补阳还五汤治疗气虚血瘀型脑梗死疗效及对患者血浆金属蛋白酶-2、8水平影响

Curative Effect on Cerebral Infarction of Qi Deficiency and Blood Stasis Type and Influence on Metalloproteinase-2 and 8 Levels in Plasma of Buyang Huanwu Decoctions

目的:探讨补阳还五汤治疗气虚血瘀型脑梗死患者的疗效及对血浆金属蛋白酶(MMP)-2、8水平的影响。方法:70例气虚血瘀型脑梗死患者,随机分为观察组和对照组。两组患者入院后予以控制血压、颅内压和血糖、抗血小板聚集、改善脑循环和维持水电解质酸碱平衡等西医常规治疗。观察组患者在对照组治疗基础上加用补阳还五汤加减口服,连用2周。观察并比较两组患者治疗前后血浆MMP-2、8水平的变化及疗效。结果:治疗2周后,两组患者血浆MMP-2、8水平均较前明显下降(P<0.01或0.05),且观察组患者下降的幅度较对照组更大(P<0.05);两组患者临床疗效比较,差异无统计学意义(P>0.05),但治疗组显效率明显优于对照组(P<0.05)。两组治疗期间均未发生严重药物不良反应,不良反应发生率差异无统计学意义(P>0.05)。结论:补阳还五汤联合西医常规治疗治疗气虚血瘀型脑梗死的疗效优于单纯西医常规治疗,安全性较好,其作用可能与降低血浆MMP-2、8水平,减少细胞外基质的降解有关。

Objective： To discuss curative effect of Buyang Huanwu decoctions on cerebral infarction of qi deficiency and blood stasis type and the influence on metalloproteinase-2 and 8 （ MMP-2 and 8 ） levels in plasma. Met＇hods： Totally 70 cases of patients with cerebral infarction of qi deficiency and blood stasis type were selected and divided into the observation group and the control group randomly. The patients in the two groups were given routine medical treatment, such as the control of blood pressure, intraeranial pres- sure and blood sugar, platelet aggregation inhibition, improvement of cerebral circulation, maintenance of water and electrolyte acid- base balance and so on. The patients in the observation group were orally given Buyang Huanwu decoctions additionally for 2 weeks. The changes of MMP-2 and 8 levels in plasma and the curative effect before and after the medical treatment were observed and com- pared. Results： After the two-week treatment, the MMP-2 and 8 levels in plasma in the two groups were obviously declined （ P 〈 0.01 or P 〈 0.05 ）, and the declining rate in the observation group was much higher than that in the control group （ P 〈 0.05 ）. Although the clinical curative effect of the two groups was without statistical difference （ P 〉 0.05 ） , the efficiency in the observation group was much better than that in the control group （ P 〈 0.05 ）. No serious drug adverse reaction appeared during the medical treatment in the two groups （P 〉 0.05 ）. Conclusion： Buyang Huanwu decoctions with high safety combined with the routine western medical treatment show more favorable curative effect on cerebral infarction of qi deficiency and blood stasis type than the routine western medical treat- ment alone, and the underlying mechanism may be related with reducing the MMP-2 and 8 levels in plasma and degradation of extracel-lular matrix.