目(JSHD2021027)
南京市卫生科技发展资金项目(YKK19098)
南京市中医药青年人才培养对象(ZYQ20004)
南京中医药大学自然科学基金项目(XZR2021045)。
关键词
急性缺血性脑卒中
加减枳实大黄汤
脑肠肽
炎症因子
Acute ischemic stroke
Modified Zhishi Dahuang Decoction
Brain intestinal peptides
Inflammatory factors
