补阳还五汤对急性脑梗死患者侧支循环的影响

Effect of Buyanghuanwu Decoction on collateral circulation in patients with acute cerebral infarction

目的探讨补阳还五汤对急性脑梗死患者侧支循环的影响。方法对2014年10月~2015年10月我院接收的40例急性脑梗死患者进行回顾性研究,将其分为研究组与对照组,两组均为20例,对照组采用调脂、活血化瘀、扩血管等西药进行治疗,研究组在对照组的基础上采用补阳还五汤治疗。通过酶联免疫吸附法（ELISA）检测血清中血管内皮生长因子（VEGF）及碱性纤维细胞生长因子（b FGF）水平,观察两组患者住院第1天及第7天神经功能缺失情况。结果经治疗,两组患者的VEGF均明显升高,差异有统计学意义（P〈0.05）;治疗第7天时,研究组患者的VEGF明显高于对照组,差异有统计学意义（P〈0.05）。治疗第7天时,研究组患者的b FGF明显上升,且高于对照组,差异有统计学意义（P〈0.05）。治疗前,两组患者的神经功能缺损评分比较,差异无统计学意义（P〉0.05）;治疗后,两组患者的神经功能缺损评分比较,差异有统计学意义（P〈0.01）;两组患者治疗后各神经功能缺损评分与治疗前比较,差异均有统计学意义（P〈0.01）。研究组与对照组的全血高切黏度、全血低切黏度、红细胞比例比较,差异均有统计学意义（P〈0.05）。结论补阳还五汤能有效促进急性脑梗死患者血清中VEGF及b FGF功能的表达与供血状态,从而促进侧支循环的建立,很大程度上改善和保护脑组织的功能。

Objective To discuss the clinical effect of Buyanghuanwu Decoction on collateral circulation in patients with acute cerebral infarction（ACI）.Methods 40 ACI patients treated in our hospital from October 2014 to October 2015 were reviewed and randomly divided into study group and control group,each with 20 cases.Patients in the control group were given western drugs for lipid regulation,blood activation and stasis elimination,and vascular dilation,while patients in the study group were additionally given Buyanghuanwu Decoction.Levels of VEGF and b FGF were detected by ELISA and neurofunction deficits at day 1 and day 7 of hospitalization were observed.Results VEGF levels were enhanced in both groups after treatment.At day 7,the VEGF level was significantly higher in the study group than that in the control group（P〈0.05）.At day 7,the b FGF level increased in the study group,while reduced in the control group,which showed significant difference（P〈0.05）.Before treatment,there was no significant difference in neurofunction deficit between two groups（P〉0.05）;while after treatment,there was significant difference in neurofunction deficit between two groups（P〈0.01）.There were significant differences in neurofunction deficit scores in each group before and after treatment（P〈0.01）.There were significant differences in high blood viscosity,low blood viscosity,and red blood cells between two groups（P〈0.05）.Conclusion Buyanghuanwu Decoction can effectively promote the expression of serum VEGF and b FGF,and improve blood supply in ACI patients,thus facilitate establishment of collateral circulation and improve and protect the function of brain tissues.