补阳还五汤对早期脑梗塞患者血浆内皮素、降钙素基因相关肽代谢失衡的临床研究

Clinical Study on Buyang Huanwu Decoction to the Metabolic Imbalance of Endothelin and Calcitonin Gene Related Peptide in Patients with Early Cerebral Infarction

目的 :探讨补阳还五汤治疗早期脑梗塞机理。方法 :70例患者随机分为中药组与西药组。中药组 3 5例 ,用补阳还五汤治疗 ;西药组 3 5例 ,用 70 6代血浆注射液和肠溶阿斯匹林片治疗。观察治疗前后血浆内皮素 (endothelin ,ET)、降钙素基因相关肽 (calcitoningenere latedpeptide,CGRP)水平与临床疗效 ,并与健康对照组比较。 结果 :治疗前两组患者ET水平均高于健康对照组 (P <0 0 0 1 ) ,而CGRP水平显著低于健康对照组 (P <0 0 0 1 )。治疗后均显著改善 ,与治疗前比较 ,有显著性差异 (中药组 ,P <0 0 0 1 ;西药组 ,P <0 0 1 ) ;并以中药组改善比西药组显著 (P <0 0 1 ,P <0 0 5 )。中药组愈显率也显著高于西药组 (68 6%与 3 1 4% ;χ2 =9 65 ,P <0 0 1 )。结论 :补阳还五汤对早期脑梗塞患者ET、CGRP代谢失衡有改善作用 ,通过这种作用 ,可治疗脑梗塞。

Objective: To explore the mechanism of Buyang Huanwu Decoction (BHD) in treating early cerebral infarction. Methods: Seventy cases with early cerebral infarction were randomly divided into two groups. Chinese medicine group (CMG, n=35) was treated with BHD; western medicine group (WMG, n=35) was treated with hydroxyethyl starch injection and enteric coated aspirin tablets. The levels of endothelin (ET) and calcitonin gene related peptide (CGRP) in plasma before and after treatment and the results of clinical treatment were observed, and also controlled with healthy subjects. Results: The levels of ET before treatment in both patient groups were significantly higher than that of the healthy subjects (P<0 001), and the levels of CGRP were significantly lower (P<0 001). After treatment the metabolic imbalance of ET and CGRP improved significantly in both treatment groups (in CMG P<0 001; in WMG (P<0 01), but the ET and CGRP in CMG improved more obviously than those in WMG (P<0 01, P<0 05).The marked effective and cure rate of CMG was higher than that of WMG (68.6% vs 31.4%;χ 2=9.65,P<0 01). Conclusions: BHD could improve the metabolic imbalance of ET and CGRP in patients with early cerebral infarction and by this mechanism it was able to treat cerebral infarction.