化瘀涤痰方对急性脑梗死患者血液流变学及血流动力学的影响

Effect of Huayu Ditan Recipe on Hemorheology and Hemodynamics in Patients with Acute Cerebral Infarction

目的:探讨化瘀涤痰方对急性脑梗患者血液流变学及血流动力学影响.方法:选取2017年11月-2019年3月湖南中医药高等专科学校附属第一医院收治的138例急性脑梗死患者作为研究对象,按治疗方法的不同分为观察组(n=72)和对照组(n=66).对照组给予常规西药治疗,观察组在对照组的基础上给予化瘀涤痰汤治疗.治疗前后采用美国国立卫生研究院卒中量表(NIHSS)评估并比较两组神经功能缺损程度,比较两组治疗效果、血液流变学指标及血流动力学指标.结果:治疗后,两组NIHSS评分均低于治疗前,且观察组NIHSS评分明显低于对照组(P<0.05).观察组治疗总有效率高于对照组(P<0.05).治疗后,两组血沉、纤维蛋白原、血浆比黏度、全血还原黏度、全血低切黏度与全血高切黏度均低于治疗前,且观察组均低于对照组(P<0.05).治疗后,两组脑部平均血流速度、基底动脉血流量、左侧椎动脉血流量及右侧椎动脉血流量均高于治疗前,且观察组均高于对照组(P<0.05).结论:在常规西药治疗的基础上加用化瘀涤痰汤可进一步提高急性脑梗患者疗效,降低患者血液黏度并提高脑部血流速度,进而改善患者神经功能.

Objective:To explore the effect of Huayu Ditan Recipe on hemorheology and hemodynamics in patients with acute cerebral infarction.Method:A total of 138 patients with acute cerebral infarction admitted to the First Affiliated Hospital of Hunan College of Traditional Chinese Medicine from November 2017 to March 2019 were selected as research objects.According to different treatment methods,they were divided into observation group(n=72)and control group(n=66).The control group was treated with conventional western medicine,and the observation group was treated with Huayu Ditan Decoction on the basis of the control group.The degree of neurological impairment of two groups were evaluated and compared by the national institutes of health stroke scale(NIHSS)before and after treatment.The therapeutic effect,hemorheological and hemodynamic indexes of the two groups were compared.Result:After treatment,NIHSS scores in both groups were lower than those before treatment,and NIHSS score in the observation group was significantly lower than that in the control group(P<0.05).The total effective rate of the observation group was higher than that of the control group(P<0.05).After treatment,serum sedimentation rate,fibrinogen,plasma specific viscosity,whole blood reduced viscosity,whole blood low shear viscosity and whole blood high shear viscosity in the two groups were all lower than those before treatment,and those in the observation group were lower than those in the control group(P<0.05).After treatment,the mean cerebral blood flow velocity,basal artery blood flow,left vertebral artery blood flow and right vertebral artery blood flow in the two groups were all higher than those before treatment,and those in the observation group were higher than those in the control group(P<0.05).Conclusion:On the basis of conventional western medicine treatment,Huayu Ditan Decoction can further improve the curative effect,reduce the blood viscosity and increase the cerebral blood flow velocity of patients with acute cerebral infarction,thereby improve the neurological function of patients.