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血府逐瘀汤加味联合西药治疗缺血性脑卒中临床研究

Clinical Study on Modified Xuefu Zhuyu Tang Combined with Western Medicine for Ischemic Stroke
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摘要 目的:观察血府逐瘀汤加味联合西药治疗缺血性脑卒中的临床疗效。方法:选取140例缺血性脑卒中患者,按随机数字表法分为对照组与中药组,每组70例。对照组在常规治疗基础上给予阿司匹林联合氯吡格雷治疗,中药组在对照组基础上联合血府逐瘀汤加味治疗,2组均连续治疗4周。比较2组治疗前后血浆凝血酶原时间(PT)、部分凝血活酶时间(APTT)、凝血酶时间(TT),血浆纤维蛋白原(FIB)、D-二聚体(D-D)水平,血清细胞色素C(CytC)、半胱氨酸天冬氨酸蛋白酶-3(Caspase-3)水平及美国国立卫生研究院卒中量表(NIHSS)评分,评价并对比2组临床疗效。结果:治疗后,2组PT均较治疗前延长,TT均较治疗前缩短,FIB、D-D、CytC、Caspase-3水平及NIHSS评分均较治疗前下降,差异均有统计学意义(P<0.05);中药组PT长于对照组,TT短于对照组,FIB、D-D、CytC、Caspase-3水平及NIHSS评分均低于对照组,差异均有统计学意义(P<0.05)。2组APTT治疗前后比较,差异无统计学意义(P>0.05)。中药组总有效率为91.43%,对照组总有效率为78.57%,2组比较,差异有统计学意义(P<0.05)。结论:血府逐瘀汤加味联合西药治疗缺血性脑卒中,可改善患者的神经功能和凝血功能,降低血清CytC及Caspase-3水平,疗效优于单纯西药治疗。 Objective:To observe the clinical effect of modified Xuefu Zhuyu tang combined with western medicine for ischemic stroke. Methods:A total of 140 cases of patients with ischemic stroke were divided into the control group and the Chinese medicine group according to the random number table method, 70 cases in each group. The control group was treated with aspirin combined with clopidogrel based on routine treatment,and the Chinese medicine group was additionally treated with modified Xuefu Zhuyu tang based on the treatment of the control group. Both groups were treated for four weeks. Before and after treatment, the levels of prothrombin time(PT), activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(FIB),D-dimer(D-D) in plasma,cytochrome C(CytC) and caspase-3 in serum as well as the National Institutes of Health Stroke Scale(NIHSS) scores in the two groups were compared. The clinical effect in the two groups were evaluated and compared. Results:After treatment,PT in the two groups were prolonged when compared with those before treatment,TT were shortened,and the levels of FIB,D-D,CytC and Caspase-3 as well as NIHSS scores were decreased,differences being significant(P<0.05);PT in the Chinese medicine group was longer than that in the control group,TT was shorter,and the levels of FIB,D-D,CytC and Caspase-3 as well as NIHSS score were lower,differences being significant(P<0.05). Before and after treatment, there was no significant difference in the comparison of APTT between two groups(P>0.05). The total effective rate was 91.43% in the Chinese medicine group and 78.57% in the control group, the difference being significant(P<0.05). Conclusion: The therapy of modified Xuefu Zhuyu tang combined with western medicine for ischemic stroke can improve coagulation function and neurological function,and reduce the levels of CytC and Caspase-3 in serum,whose curative effect is better than that of simple western medicine.
作者 董明安 DONG Ming’an
出处 《新中医》 CAS 2020年第17期32-35,共4页 New Chinese Medicine
关键词 缺血性脑卒中 血府逐瘀汤 凝血功能 神经功能 细胞色素C 半胱氨酸天冬氨酸蛋白酶-3 Ischemic stroke Xuefu Zhuyu tang Coagulation function Neurological function Cytochrome C Caspase-3
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