中风醒脑液对缺血性脑中风早期神经功能恢复的影响

Effect of Zhongfeng Xingnao Liquid on Neurological Recovery of Patients with Ischemic Stroke at Early Recovery

目的:探讨中风醒脑液对缺血性脑中风恢复早期气虚血瘀证患者神经功能恢复的影响及抗炎、神经保护和改善微循环机制。方法:将128例患者采用随机按数字表法分为对照组和观察组各64例。两组患者基础治疗,口服阿托伐他汀钙片,10 mg·d-1;口服阿司匹林肠溶片,100 mg·d-1;控制血压、血糖,结合现代康复训练。观察组口服中风醒脑液,25 m L/次,3次/d;对照组口服中风醒脑液模拟剂,25 m L/次,3次/d。两组疗程均连续治疗90 d。记录治疗后不同时点美国国立卫生院神经功能缺损(NIHSS)评分;进行治疗前后Barthel指数,改良Rankin量表,Brunel平衡量表(BBA),Fugl-Meyer量表(FMA),气虚血瘀证评分和中风专用生活质量量表(SS-QOL)评分;检测治疗前后脑源性神经营养因子(BDNF),肿瘤坏死因子-α(TNF-α),同型半胱氨酸(Hcy),血清胱抑素C(Cys-C),血小板聚集率(ADP),纤维蛋白原(FIB)水平。结果:观察组临床疗效优于对照组(Z=1.981,P<0.05);观察组在治疗后不同时点NIHSS评分均低于对照组(P<0.01);观察组Barthel指数,FMA,BBA,SS-QOL评分均高于对照组(P<0.01),气虚血瘀证评分低于对照组(P<0.01);观察组残疾程度轻于对照组(Z=1.932,P<0.05);观察组运动障碍程度轻于对照组(Z=2.149,P<0.05);观察组BDNF水平高于对照组(P<0.01),TNF-α,Hcy,Cys-C,ADP和FIB水平均低于对照组(P<0.01)。结论:在常规西医综合康复措施的基础上,中风醒脑液可促进脑梗死恢复期(气虚血瘀证)患者神经功能缺损修复,有利于患者的康复,提高了生活质量,并具有一定的抗炎、改善微循环和神经保护作用,疗效优于单纯的西医综合康复治疗。

Objective:To discuss the effect of Zhongfeng Xingnao liquid on neurological recovery of patients of ischemic stroke with Qi deficiency and blood stasis syndrome at early recovery,and the mechanisms of anti-inflammation,neuroprotection and improvement of microcirculation.Method:One hundred and twenty-eight patients were randomly divided into control group(64 cases)and observation group(64 cases)by random number table.Both groups’patients got atorvastatin,10 mg/days,aspirin enteric-coated tablets,100 mg/days,and control of blood pressure and blood sugar,and modern rehabilitation training.Patients in control group orally got Zhongfeng Xingnao liquid,25 m L/time,3 times/days.The course of treatment was 90 days.And before and after treatment,national institutes of health neurological deficiency(NIHSS),Barthel index,improvement Rankin scale,brunel balance scale(BBA),Fugl-Meyer scale(FMA),Qi deficiency and blood stasis syndrome(SS-QOL)were scored.And levels of brain-derived neurotrophic factor(BDNF),tumor necrosis factor-alpha(TNF-alpha),homocysteine(Hcy),serum cystatin C(Cys-C),platelet aggregation rate(ADP)and fibrinogen(FIB)were detected.Result:The clinical efficacy in observation group was better than that in control group(Z=1.981,P<0.05).At different time points after treatment,scores of NIHSS and Qi deficiency and blood stasis syndrome were lower than those in control group(P<0.05),whereas scores of Barthel index,FMA,BBA and SSQOL were higher than those in control group(P<0.01).Degrees of disability and dyskinesia in observation group was lighter than those in control group(Z=1.932,P<0.05).Degree of dyskinesia was lighter than that in control group(Z=2.149,P<0.05).And level of BDNF was higher than that in control group(P<0.01),while levels of TNF-α,Hcy,Cys-C,ADP and FIB were lower than those in control group(P<0.01).Conclusion:In addition to the routine comprehensive rehabilitation measures of western medicine,Zhongfeng Xingnao liquid can promote recovery of nerve function defect of patients of cerebral infarction with Qi deficiency and blood stasis syndrome at convalescence,is beneficial for rehabilitation of patients and improving the quality of life,with certain effects in resisting inflammation,improving microcirculation and protecting nerves,and better efficacy than simple western medicine treatment.