不同剂量黄芪复方对气虚血瘀型脊髓损伤患者的临床疗效

Clinical observation of different doses of astragalus compound on patients with spinal cord injury with Qi deficiency and blood stasis

目的:观察补阳还五汤中黄芪不同剂量对气虚血瘀型脊髓损伤(SCI)患者的临床疗效,为临床用药提供依据。方法:选取2015年7月至2016年12月福建医科大学附属宁德市医院骨科SCI患者中符合气虚血瘀证的住院患者90例,在西医基本治疗的基础上,于伤后1周行中药治疗,疗程为1个月,根据患者进入试验的先后顺序,按随机数字表法分成3组,基本方为补阳还五汤,A组为黄芪30 g组,B组为黄芪60 g组,C组为黄芪120 g组,中药治疗前、中药治疗1个月后分别行中医证候积分评定、SCI程度分级、日常生活活动(ADL)能力评定,并于中药治疗1个月后进行中医证候主要症状疗效判定。结果:气虚证主要症状疗效C组好于A组和B组,差异有统计学意义(P<0.05),B组与A组比较疗效较好,差异有统计学意义(P<0.05)。血瘀证主要症状疗效C组好于A组和B组,差异有统计学意义(P<0.05),B组与A组比较疗效较好,差异有统计学意义(P<0.05)。SCI程度分级比较,A组和B组比较,差异无统计学意义;C组与B组和A组比,差异有统计学意义(P<0.05)。ADL能力评定比较,A组与B组比较,差异无统计学意义;C组与A组和B组比较,差异有统计学意义(P<0.05)。结论:补阳还五汤中黄芪不同剂量治疗气虚血瘀型SCI患者,黄芪120 g组疗效好于60 g组和30 g组,有一定程度的剂量依赖性。

Objective： To observe the clinical effect of different doses of astragalus membranaceus on the patients with spinal cord injury due to Qi deficiency and blood stasis in Buyang Huanwu Decoction, and to provide the basis for clinical medication. Methods： Ninty spinal cord injury with Qi deficiency and blood stasis syndrome cases from July 2015 to December 2016 in orthopedics department of the Affiliated Ningde Hospital of Fujian Medical University, according to the order of the patients entered the trial, and to the random number table, randomly divided into 3 groups. Each group based on basic treatment, in a week after injury for traditional Chinese medicine （TCM） treatment, last one month, each group use basic prescription Buyang Huanwu Decoction. Group A with astragalus 30 grams, group B with 60 grams and group C with 120 grams, evaluated TCM syndrome score, the degree of spinal cord injury, activities of daily living （ADL） ability before and after traditional Chinese medicine treatment, judging TCM main symptoms and treatment efficacy after traditional Chinese medicine. Results： Compared with the main symptoms of Qi deficiency syndrome, group C was better than that of group A and B, the difference was statistically significant （P〈0.05）, group B was better than group A, the difference was statistically significant （P〈0.05）. Compared with the main symptoms of blood stasis syndrome, group C was better than that of group A and B, the difference was statistically significant （P〈0.05）, group B was better than group A, the difference was statistically significant （P〈0.05）. There was no significant difference between group A and B in the degree of SCI classification; the difference between group C and B was statistically significant, and also group C and A （P〈0.05）. Compared with ADL, there was no significant difference between group A and B, but the difference between group C and B was statistically significant, and also group C and A （P〈0.05）. Conclusion： Astragalus membranaceus 120 grams group is better than 60 grams group and 30 grams group in the treatment of SCI patients with Qi deficiency and blood stasis syndrome in different doses of Buyang Huanwu Decoction, which has a certain degree of dependence on measurement.