自拟脑府逐瘀汤治疗急性脑出血吸收期的疗效及对血液流变学和SOD、MDA水平的影响

Effects of Naofu Zhuyu Decoction on the Hemorheology,SOD and MDA Levels in the Absorption Phase of Acute Intracerebral Hemorrhage

目的探讨急性脑出血(ACH)吸收期应用自拟脑府逐瘀汤联合西药治疗的临床效果及对血液流变学和血清超氧化物歧化酶(SOD)、丙二醛(MDA)水平的影响。方法选取我院2015年1月—2017年1月收治的144例ACH病人,采用随机数字表法均分为两组。对照组采用常规西药治疗,观察组在此基础上加用自拟脑府逐瘀汤治疗。比较两组临床疗效、治疗前后中医证候评分、血液流变学指标及血清指标变化。结果治疗2周后,观察组总有效率为94.4%,较对照组(83.3%)明显升高(P<0.05)。两组治疗2周后中医证候评分及血浆黏度、全血黏度、聚集指数、刚性指数值均显著低于治疗前(P<0.01),且观察组下降更显著(P<0.01)。与治疗前对比,两组治疗2周后血清SOD水平均显著升高(P<0.01),MDA水平均显著降低(P<0.01),且观察组改善更显著(P<0.01)。结论应用自拟脑府逐瘀汤联合西药治疗急性脑出血吸收期更能有效缓解或消除病人症状体征,改善血液循环,调节氧化应激状态。

Objective To investigate the effects of Naofu Zhuyu decoction（ NZD） on the hemorheology,serum superoxide dismutase（ SOD）,malondialdehyde（ MDA） levels in the absorption phase of acute intracerebral hemorrhage（ ACH）.Methods One hundred and forty-four patients with ACH in our hospital from January 2015 to January 2017 were selected and randomly divided into two groups： control group treated with routine western medicine treatment,and treatment group treated with NZD in the basis of routine western medicine treatment for 2 weeks.The clinical efficacy,the scores of traditional Chinese medicine（ TCM） syndromes,hemorheological indexes and serum indexes were observed before and after treatment.Results After 2 weeks of the treatment,the total effective rate was significantly higher in treatment group than that in control group（ 94.4% vs 83.3%,P〈0.05）.The scores of TCM syndromes,plasma viscosity,whole blood viscosity,aggregation index and rigidity index in two groups were lower than those before the treatment（ P〈0.01）,which were lower in treatment group than that in control group（ P〈0.01）.The levels of serum SOD increased significantly in two groups（ P〈0.01）,which was higher in treatment group than that in control group（ P〈0.01）.The levels of serum MDA decreased significantly in two groups（ P〈0.01）,which was lower in treatment group than that in control group（ P〈0.01）.Conclusion NZD and western medicine can relieve or eliminate the symptoms and signs,improve the blood circulation and regulate the oxidative stress in the absorption phase of ACH.