益气祛瘀涤痰汤治疗脑梗死恢复期患者临床疗效分析

Clinical Analysis of the Effect of Yiqi Quyu Ditan Decoction on Patients with Cerebral Infarction in Convalescence

目的:探讨益气祛瘀涤痰汤治疗脑梗死恢复期患者临床疗效及作用机制。方法:选取2018年1月-2019年6月脑梗死恢复期患者86例,采用随机数字表法分为观察组43例和对照组43例。对照组采用二级预防用药,并根据患者病情、体质等情况开展认知、运动功能或语言功能训练,观察组在对照组治疗方法基础上服用益气祛瘀涤痰汤,连续治疗8周。治疗前后采用美国国立卫生研究院卒中量表(NIHSS)评价神经功能缺损情况,采用Barthel指数评价日常生活活动能力,并检测血清Hcy水平、FIB水平及活化部分凝血活酶时间,综合评价临床疗效及作用机制。结果:治疗后,观察组NIHSS评分及Barthel指数较治疗前明显改善,与对照组相比差异具有显著性(P<0.05),血清活化部分凝血活酶时间(APTT)较治疗前明显延长,与对照组相比差异具有显著性(P<0.05);观察组血清FIB及Hcy水平较治疗前明显下降,与对照组相比差异具有显著性(P<0.05)。结论:益气祛瘀涤痰汤能显著改善脑梗死恢复期患者的神经缺损程度及日常生活活动能力,其作用机制与改善患者活化部分凝血活酶时间、降低血清FIB、Hcy水平有关。

Objective:To investigate the clinical efficacy and mechanism of Yiqi Quyu Ditan Decoction in the treatment of patients with cerebral infarction in convalescence.Methods:86 patients with cerebral infarction in convalescence were enrolled,and were randomly divided into two groups,43 in each group.The control group was treated with secondary preventive medicine,and the cognitive,motor or language function training was carried out according to the patient’s condition and constitution.The observation group was treated with Yiqi Quyu Ditan Decoction on the basis of the treatment method of the control group for 8 weeks.National Institutes of Health Stroke Scale(NIHSS)was used to evaluate neurological deficit before and after treatment.Barthel index was used to evaluate activities of daily living.Serum Hcy level,FIB level and activated partial thromboplastin time(APTT)were detected to evaluate the clinical efficacy and mechanism.Results:After 8 weeks of treatment,the NIHSS score and the Barthel index in observation group was significantly improved,the difference was significant compared with the control group(P<0.05).Serum activated partial thromboplastin time(APTT)was significantly longer than before treatment,the difference was significant compared with the control group(P<0.05).The level of the serum Hcy and FIB in observation group was significantly lower than before treatment,the difference was also significant compared with the control group(P<0.05).Conclusion:Yiqi Quyu Ditan Decoction can significantly improve the degree of neurological deficit and activities of daily living in patients with cerebral infarction in convalescence,and its mechanism is related to improving activated partial thromboplastin time and reducing serum FIB and Hcy levels.