加味补阳还五汤治疗急性脑梗死临床研究

Clinical Study of Modified Buyang Huanwu Decoction for Treatment of Acute Cerebral Infarction

目的:观察加味补阳还五汤治疗急性脑梗死的临床疗效及血栓前体蛋白(TpP)治疗前后的变化。方法:将60例急性脑梗死(气虚血瘀型缺血性中风)患者随机分为治疗组和对照组各30例。2组均予急性脑梗死常规基础治疗,治疗组口服加味补阳还五汤煎剂。观察2组患者入组时及2疗程后(14天为1疗程)TpP、凝血4项[凝血酶原时间(PT)、纤维蛋白原(Fib)、部分凝血活酶时间(APTT)、凝血酶时间(TT)]变化,以及加味补阳还五汤治疗4周的临床疗效。结果:总有效率治疗组92.6%,对照组82.1%,2组比较,差异有显著性意义(P<0.05);治疗后2组神经功能缺损程度评分均有所降低,与治疗前比较,差异均有非常显著性意义(P<0.01);治疗后治疗组TpP及Fib与对照组比较,差异有显著性或非常显著性意义(P<0.05,P<0.01)。而PT、APTT、TT治疗前后无显著性差异(P>0.05)。结论:加味补阳还五汤治疗急性脑梗死临床疗效显著,可降低Fib和TpP,可用于观察抗血栓效果的评价。

Objective. To evaluate the effect of Modified Buyang Huanwu Decoction for the treatment of acute cerebral infarction and to observe the change of thrombosis premise protein（TpP）before and after treatment. Methods.. Sixty patients who were in accordance with the inclusion criteria of acute cerebral infarction （ischemic stroke with the pattern of qi deficiency and blood stasis） were randomly divided into the treatment group and the control group, 30 cases in each group. All patients were treated with basic conventional treatment for acute cerebral infarction, and the treatment group received Modified Buyang Huanwu Decoction additionally. TpP as well as fouritem coagulation indexes including prothrombin time（PT）, fibrinogen （Fib）, activated partial thromboplastin time （APTT）, and thrombin time（TT）] was detected before treatment and 7 days after treatment. Clinical effect was also evaluated after treatment. Results： The total effective rate was 92.6% in the treatment group, and was 82.1% in the control group, the difference being significant（P 〈 0.05）.The neurological deficit scores of both groups were decreased（P 〈 0.05 compared with those before treatment）.After treatment the differences of TpP and Fib between the two groups were significant（P 〈 0.05）, but the differences of PT, APTT and TT were not significant（P 〉 0.05）. Conclusion.. Modified Buyang Huanwu Decoction has certain effect for the treatment of acute cerebral infarction. TpP and Fib have been decreased after treatment with Modified Buyang Huanwu Decoction, which can be used as the evaluation indexes of antithrombotic effect.