补肾益脑通络胶囊对脑卒中患者血液流变学及血脂相关指标的影响

Effects of bushen yinao tongluo capsule on the relative indexes of hemorheology and blood fat in patients with stroke

目的:观察中药补肾益脑通络胶囊配合西药对脑卒中患者血液流变学和血脂的影响,并与单纯应用西药者比较。方法:脑卒中患者452例为1999-06/2002-12山东中医药大学附属康复医院收治,随机分为补肾益脑通络组270例和对照组182例,对照组应用低分子右旋糖酐、胞二磷胆碱钠和复方丹参等药物治疗,补肾益脑通络组在此基础上服用补肾益脑通络胶囊(人参、何首乌、菖蒲、水蛭、川芎等组成,每粒0.5g)6粒/次,3次/d,15d为1个疗程,治疗两个疗程。所有患者治疗前后均进行神经功能缺损程度评分评估神经功能缺损程度,并做血液流变学、血脂检查,均获参与者知情同意。结果:按实际处理分析,386例进入结果分析。①血液流变学指标:两组治疗后均较治疗前改善,但补肾益脑通络组治疗后全血高切、低切黏度、血浆黏度和纤维蛋白原显著低于对照组(P<0.001)。②血脂结果:补肾益脑通络组治疗后较治疗前显著改善,且胆固醇和三酰甘油显著低于对照组治疗后犤(4.88±0.45),(5.25±0.67)mmol/L,t=6.49;(1.52±0.32),(1.86±0.50)mmol/L,t=8.14,P均<0.001犦。③神经功能缺损程度评分:两组治疗后均较治疗前显著改善(P<0.001),但补肾益脑通络组治疗后显著低于对照组(9.01±8.16,16.10±9.86,t=7.71,P<0.001)。结论:补肾益脑通络胶囊与西药配合应用能明显改善缺血性脑卒中患者的血液流变学及血脂多项指标,可以显著促进神经功能的恢复,改善肢体功能障碍,效果明显优于单纯西药治疗。

AIM： To observe the effect of the traditional Chinese medicine bushen yinao tongtuo （tonifying the kidney to reinforcing the brain and removing obstruction in the channels） capsule mediated with western medicine on hemorheology and blood fat in patients with stroke, and compare with the patients only using western medicine. METHODS： 452 inpatients with stroke from Affiliated Rehabilitation Hospital of Shandong University of Traditional Chinese Medicine from June 1999 to December 2002 were selected and divided randomly into bushen yinao tongluo group with 270 cases and control group with 182 cases. The patients in control group were treated with low molecular dextran, corenalin natrium and compound prescripition dan-shen root etc. On this basis the patients in bushen yinao tongtuo group were treated with tonifying the kidney to reinforcing the brain and removing obstruction in the channels capsule （composed of ginseng, tuber fleeceflower root, leech, Szechwan lovge rhizome etc., 0.5 g per capsule） 6 capsule every time and three times per day and 15 days for 1 course for 2 courses. All the patients were performed with neurologic impairment degree score to evaluate the neurologic impairment degree, and hemorheology and blood fat were detected with the know and agreement of the participators. RESULTS： According to actually disposal analysis, 386 cases were involved in the result analysis. ① The index of hemorheology： The patients in the two groups post-treatment became better than that pro-treatment, but viscosity of whole blood high and low cut, plasm viscosity and fibrinogen in patients in the bushen yinao tongtuo group post-treatment were significantly lower than that in control group （P 〈 0.001 ）. ② The result of blood fat： It was significantly ameliorated in the bushen yinao tongluo group posttreatment than that pre-treatment, and cholestery and triacylglycerol were significantly lower than that in control group post-treatment [（4.88±0.45）,（5.25±0.67） mmol/L, （t=6.49） ; （1.52±0.32）, （1.86±0.50） mmol/L, （t=8.14, P 〈 0.001）]. ③ The score of neurologic impairment level： It was significantly ameliorated in the two groups post-treatment than that pretreatment （P 〈 0.001 ）, but it was significantly lower in the bushen yinao tongtuo group post-treatment than that in control group （9.01±8.16, 16.10±9.86, t=7.71, P 〈 0.001 ）. CONCLUSION： The application of bushen yinao tongluo capsule mediated with western medicine can significantly ameliorate the hemorheology and blood fat etc. index in patients with ischemia stroke, and significantly improve the recovery of neural function, improve advantageously the limbs disturbancde, and its effect is significantly better than the pure usage of western medicine to treat.