益气心脑宁防治老年心脑缺血临床研究

The clinical study of Yiqixinnaoning to prevent and treat cerebral infarction combined angina of coronary atherosclerosis heart disease about the elderly

目的观察自拟中药复方煎剂益气心脑宁治疗脑梗塞合并冠心病的临床疗效,探讨其对缺血性脑血管病和心血管病同时干预治疗的生物学机制,为中医药防治缺血性心脑血管病提供新的理论依据和有效方药。方法以20例脑梗塞合并冠心病心绞痛患者为研究对象,口服益气心脑宁4周,按积分记录症状体征,检测疗效指标:包括中医证候疗效,神经功能缺损(NIHSS)水平,认知功能障碍(MMSE)水平,日常生活活动能力(Barthel),心电图,左心室功能,血脂指标,血液流变指标,内皮功能等。同时监测血、尿、大便常规、肝、肾功能等安全性指标。并与20例通心络胶囊对照组作比较研究。结果治疗4周后,患者证候积分较治疗前明显下降,治疗组在改善认知功能、心绞痛情况、心电图等方面疗效与通心络对照组相同,在改善中医证候、神经功能缺损、日常生活能力、左心室功能、血流变、血脂、内皮功能等各项指标方面均优于通心络胶囊组,具有显著性差异(P<0.05)。结论益气心脑宁具有确切的心脑血管保护作用。本研究证实,气虚血瘀、痰浊阻络是脑梗塞与冠心病的共同病机,益气活血、化瘀通络、心脑同治是缺血性心脑血管病的重要治法。益气心脑宁具有显著的临床疗效,是治疗缺血性心脑血管病的有效复方。

Objective To investigate the curative efficiencies of Yiqixinnaoning on patients withcerebral infarction combined cerebral infarction combined angina of coronary atherosclerosis heart disease （CAHD）, and its biological mechanism of curative effect. We may provide new theoretical guidance on treatment ischemic angiocardiopathy and cerebrovascular disease by using Traditional Chinese Medicine. Methods 20 cases with cerebral infarction combined CAHD were taken as objects, and treatmeant with chinses medicine Yiqixinnaoning. The whole course of was 4 weeks. By means of comparative the curative effect for patients per as before and after therapy and between treatment group and control group which treated with Tongxinluojiaonang, the observations on effects were made. The indexes of curative effects included such as： clinical symptoms scores; nerval dysfunctions system, gnosia, viability, quality of life index, ECG, cardiac function, blood-lipid, blood rheology, the functions of endothelial cell, and etc. The safety evaluations were surveillance at the same time. Results The scores of the clinical symptons declined after 4 weeks treatment. The outcomes of statistic showed that, except MMSE, frequencies and continude-time of angina peetoris and ECG, the other indexes of Yiqixinnaoning were better than that of the group of Tongxinluo（ P 〈 0. 05 ）. Conclusion Yiqixinnaoning possesses the confired protective functions to angiocardiopathy and cerebrovascular. The studies showed that, the common pathogenesis of cerebral infarction and CAHD were deficiency of qi and blood stasis, pathogens injuried the collateral branch of the large channel. The important principle in treatment on ischemic angiocar diopathy and eerebrovaseular disease were supplementing qi and promoting blood, removing the phlegm and turbid urine, and treatment heart and brain with the same methods. Yiqixinnaoning possessed notable curative effect; it is the effective complex prescription for the treatment of ischemic angiocardiopathy and cerebrovascular disease.