补阳还五汤防治急性缺血性脑卒中早期神经功能恶化的临床研究

Clinical Study of Buyang Huanwu Decoction on Early Neurological Deterioration in Acute Ischemic Stroke Patients

目的研究补阳还五汤防治急性缺血性脑卒中早期神经功能恶化的疗效。方法选取本院2012年3月至2016年8月急性缺血性脑卒中患者60例,按照入院顺序编号,采取随机数字表法将患者分为观察组与对照组,每组30例,给予对照组患者常规西药治疗,观察组患者在对照组治疗基础上联合补阳还五汤治疗,比较两组患者临床治疗有效率,比较治疗前后血液流变学指标、血同型半胱氨酸(Hcy)、C反应蛋白(CRP)、D-二聚体水平以及美国国立卫生院神经功能缺损评分(NIHSS)、日常生活活动能力(Barthel)评分变化情况。结果观察组临床治疗总有效率为86.67%,显著高于对照组63.33%(P<0.05);治疗后,观察组血小板聚集率、纤维蛋白原水平、全血粘度、血浆粘度较对照组显著降低(P<0.05);观察组Hcy、CRP、D-二聚体水平较对照组显著降低(P<0.05);观察组NIHSS评分较对照组显著降低(P<0.05),Barthel评分较对照组显著升高(P<0.05)。结论补阳还五汤联合西药防治缺血性脑卒中早期神经功能恶化疗效确切,能通过改善患者血液流变学指标水平降低血脂、降低炎性水平达到提高脑神经功能水平的目的,值得临床推广应用。

Objective To study the efficacy of Buyang Huanwu Decoction in treating early neurological deterioration in acute ischemic stroke.Methods60patients with acute ischemic stroke treated in our hospital from March2012to August2016were selected and numbered according to the order of admission,and they were divided into the observation group and control group,30cases in each group.The control group was treated with routine western medicine,while the observation group was treated with Buyang Huanwu decoction on the basis of the treatment for control group.The clinical treatment effective rate,changes in blood rheological indexes,blood homocysteine(Hcy),C reactive protein(CRP)and D-dimer levels,scores of National Institutes of Health Stroke(NIHSS)and activities of daily living(Barthel)before and after treatment were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group(86.67%vs63.33%)(P<0.05).After treatment,levels of fibrinogen,blood viscosity,plasma viscosity,levels of Hcy,CRP and D-D and NIHSS score in the observation group were significantly lower than those in the control group(P<0.05),while Barthel score was significantly higher than that of the control group(P<0.05).Conclusion Buyang Huanwu decoction combined with Western medicine is effective in treating early neurological deterioration in ischemic stroke.The decoction can improve the neurological function through improving levels of blood rheological indexes,decreasing levels of blood lipids and inflammatory levels.