血府逐瘀汤配合rtPA静脉溶栓对急性脑梗死患者神经功能及血清MMP-3、TIMP-1的影响

Influence of Xuefu Zhuyu Decoction Combined with rtPA Intravenous Thrombolysis on Neurological Function and Serum MMP-3 and TIMP-1 of Patients with Acute Cerebral Infarction

目的观察血府逐瘀汤配合重组组织型纤溶酶原激活剂(rt PA)静脉溶栓对急性脑梗死患者神经功能及血清基质金属蛋白酶-3(MMP-3)、基质金属蛋白酶抑制物-1(TIMP-1)的影响。方法急性脑梗死患者122例随机分为观察组和对照组各61例,两组均给予健康教育、饮食、运动等基础干预,对照组另予rt PA静脉溶栓治疗,观察组在此基础上配合血府逐瘀汤治疗。比较两组中医证候积分、临床疗效、神经功能和日常生活能力、脑部动脉血流状况以及血清MMP-3、TIMP-1变化情况。结果治疗后两组中医证候积分显著低于治疗前(P<0.05),且观察组显著低于对照组(P<0.05);观察组总有效率90.16%,显著高于对照组75.41%(P<0.05);治疗后两组NIHSS评分显著低于治疗前(P<0.05),且观察组显著低于对照组(P<0.05),两组ADL评分显著高于治疗前(P<0.05),且观察组显著高于对照组(P<0.05);治疗后两组Vm、EDV、PSV显著高于治疗前(P<0.05),且观察组显著高于对照组(P<0.05);治疗后两组MMP-3、TIMP-1水平显著低于治疗前(P<0.05),且观察组显著低于对照组(P<0.05)。结论血府逐瘀汤配合rt PA静脉溶栓可有效提高急性脑梗死患者神经功能和日常生活能力,改善血清MMP-3、TIMP-1水平,提高临床疗效。

Objective： To observe the influence of Xuefu Zhuyu Decoction combined with recombinant tissue plasminogen activator（rt PA） intravenous thrombolysis on neurological function and serum matrix metalloproteinase-3（MMP-3）,matrix metalloproteinase inhibitor-1（TIMP-1） of patients with acute cerebral infarction.Methods： 122 cases of patients with acute cerebral infarction were selected as the study objects,and were divided into the observation group and the control group according to random number table method,64 cases in each group. Both groups were given basic intervention such as health education,diet and exercise,on the basis of which,the control group were given rt PA intravenous thrombolysis treatment,and the observation group were added Xuefu Zhuyu Decoction. TCM symptom scores,clinical efficacy,neurological function and daily living ability,cerebral arterial blood flow and serum MMP-3 and TIMP-1 were observed in the two groups. Results： After treatment,TCM symptoms scores were significantly lower than those before treatment in the two groups（P〈0.05）,and those in the observation group were significantly lower than those in the control group（P〈0.05）. The total effective rate of the observation group was 90.16%,significantly higher than that of the control group（75.41%）（P〈0.05）. After treatment,NIHSS score was significantly lower than that before treatment in the two groups（P〈0.05）,and that in the observation group was significantly lower than that in the control group（P〈0.05）. ADL score was significantly higher than that before treatment in the two groups（P〈0.05）,and that in the observation group was significantly higher than that in the control group（P〈0.05）. After treatment,Vm,EDV and PSV were significantly higher than those before treatment in the two groups（P〈0.05）,and those in the observation group was significantly higher than those in the control group（P〈0.05）. After treatment,MMP-3 and TIMP-1 levels were significantly lower than those before treatment in the two groups（P〈0.05）,and those in the observation group were significantly lower than those in the control group（P〈0.05）. Conclusion： Xuefu Zhuyu Decoction combined with rt PA intravenous thrombolysis can effectively improve neurological function and daily living ability of patients with acute cerebral infarction,and improve serum MMP-3 and TIMP-1 levels and clinical efficacy.