益气活血方对急性脑卒中缺血再灌注损伤的预防作用及机制分析

The Effect of Yiqi Huoxue Recipe in Preventing Ischemia-reperfusion Injury in Patients with Acute Stroke and the Mechanism Analysis

目的:观察益气活血方治疗急性脑卒中的临床疗效,并初步分析益气活血方对急性脑卒中缺血再灌注损伤的预防作用及机制。方法:以2017年5~12月期间本院收治的80例急性脑卒中病例为研究对象,按是否应用益气活血方治疗分为常规对照组(43例)和中药试验组(37例)。常规对照组给予临床常规治疗(包括基础疾病治疗、阿司匹林肠溶片、疏血通注射液、依达拉奉注射液等),中药试验组在常规对照组用药方案基础上给予益气活血方治疗。观察两组临床疗效、再灌注损伤发生率及再灌注损伤相关指标(氧自由基水平及相关应激产物水平)情况。结果:中药试验组临床总有效率(94.60%),高于常规对照组(79.07%)(P<0.05)。常规对照组的缺血性再灌注损伤发生率(18.60%)高于中药试验组(2.70%)(P<0.05)。用药前、用药后12 h(T12)、24 h(T24)、48 h(T48)时刻的再灌注损伤相关指标超氧化物歧化酶(SOD)、晚期氧化蛋白产物(AOPP)、过氧化脂质(LPO)、一氧化氮自由基(NO)、羟自由基(·OH)比较,常规对照组和中药试验组均依次下降(P<0.05);在T12时刻、T24时刻、T48时刻,中药试验组以上指标均低于常规对照组(P<0.05)。在T12时刻、T24时刻、T48时刻的再灌注损伤相关指标血清谷胱甘肽过氧化物酶(GSH-Px)、丙二醛(MDA)比较,常规对照组和中药试验组均依次上升(P<0.05);在T12时刻、T24时刻、T48时刻,中药试验组以上指标均高于常规对照组(P<0.05)。结论:益气活血方可明显提升急性脑卒中的临床疗效,降低缺血再灌注损伤发生率,可通过改善氧自由基及相关应激产物水平降低患者再灌注损伤的发生。

Objective:To observe the clinical effect of yiqi huoxue recipe on acute stroke,and to analyze its effect and mechanism on preventing ischemia-reperfusion injury in patients with acute stroke.Methods:80 cases of acute stroke treated in our hospital from May 2017 to December 2017 were selected as the research object.According to whether to use yiqi huoxue recipe,the patients were divided into the routine treatment control group(43 cases)and the traditional Chinese medicine experimental group(37 cases).The control group was given clinical routine treatment(including basic disease treatment,aspirin enteric coated tablets,shuxuetong injection,edaravone injection,etc.),and the experimental group was given yiqi huoxue recipe based on the treatment of the control group.The clinical effect,the incidence of reperfusion injury and the level of oxygen free radicals and related products of oxidative stress were observed in the two groups.Results:The total effective rate(94.60%)of the experimental group was higher than that of the control group(79.07%)(P<0.05).The incidence of ischemic reperfusion injury of the control group(18.60%)was higher than that of the experimental group(2.70%)(P<0.05).The related indexes of reperfusion injury,such as superoxide dismutase(SOD),advanced oxidation protein products(AOPP),lipid peroxide(LPO)and nitric oxide(NO)free radical,hydroxyl free radical(·OH)of both two groups,declined in turn at T12,T24,T48 moments(P<0.05),and at T12,T24 and T48 moments,all the above indexes in the experimental group were lower than those in the control group(P<0.05).The serum glutathione peroxidase(GSH-PX)and malondialdehyde(MDA)levels of both two groups increased in turn at T12,T24 and T48 moments(P<0.05),and at T12,T24 and T48 moments,the GSH-PX,MDA levels in the experimental group were higher than those in the control group(P<0.05).Conclusion:Yiqi huoxue recipe can obviously improve the clinical effect of acute stroke,reduce the incidence of ischemia-reperfusion injury,and prevent reperfusion injury by improving the level of oxygen free radicals and related products of oxidative stress.