加味星蒌承气汤对急性脑梗死(痰热腑实证)患者神经损伤的影响

Effect of Jiawei Xinglou Chengqi Decoction on Nerve Injury in Acute Cerebral Infarction(Phlegm heat and Fu Stagnation Syndrome)

目的观察加味星蒌承气汤对急性脑梗死(痰热腑实证)患者神经功能和神经细胞损伤的影响。方法选取本院脑病科收治的92例急性脑梗死(痰热腑实证)患者,按照随机数表字表法分为观察组和对照组各46例。对照组采用西医常规治疗,观察组在对照组治疗的基础上加用加味星蒌承气汤治疗,分析两组患者治疗后的中医疗效,并观察治疗前后神经损伤相关因子的变化。结果治疗前,两组中医证候评分、美国国立卫生研究院卒中量表(NIHSS)评分、中风专用生活质量量表(SS-QOL)评分、神经元特异性烯醇化酶(NSE)和肿瘤坏死因子-α(TNF-α)水平相比无差异(P>0.05);治疗7 d后,观察组NSE和TNF-α水平明显低于对照组,差异存在统计学意义(P<0.05);治疗1个月后观察组中医证候评分、NIHSS评分、SS-QOL评分低于对照组,差异存在统计学意义(P<0.05)。结论针对急性脑梗死(痰热腑实证)患者,使用加味星蒌承气汤可以改善中医症状,促进神经功能的恢复,减轻神经细胞的损伤程度,同时抑制神经细胞炎性因子,有着良好的临床实际应用价值。

Objective:To observe the effect of Jiawei Xinglou Chengqi Decoction on nerve function and nerve cell injury in patients with acute cerebral infarction(Phlegm heat and Fu Stagnation Syndrome).Methods:A total of 92 patients with acute cerebral infarction(Phlegm heat and Fu Stagnation Syndrome)from October 2017 to September 2019 were selected and divided into the observation group and control group according to the random number table method,46 cases in each group.The control group was treated with routine western medicine,and the observation group was treated with Jiawei Xinglou Chengqi Decoction.The effects of traditional Chinese medicine in the two groups after treatment were analyzed,and the changes in nerve injury-related factors before and after treatment were observed.Results:Before treatment,there were no differences between the two groups in TCM syndrome score,National Institutes of Health Stroke Scale(NIHSS)score,SS-QOL score,NSE and TNF-αlevel(P>0.05).After 7 days of treatment,the NSE and TNF-αlevels in the observation group were significantly lower than those in the control group with statistical differences(P<0.05);the scores of TCM syndromes,NIHSS and SSQOL in the observation group after 1 month of treatment were lower than those in the control group with statistical differences(P<0.05).Conclusion:For patients with acute cerebral infarction(Phlegm heat and Fu Stagnation Syndrome),the application of Jiawei Xinglou Chengqi Decoction can improve the evidence of Phlegm heat and Fu Stagnation,promote the recovery of nerve function,reduce the damage to nerve cells,and inhibit neuroinflammatory factors,which has good clinical application value.