复脉滋肾化痰饮辅助西医规范干预方案治疗急性脑梗死痰瘀痹阻证的疗效及其作用机制探讨

Clinical Effect and Mechanism Investigation of Western Medicine Standardized Intervention Program Assisted with Fumai Zishen Huatan Decoction in the Treatment of Acute Cerebral Infarction with Phlegm and Blood Stasis Syndrome

目的探讨复脉滋肾化痰饮辅助西医规范干预方案治疗急性脑梗死痰瘀痹阻证的疗效及其作用机制。方法选取我院2017年1月—2018年6月收治的急性脑梗死痰瘀痹阻证病人140例,以随机抽签法分为对照组(70例)和中西医结合组(70例)。对照组采用西医规范干预方案治疗,中西医结合组则在此基础上加用复脉滋肾化痰饮治疗,比较两组近期疗效、治疗前后主要证候评分、美国国立卫生研究院卒中量表(NIHSS)评分、Barthel巴塞尔指数评分、血液流变学指标、凝血功能指标、血管生成相关因子及过氧化氢酶(CAT)水平。结果中西医结合组近期疗效优于对照组(P<0.05);中西医结合组治疗后NIHSS评分、Barthel指数评分、血液流变学指标及凝血功能指标均优于对照组及本组治疗前(P<0.05);中西医结合组治疗后血管生成相关因子和CAT水平均优于对照组及本组治疗前(P<0.05)。结论相较于单用西医规范干预方案治疗,联合复脉滋肾化痰饮辅助治疗急性脑梗死痰瘀痹阻证有助于保护神经系统功能,改善生存质量,增加血流灌注量及降低血液黏稠度,疗效优势可能与该方案在调节血管生成相关因子和CAT水平方面作用密切相关。

Objective To investigate the clinical effect and mechanism of western medicine standardized intervention program assisted with Fumai Zishen Huatan decoction(FZHD)in the treatment of acute cerebral infarction with phlegm and blood stasis syndrome.Methods A total of 140 patients with acute cerebral infarction and phlegm and blood stasis syndrome in our hospital from January 2017 to June 2018 were randomly divided into 2 groups:control group(n=70)treated with western medicine standardized intervention program,and TCM combined with western medicine group(n=70)treated with FZHD on the basis of western medicine standardized intervention program.The short-term clinical efficacy,main syndrome score,National Institutes of Health Stroke Scale(NIHSS)score,Barthel index(BI)score,the levels of hemorheology index,coagulation function index,angiogenesis related factor and cata-lase(CAT)were compared between two groups.Results The short-term clinical efficacy in TCM combined with western medicine group was significantly better than that in control group(P<0.05).The main syndrome score,NIHSS score,BI score,the levels of hemorheology index and coagulation function index in TCM combined with western medicine group after treatment were significantly better than that in control group and before treatment(P<0.05).The levels of angiogenesis related factor and CAT in TCM combined with western medicine group after treatment were significantly better than that in control group(P<0.05).Conclusion Western medicine standardized intervention program,FZHD for treatment of acute rebral infarction can effectively protect nervous system function,improve quality of life,increase blood perfusion and reduce blood viscosity,which may be closely related to the role of regulating angiogenesis-related factors and CAT.