回药扎里奴思方加减对痰瘀互结型急性脑梗死患者炎性因子的影响

Impact of Hui Nationality Herb Modified Zhalinusi Fang (扎里奴思方) on Inflammatory Factors of Acute Cerebral Infarction Patients of Intermingled Phlegm and Stasis Type

目的观察扎里奴思方加减对痰瘀互结型急性脑梗死患者的临床疗效及可能机制。方法将120例痰瘀互结型急性脑梗死患者随机分为治疗组和对照组各60例。两组均给予西医基础治疗,治疗组同时口服回药扎里奴思方加减汤剂,每日1剂;对照组口服尼莫地平片,每日1次,每次20 mg,两组均治疗14天。治疗前及治疗7、14天观察两组患者的神经功能缺损(NIHSS)评分,检测血清肿瘤坏死因子α(TNF-α)和白细胞介素6(IL-6)水平,治疗后评价临床疗效。结果治疗组临床疗效总有效率为88.33%,对照组为66.67%,治疗组临床疗效优于对照组(P<0.01)。两组患者治疗7、14天NIHSS评分及血清TNF-α和IL-6水平均较本组治疗前明显降低,尤以治疗14天降低更明显(P<0.05或P<0.01)。治疗后两组间比较,治疗组NIHSS评分及血清TNF-α和IL-6水平亦明显低于同时间对照组(P<0.05或P<0.01)。结论扎里奴思方加减可显著改善痰瘀互结型急性脑梗死患者神经功能缺损情况,其机制可能与降低血清炎性细胞因子水平有关。

Objective To examine the clinical effect and possible mechanism of modified Zhalinusi Fang （扎里奴思方） on acute cerebral infarction （ACI） patients of intermingled phlegm and stasis type. Methods One hun- dred and twenty ACI patients of intermingled phlegm and stasis type were randomized into treatment group and control group, 60 cases in each group. Both groups were given western medicine routine treatment. The treatment group was given oral Hui Nationality herb modified Zhalinusi Fang decoction at the same time, one dose every day. The control group was given oral nimodipine tablet 20 mg every day. Both groups were treated for 14 days. Patients＇ scores of the national institutes of health stroke scale （NIHSS） in both groups were examined before treatment, on the 7th and 14th day of treatment. The levels of serum tumor necrosis factortx （TNF-ot） and interleukin 6 （IL-6） were detected. The clinical effect was evaluated after treatment. Results The total effective rate in the treatment group was 88.33%, 66.67% in the control group. The clinical effect in the treatment group was superior to that in the control group （P 〈 0. 01 ）. The scores of NIHSS and the levels of serum TNF-αand IL-6 of patients in each group were lower on the 7th and 14th day of treatment than those before treatment in each group. On the 14th day of treatment, the result was the lowest （P 〈 0. 05 or P 〈 0. 01 ）. After treatment, the scores of NIHSS and the levels of serum TNF-αand IL-6 in the treatment group was lower than those in the control group at the same time point （P 〈 0. 05 or P 〈 0. 01 ）. Conclusion Modified Zhalinusi Fang might improve intermingled phlegm and stasis type ACI patients＇ neurological deficit. The mechanism might relate to decreasing the levels of serum inflammatory factors.