补肾活血化痰方治疗缺血性卒中脑动脉狭窄临床疗效及对患者血清基质金属蛋白酶9、基质金属蛋白酶组织抑制因子的影响

Clinical effect of Bushen Huoxue Huatan recipe on cerebral artery stenosis of ischemic stroke and its effect on serum metalloproteinase-9 and tissue matrix metalloproteinase inhibitor

目的观察补肾活血化痰方治疗缺血性卒中脑动脉狭窄的临床疗效及对患者血清基质金属蛋白酶9(MMP-9)、基质金属蛋白酶组织抑制因子(TIMP-1)的影响。方法将138例缺血性卒中脑动脉狭窄患者随机分为2组。对照组69例予阿司匹林肠溶片联合瑞舒伐他汀钙片等常规治疗;治疗组69例在对照组治疗基础上加补肾活血化痰方治疗。2组均4周为1个疗程,治疗2个疗程后统计疗效。比较2组治疗前及治疗第4、8周大脑前动脉(ACA)、大脑后动脉(PCA)平均血流速度及病变血管狭窄率,血清MMP-9、TIMP-1水平,Barthel指数评定量表(BI)评分。结果治疗组基本痊愈率(37.68%)及总有效率(94.20%)均高于对照组(20.29%,78.26%)(P<0.05)。治疗第4、8周,2组PCA、ACA平均血流速度均较本组治疗前减慢(P<0.05),血管狭窄率及血清MMP-9、TIMP-1水平降低(P<0.05),BI评分升高(P<0.05),且2组组间同期比较差异均有统计学意义(P<0.05)。结论补肾活血化痰方治疗缺血性卒中脑动脉狭窄临床效果确切,可降低MMP-9、TIMP-1水平,改善脑动脉狭窄。

Objective To observe the clinical effect of Bushen Huoxue Huatan recipe on cerebral artery stenosis of ischemic stroke and its effect on serum metalloproteinase-9（ MMP-9） and tissue matrix metalloproteinase inhibitor（ TIMP-1）. Methods 138 patients with cerebral artery stenosis of ischemic stroke were randomly divided into two groups. 69 casess in control group were treated by aspirin enteric-coated tablets combined with rosuvastatin calcium tablets. 69 cases in treatment group were treated by Bushen Huoxue Huatan recipe on the basis of the control group. Both groups received a course of treatment for 4 weeks,and the therapeutic effect was measured after 2 courses of treatment. The mean blood flow velocity and stenosis rate of anterior cerebral artery（ ACA） and posterior cerebral artery（ PCA）,serum levels of MMP-9,TIMP-1 and Barthel index scale（ BI） were compared between the two groups before treatment and at the 4th and 8th week after treatment. Results The basic recovery rate（ 37. 68%）and total effective rate（ 94. 20%） of the treatment group were higher than those of the control group（ 20. 29%,78. 26%,P〈0. 05）. At the 4th and 8th week of treatment,the average blood flow velocity of PCA and ACA decreased（ P〈0. 05）,the rate of vascular stenosis,the levels of MMP-9 and TIMP-1 decreased（ P〈0. 05）,the BI score increased（ P〈0. 05）,and the difference between the two groups was statistically significant（ P〈0. 05）. Conclusion Bushen Huoxue Huatan recipe is effective in treating cerebral artery stenosis after ischemic stroke. It can reduce the levels of MMP-9 and TIMP-1 and improve cerebral artery stenosis.