羚角钩藤汤联合依达拉奉治疗风痰阻络型急性脑梗死的临床观察

Clinical Observation on the Combination of Lingjiao Gouteng Tang and Edaravone in the Treatment of Acute Cerebral Infarction with Wind Phlegm Obstruction Syndrome

目的探讨风痰阻络型急性脑梗死患者应用依达拉奉治疗同时与羚角钩藤汤联合应用效果。方法选取该院2022年5月—2023年5月收治的80例风痰阻络型急性脑梗死患者为研究对象,按照随机数字表法将其分为对照组与观察组,各40例。对照组采用单一依达拉奉治疗,观察组联合依达拉奉与羚角钩藤汤治疗。对比两组患者的临床疗效、中医证候评分、炎症因子、脑血液流变学及不良反应发生情况。结果观察组临床治疗总有效率为95.00%,高于对照组的75.00%,差异有统计学意义(P<0.05)。治疗前,两组中医证候评分、基质金属蛋白酶-9(MMP-9)、肿瘤坏死因子-α(TNF-α)、血浆黏度(PV)、红细胞聚集指数(EAI)表达比较,组间差异无统计学意义(P>0.05)。治疗后,观察组半身不遂评分为(0.91±0.15)分,舌强语謇评分为(0.99±0.12)分,头晕目眩评分为(0.95±0.11)分,嘴眼歪斜评分为(0.92±0.33)分,MMP-9为(90.92±8.78)ng/mL,TNF-α为(15.72±5.06)ng/L,PV为(1.19±0.13)mPa·s,EAI为(2.08±0.23),均低于对照组的(1.28±0.13)分、(1.31±0.19)分、(1.29±0.16)分、(1.27±0.31)分、(108.98±9.03)ng/mL、(32.33±6.65)ng/L、(1.72±0.15)mPa·s、(2.81±0.22),组间差异有统计学意义(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论风痰阻络型急性脑梗死患者应用依达拉奉治疗同时加服羚角钩藤汤,能够有效缓解临床症状,减轻炎性损伤,改善脑血循环,临床治疗效果确切,安全性高,不良反应未增加。

Objective To observe and explore the effect of using edaravone in the treatment of acute cerebral infarction patients with wind phlegm obstruction syndrome,and combining it with Lingjiao Gouteng Tang.Methods 80 patients with acute cerebral infarction with wind-phlegm-blocking syndrome treated in our hospital from May 2022 to May 2023 were selected as the research objects,and were divided into a control group and an observation group according to random number table method,with 40 cases in each group.The control group was treated with edaravone alone,and the observation group was treated with Edaravone and Lingjiao Guteng decoction.The clinical efficacy,TCM syndrome score,inflammatory factors,cerebral hemorheology and the occurrence of adverse reactions were compared between the two groups.Results The total effective rate of observation group was 95.00%,which was higher than 75.00%of the control group,and the difference was statistically significant(P<0.05).Before treatment,there were no significant differences in TCM syndrome score,matrix metalloproteinase-9(MMP-9),tumor necrosis faction-α(TNF-α),plasma viscosity(PV)and red blood cell aggregation index(EAI)between two groups(P>0.05).After treatment,in the observation group,the score of hemiplegia was(0.91±0.15)points,the score of tongue strength speech was(0.99±0.12)points,the score of dizziness was(0.95±0.11)points,the score of mouth and eye skew was(0.92±0.33)points,the score of MMP-9 was(90.92±8.78)ng/mL,and the score of TNF-αwas(15.72±5.06)ng/L,PV was(1.19±0.13)mPa·s,EAI was(2.08±0.23),they were lower than(1.28±0.13)points,(1.31±0.19)points,(1.29±0.16)points,(1.27±0.31)points,(108.98±9.03)ng/mL,(32.33±6.65)ng/L,(1.72±0.15)mPa·s,(2.81±0.22)of the control group,the differences between groups were statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion The application of edaravone combined with Lingjiao Gouteng Tang in the treatment of acute cerebral infarction patients with wind phlegm obstruction syndrome can effectively alleviate clinical symptoms,reduce inflammation damage,improve cerebral blood circulation,and have a definite clinical treatment effect,high safety,and no increase in adverse reactions.