补阳还五汤加减对急性脑梗死患者β2-MG和脑水肿情况的影响

Effect of Buyang Huanwu Decoction on β_2-MG and cerebral edema in patients with acute cerebral infarction

目的观察补阳还五汤加减辅助治疗急性脑梗死患者的疗效及对脑水肿和脑脊液中β_2微球蛋白(β_2-MG)水平的影响。方法将80例急性脑梗死患者随机分为2组,对照组40例给予拜阿司匹林肠溶片、辛伐他汀胶囊等常规西医治疗,治疗组40例在对照组治疗基础上给予补阳还五汤加减治疗,分别于治疗前及治疗7 d后检测脑脊液中β_2-MG水平,通过脑水肿动态监测仪检查脑水肿情况,观察2组治疗1个月后神经功能缺损评分变化情况并统计临床疗效。结果治疗7 d后,2组患者脑水肿指数和脑脊液中β_2-MG水平均明显降低(P均<0.05),且治疗组脑水肿指数和脑脊液中β_2-MG水平均明显低于对照组(P均<0.05);治疗1个月后,治疗组临床治疗总有效率明显高于对照组(P<0.05),2组神经功能缺损评分均明显降低(P均<0.05),且治疗组明显低于对照组(P<0.05)。结论补阳还五汤加减辅助治疗急性脑梗死可以明显降低脑脊液β_2-MG含量,快速缓解脑水肿,促进神经功能损伤的恢复,具有较高的临床价值。

Objective It is to observe the curative effect of Buyang Huanwu Decoction on acute cerebral infarction, and the effects on cerebral edema and the level of β2 microglobulin （β2-MG） in cerebrospinal fluid. Methods 80 eases of patients with acute cerebral infarction were randomly divided into two groups, the control group （40 cases） was treated with routine western medicine such as aspirin enteric-coated tablets, and simvastatin capsule, the treatment group （40 cases） was treated with Buyang Huanwu Decoction based on the therapy in the control group. The level of β2-MG in cerebrospinal fluid was determined, cerebral edema was detected through cerebral edema dynamic monitor before treatment and after treatment for 7 days in both groups. The changes of scores of neural function defect scale after treatment for one month were observed, and clinical curative effects were evaluated in both groups. Results After treatment for 7 days, the cerebral edema index and the level of β2-MG in cerebrospinal fluid were significantly decreased in both groups（P 〈0.05） , and the index and level in the treatment group were significantly lower than that in the control group （P 〈 0.05 ）. After treatment for one month, the clinical total effective rate in the treatment group was obviously higher than that of control group （P 〈 0. 05） , the scores of neural function defect scale in the 2 groups were significantly decreased, and the scores in the treatment group were significantly lower than that in the control group （ P 〈 0.05 ）. Conclusion Buyang Huanwu Decoction can significantly reduce the content of β2-MG in cerebrospinal fluid, quickly relieve cerebral edema, promote the recovery of neural function damage in the treatment of acute cerebral infarction, the clinical value is higher.