通腑清窍汤联合灯盏细辛注射液治疗急性脑梗死的疗效及对血小板CD62p、TNF-α、IL-6表达的影响

Efficacy of Tongfuqingqiao Decotion Combined with Dengzhanxixin Injections in Treatment of Acute Cerebral Infarction Patients and Effects on Platelet CD62p,TNF-α and IL-6

目的:探讨通腑清窍汤联合灯盏细辛注射液治疗急性脑梗死的临床疗效,及其对血小板活化依赖性颗粒表面膜蛋白(CD62p)、肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)表达的影响。方法:选取2015年牡丹江医学院附属红旗医院收治的急性脑梗死患者78例,按照入院先后顺序进行随机分组,奇数号分入对照组,偶数号分入观察组,各39例。对照组患者给予灯盏细辛注射液,观察组患者在对照组基础上加服通腑清窍汤,2周为1个疗程,两组患者均治疗1个疗程。对比观察两组患者的临床疗效、安全性,以及治疗前后血小板CD62p及血清TNF-α、IL-6水平变化情况。结果:治疗后,两组患者的临床症状均较治疗前明显改善,观察组患者的总有效率为89.74%(35/39),明显高于对照组的71.79%(28/39),差异有统计学意义(P<0.05)。治疗前,两组患者CD62p及血清TNF-α、IL-6水平的差异均无统计学意义(P>0.05);治疗后,两组患者CD62p及血清TNF-α、IL-6水平明显降低,且观察组患者较对照组降低更明显,差异均有统计学意义(P<0.05)。结论:通腑清窍汤与灯盏细辛注射液联合治疗急性脑梗死,疗效较好,能有效缓解患者的临床症状,促进神经功能恢复,其作用机制可能与下调血小板CD62p的表达、减轻细胞因子所介导的中枢神经系统免疫应答及炎性损伤有关。

OBJECTIVE： To probe into the the clinical efficacy of Tongfuqingqiao decotion combined with Dengzhanxixin injections in treatment of acute cerebral infarction patients and effects on platelet CD62 p,TNF-αand IL-6. METHODS：78 patients with cerebral infarction admitted into Hongqi Hospital Affiliated to Mudanjiang Medical College in 2015 were extracted to be divided into control group（ odd number） and observation group（ even number） via the admission sequence,with 39 cases in each. The control group was given Dengzhanxixin injections,while the observation group additionally received Tongfuqingqiao decotion based on the control group,two weeks were set as one treatment course,two groups both lasted for one course of treatment. The clinical efficacy,safety,and change of platelet CD62 p,TNF-αand IL-6 of two groups were compared and observed. RESULTS： After treatment,the clinical symptoms of two groups had been improved significantly compared with before treatment,the total effective rate of observation group was89. 74%（ 35/39）,significantly higher than that of control group [71. 79%（ 28/39） ],with statistically significant difference（ P〈0. 05）. Before treatment,there was no statistical significance between two groups in the level of platelet CD62 p,TNF-α and IL-6（ P〉0. 05）. After treatment,the level of platelet CD62 p,TNF-α and IL-6 decreased significantly,and the decent in observation group was more obvious than that in control group,with statistically significant difference（ P〈0. 05）. CONCLUSIONS： The efficacy of Tongfuqingqiao decotion combined withDengzhanxixin injections in treatment of acute cerebral infarction patients is effective,which can obviously alleviate the clinical symptoms,promote neurological recovery; and the mechanism may be related with the down-regulation expression of platelet CD62,reducing of the immune response and inflammatory lesions of the central nervous system mediated by cytokines.