涤痰通络方治疗痰瘀阻络型急性缺血性脑卒中的临床疗效观察及对神经功能的影响

Clinical Observation on Therapeutic Effect of Ditan Tongluo Decoction( 涤痰通络方) onAcute Ischemic Stroke of Phlegm and Blood Stasis Obstructing Collaterals Type and ItsEffect on Nerve Function

目的探讨涤痰通络方治疗痰瘀阻络型急性缺血性脑卒中的临床疗效,并研究其对患者神经功能的影响。方法将2016年5月—2019年5月老年病科收治的98例缺血性脑卒中患者随机分为两组,各49例,对照组采用常规治疗方案,在对照组的基础上,观察组给予涤痰通络方治疗,两组持续治疗2个疗程。分别于治疗前后比较两组患者的临床疗效、中医证候积分、临床神经功能缺损(NIHSS量表)评分、改良Rankin量表(mRS)积分、脑血流动力学指标、神经胶质纤维酸性蛋白(GFAP)、神经元特异性烯醇化酶(NSE)、血清髓鞘碱性蛋白(MBP)、S100B蛋白水平。结果观察组总有效率为91.8%(45/49),对照组总有效率为75.5%(37/49),两组比较差异有统计学意义(P<0.05)。观察组治疗后中医证候积分、mRS积分及NIHSS评分均显著降低(P<0.05),并且显著低于对照组(P<0.05)。观察组治疗后CBV、CBF明显升高(P<0.05),MTT、TTP明显降低(P<0.05),并且优于对照组(P<0.05)。治疗后观察组患者GFAP、NSE、MBP及S100B均显著降低(P<0.05),并且均显著较对照组低(P<0.05)。结论涤痰通络方治疗痰瘀阻络型急性缺血性脑卒中临床疗效显著,促进患者脑内微循环,修复患者神经功能,值得临床推广。

Objective To explore the clinical effect of Ditan Tongluo Decoction(涤痰通络方)on the acute ischemic stroke of phlegm and blood stasis obstructing collaterals type and study its influence on the patients’nerve function.Methods A total of 98 patients with ischemic stroke admitted to geriatric department from May 2016 to may 2019 were randomly divided into two groups,49 cases in each group.The control group was treated with routine treatment plan.On the basis of the control group,the observation group was treated with Ditan Tongluo Decoction,and the two groups were treated for two courses continuously.Before and after treatment,the clinical efficacy,TCM syndrome score,NIHSS score,modified Rankin score,cerebral hemodynamic index,glial fibrillary acidic protein(GFAP),neuron specific enolase(NSE),serum myelin basic protein(MBP)and S100 B protein of the two groups were compared.Results The total effective rate was 91.8%(45/49)in the observation group and 75.5%(37/49)in the control group.The difference was statistically significant(P<0.05).After treatment,TCM syndrome score,mRS score and NIHSS score in the observation group were significantly lower than those in the control group(P<0.05).After treatment,CBV and CBF in the observation group were increased significantly(P<0.05).MTT and TTP were decreased significantly(P<0.05),which were lower than those of the control group(P<0.05).After treatment,GFAP,NSE,MBP and S100 B in the observation group were significantly lower than those in the control group(P<0.05).Conclusion The therapeutic effect of Ditan Tongluo Decoction on acute ischemic stroke of phlegm and blood stasis obstructing collaterals type is significant.Ditan Tongluo Decoction can promote the microcirculation in the brain and repair the nerve function of the patients,and is worthy of clinical promotion.