蒺藜总皂苷对缺血性脑卒中患者神经功能重建的影响

Effect of gross saponin from Tribulus terrestris on reconstruction of neural function in patients with ischemic stroke

目的观察蒺藜总皂苷(GSTT)对缺血性脑卒中患者神经功能重建的影响。方法按照全国第四届脑血管病学术会议制定的诊断标准,选择2001年5月-2006年12月在山西医科大学第二医院接受治疗的118例缺血性脑卒中后出现神经功能缺损的患者。采用抽签法将患者随机分为两组,治疗组(60例)和对照组(58例)。两组患者在年龄、性别、病程、临床神经功能缺损程度(ND)及Barthel指数(BI)评分等基础临床资料方面无统计学差异(P>0.05)。两组患者均接受原发病和神经内科的常规治疗,并进行早期康复训练。在此基础上,治疗组餐后口服GSTT30mg,3次/d,对照组餐后顿服肠溶阿司匹林100mg,疗程12周。检测两组患者的血液流变学、ND及BI的变化,并记录不良反应。结果两组患者治疗后上述各项指标均优于治疗前(P<0.01),治疗组副作用明显少于对照组(P<0.01)。结论GSTT治疗缺血性脑卒中,可降低血黏度,患者的神经功能重建疗效满意,且不良反应少。

Objective To investigate the effect of gross saponin from Tribulus terrestris （GSTT） on the reconstruction of neural function in patients with ischemic stroke. Methods According to the diagnostic criteria proposed by the 4th International Congress of Cardiology held in China, 118 patients suffering from neural functional damage （ND） after cerebral ischemic stroke, who were admitted to our hospital from May 2001 to December 2006 were enrolled for the study. The patients were randomly divided into test group （n=60） and control group （n=58）. There was no significant difference in basic data between the two groups Eage, sex, course of the disease, hemorheological indexes, clinical ND and Barthel index （BI）] （P〉0. 05）. On the basis of conventional treatment to original disease and early rehabilition therapy, GSTT capsules were administered three times after meal each day in 30mg dosage in the test group, and coated aspirin enteric tablets were administered in 100mg after breakfast once a day in the control group. The treatment period for each group was 12 weeks. The clinical data were recorded including hemorheological indexes, clinical ND and BI before and after therapy. The side effects of the treatment in both groups were also recorded. Results The neural function in both groups was improved obviously after therapy （P〈2 0.01）, and no significant difference existed between the two groups on the extent of improvement （P〉0. 05）. Furthermore, the side effects in the test group were significantly less than that in control group （P〈0. 01）. Conclusions The treatment of cerebral ischemic stroke with neural functional damage with GSTT can reduce blood viscosity effectively, and improve blood flow of the brain. It seems that GSTT is a good drug for the neural functional reconstruction with little side effects. It might be used as a long-term therapy in the future.