降浊通络益气养阴法治疗糖尿病性脑梗死的临床观察

Clinical Observation on Jiangzhuo Tongluo,Supplementing Qi and Nourishing Yin Therapy in the Treatment of Diabetic Cerebral Infarction

目的探讨降浊通络益气养阴法治疗糖尿病性脑梗死(DCI)病人的临床疗效及其对炎性因子的影响。方法选取2017年7月—2018年7月收治的DCI病人118例为研究对象,随机分为观察组和对照组,各59例。对照组行传统治疗,包括控制血糖、血压、血脂、抗血小板聚集、抗凝治疗及饮食指导、运动指导等;观察组在对照组基础上联合降浊通络益气养阴法治疗,两组于治疗1个月后进行疗效评价。治疗前及疗程结束后采集晨起空腹外周静脉血测定血清C反应蛋白(CRP)、白细胞介素-6(IL-6)、可溶性细胞间黏附分子-1(sICAM-1),全自动血生化仪测定空腹血糖(FPG)、餐后2 h血糖(2 hPG),采用Bathel指数评价日常生活活动能力,美国国立卫生研究院卒中量表(NIHSS)评分评价神经功能缺损情况,脑卒中神经功能缺损量表(CSS)评分评价神经系统功能。结果两组疗程结束后CRP、IL-6、sICAM-1低于同组治疗前(P<0.05),观察组CRP、IL-6、sICAM-1低于同期对照组(P<0.05);两组疗程结束后FPG、2 hPG低于同组治疗前(P<0.05),观察组FPG、2 hPG低于同期对照组(P<0.05);两组疗程结束后Bathel指数高于同组治疗前,NIHSS评分、CSS评分低于同组治疗前(P<0.05),观察组Bathel指数高于对照组,NIHSS评分、CSS评分低于对照组(P<0.05)。结论联合降浊通络益气养阴法能够调节DCI病人血糖水平,降低炎症反应,有效改善脑部血液循环,促进神经功能恢复,提高治疗效果。

Objective To explore the clinical efficacy of Jiangzhuo Tongluo,supplementing qi and nourishing yin therapy in the treatment of diabetic cerebral infarction(DCI),and its effect on the inflammatory cytokines.Methods A total of 118 patients with DCI were randomly divided into two groups:the control group(n=59)treated with routine treatment including blood sugar,blood pressure,and blood lipid controlling,anti-platelet aggregation,anticoagulant therapy,and diet and exercise guidance,and the observation group(n=59)treated with Jiangzhuo Tongluo,supplementing qi and nourishing yin therapy in the basis of routine treatment for 1 month.The clinical efficacy was evaluated.The morning fasting peripheral venous blood was collected before and after treatment in the two groups.The levels of serum C-reactive protein(CRP),interleukin-6(IL-6),and soluble intercellular adhesion molecule-1(sICAM-1)were detected.The Bathel Index(BI)was used to evaluate the ability of daily living.The neurological deficit was evaluated by the National Institutes of Health Stroke Scale(NIHSS).China Stroke Scale(CSS)was used to assess nervous system function.Results The levels of serum CRP,IL-6,and sICAM-1t in the two groups after treatmen were significantly reduced when compared with data before treatment(P<0.05).The levels of serum CRP,IL-6,and sICAM-1 in the observation group were significantly lower than those in the control group(P<0.05).The levels of FPG and 2 h PG in the two groups after treatment were significantly reduced when compared with data before treatment(P<0.05),which were significantly lower in the observation group after treatment than those in the control group(P<0.05).after treatment BI in the two groups was significantly elevated when compared with data before treatment(P<0.05),while the scores of NIHSS and CSS were significantly reduced when compared with before treatment(P<0.05).BI in the observation group was significantly higher than that in the control group,the scores of NIHSS and CSS were significantly lower than those in the control group(P<0.05).Conclusion Jiangzhuo Tongluo,supplementing qi and nourishing yin therapy can regulate the blood sugar,reduce the inflammatory reaction,improve the cerebral blood circulation,promote the recovery of neurological function,and enhance the treatment efficacy in patients with DCI.