补阳还五汤联合重组人组织型纤溶酶原激活物静脉溶栓治疗脑梗死的研究

Research of Buyang Huanwu decoction combined urokinase thrombolysis on acute cerebral infarction

目的探讨补阳还五汤联合重组人组织型纤溶酶原激活物静脉溶栓治疗脑梗死的临床疗效以及对患者血清中血管内皮生长因子(VEGF)、血管生成素-2(Ang-2)的影响。方法选择2016年1月—2017年1月临沂市中医医院治疗的脑梗死患者106例,采用随机数字法将患者随机分为2组,每组53例。对照组给予重组人组织型纤溶酶原激活剂治疗,观察组在对照组基础上加用补阳还五汤治疗。统计并比较2组患者治疗前后神经功能缺损评分、血液流变学(全血粘度、血浆粘度、红细胞沉降率)、血清VEGF与Ang-2水平及临床疗效。结果观察组总有效率为90.57%,明显高于对照组的67.92%(P<0.05)。治疗后,2组神经功能缺损评分均明显降低(均P<0.05),且观察组低于对照组(P<0.05)。治疗后,2组全血粘度、血浆粘度与红细胞沉降率均明显降低(均P<0.05),且观察组低于对照组(P<0.05)。治疗后,2组血清VEGF、Ang-2均显著升高(P<0.05),且观察组高于对照组(P<0.05)。结论补阳还五汤联合重组人组织型纤溶酶原激活物静脉溶栓治疗脑梗死临床疗效显著,可明显改善患者神经缺损程度,改善微循环,其作用机制可能与其可有效调节患者血清中的VEGF、Ang-2水平有关。

Objective To investigate the clinical efficacy of Buyang Huanwu decoction combined urokinase thrombolysis on acute cerebral infarction and its effect on serum VEGF and Ang-2. Methods A total of 106 patients with acute cerebral infarction treated in our hospital were randomly divided into two groups,with 53 cases in each group. The control group was given urokinase treatment,and the observation group was added Buyang Huanwu decoction based on the control group. The neurological deficits,hemorheology（ whole blood viscosity,plasma viscosity,and erythrocyte sedimentation rate）,serum VEGF and Ang-2 levels and clinical efficacy of two groups were compared. Results The total effective rate of observation group was 90. 57%,which was significantly higher than that of the control group（ 67. 92%,P〈 0. 05）.After treatment,the neurological deficit scores of two groups were significantly reduced（ P〈 0. 05）,and the neurological deficit score of observation group was significantly lower than that of control group（ P〈 0. 05）. After treatment,the whole blood viscosity,plasma viscosity and erythrocyte sedimentation rate levels were significantly decreased（ P〈 0. 05）,and the index levels of observation group were significantly lower those of control group（ P〈 0. 05）. After treatment,serum VEGF and Ang-2 levels of two groups were significantly increased（ P〈 0. 05）,and VEGF and Ang-2 levels of observation group were significantly higher than those of control group（ P〈 0. 05）. Conclusion Buyang Huanwu decoction combined urokinase thrombolysis could effectively treat acute cerebral infarction,significantly improve the nerve defects degree and microcirculation. And its mechanism might be related to its regulation of VEGF and Ang-2.