芪蛭活血通络饮联合西医常规疗法治疗老年急性脑梗死临床研究

Clinical Study on Qizhi Huoxue Tongluo Decoction Combined with Conventional Western Medicine Therapy for Elderly Patients with Acute Cerebral Infarction

目的探讨芪蛭活血通络饮治疗老年急性脑梗死气虚血瘀证患者临床疗效,观察其对患者炎性指标、纤维化指标、神经功能恢复的影响。方法采用随机数字表法将94例患者分为观察组和对照组各47例。对照组采用西医常规治疗,观察组在对照组基础上予芪蛭活血通络饮,每日1剂,每次150 mL,每日2次,口服(吞咽困难者胃管给药),2组均连续治疗2周。观察2组治疗前后血液流变学指标、转化生长因子-β1(TGF-β1)、同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CPR)、血管内皮生长因子(VEGF)水平,及神经功能(NIHSS)评分、日常生活能力(ADL)评分,比较2组临床疗效及不良反应。结果与本组治疗前比较,2组治疗后全血高切黏度、全血低切黏度、纤维蛋白原、hs-CPR、Hcy水平明显下降,TGF-β1、VEGF水平明显升高(P<0.05);2组治疗后比较,观察组上述实验室指标改善明显优于对照组(P<0.05)。与本组治疗前比较,2组治疗后NIHSS评分明显降低,ADL评分明显升高(P<0.05);2组治疗后比较,观察组NIHSS评分低于对照组,ADL评分高于对照组(P<0.05)。观察组总有效率为93.62%(44/47),对照组为74.47%(35/47),2组比较差异有统计学意义(P<0.05)。观察组不良反应率为14.89%(7/47),对照组为19.15%(9/47),2组比较差异无统计学意义(P>0.05)。结论芪蛭活血通络饮联合西医常规疗法治疗老年急性脑梗死气虚血瘀证疗效满意,可有效减轻患者炎症反应,改善机体高凝状态,促进神经功能修复。

Objective To investigate the clinical efficacy of Qizhi Huoxue Tongluo Decoction for the treatment of elderly patients with acute cerebral infarction(qi-deficiency and blood-stasis syndrome);To observe its effects on inflammatory indicators,fibrosis indicators and neurological function recovery.Methods Totally 94 elderly patients with acute cerebral infarction were divided into observation group and control group according to random number table method,with 47 cases in each group.Control group received conventional Western medicine therapy,and observation group received Qizhi Huoxue Tongluo Decoction on the basis of the control group,one dosage per day,150 mL each time,twice a day,orally(gastrointestinal administration in patients with dysphagia);treatment for both groups lasted for two weeks.The blood rheology indexes and transforming growth factor-β1(TGF-β1),homocysteine(Hcy),high-sensitivity C-reactive protein(hs-CPR)and vascular endothelial growth factor(VEGF)levels were observed before and after treatment,as well as neurological function(NIHSS)score,daily living ability(ADL)score.Clinical efficacy and adverse reactions of the two groups were compared.Results Compared with before treatment,the whole blood high-shear viscosity,whole blood low-shear viscosity,fibrinogen,hs-CPR and Hcy levels significantly decreased,and TGF-β1 and VEGF levels significantly increased(P<0.05);after treatment,the improvement of the above laboratory indexes in the observation group was significantly better than that in the control group(P<0.05).Compared with before treatment,the NIHSS scores of the two groups were significantly lower after treatment,and the ADL scores were significantly higher(P<0.05);after treatment,the NIHSS score of the observation group was lower than that of the control group,and the ADL score was higher than the control group(P<0.05).The total effective rate was 93.62%(44/47)in the observation group and 74.47%(35/47)in the control group,with statistical significance(P<0.05).The adverse reaction rate was 14.89%(7/47)in the observation group and 19.15%(9/47)in the control group,without statistical significance(P>0.05).Conclusion Qizhi Huoxue Tongluo Decoction combined with conventional Western medicine therapy for the treatment of elderly patients with acute cerebral infarction(qi-deficiency and blood-stasis syndrome)can achieve satisfactory efficacy,which can effectively alleviate inflammatory response and fibrosis indicators,and promote neurological function repair.