甘草附子汤加减辅助西药治疗中风后偏瘫对患者炎症因子、Klotho蛋白的影响

Effect of Western medicine assisted by modified Gancao Fuzi Decoction in the treatment of patients with hemiplegia after stroke on inflammatory factors and Klotho protein

目的观察甘草附子汤加减辅助西药治疗中风后偏瘫对患者炎症因子、Klotho蛋白的影响,为临床治疗提供参考。方法选取江苏省苏州市中西医结合医院2017年8月—2019年8月收治的中风后偏瘫患者118例,根据治疗方法将其分为两组,每组59例。常规组给予积极改善循环、调节脑细胞代谢、营养神经等西医常规治疗,中药组在常规组的基础上给予甘草附子汤加减治疗。两组均连续治疗4周,记录两组治疗前后成纤维细胞生长因子23(FGF23)、Klotho蛋白、超敏C反应蛋白(hs-CRP)、白介素-1β(IL-1β)、内皮源性超极化因子(EDHF)、内皮素(ET)水平及改良Barthel指数(BI)、Fugl-Meyer运动功能评定量表(FMA)、改良Ashworth量表(MAS)评分的变化,并统计两组临床治疗总有效率。结果治疗后,中药组总有效率高于常规组,差异有统计学意义(P<0.05)。治疗后,两组FGF23、Klotho蛋白、hs-CRP、IL-1β、ET水平及MAS评分均较治疗前下降(P<0.05),EDHF水平及BI、FMA评分均较治疗前上升(P<0.05),且中药组FGF23、Klotho蛋白、hs-CRP、IL-1β、ET水平及MAS评分低于常规组(P<0.05),EDHF水平及BI、FMA评分高于常规组(P<0.05)。结论甘草附子汤加减辅助西药治疗中风后偏瘫可调节FGF23、Klotho蛋白表达,抑制炎症状态,提高疗效。

Objective To observe the effect of Western medicine assisted by modified Gancao Fuzi Decoction in the treatment of patients with hemiplegia after stroke on inflammatory factors and Klotho protein,and to provide reference for clinical treatment.Methods One hundred and eighteen patients with hemiplegia after stroke admitted to Suzhou Hospital of Integrated Traditional Chinese and Western Medicine from August 2017 to August 2019 were selected.According to the treatment method,they were divided into two groups,with 59 cases in each group.The conventional group was given routine Western medicine treatment,such as active improvement circulation,regulation of brain cell metabolism,nutrition of nerve,and so on.The traditional Chinese medicine group was treated with modified Gancao Fuzi Decoction on the basis of conventional group.Both groups were treated continuously for four weeks.The changes of fibroblast growth factor 23(FGF23),Klotho protein,highly sensitive C reactive protein(hs-CRP),interleukin-1β(IL-1β),endothelium-derived hyperpolarizing factor(EDHF),endothelin(ET),and modified Barthel index(BI)score,Fugl-Meyer assessment(FMA)score,modified Ashworth scale(MAS)were recorded before and after treatment,the total effective rate of clinical treatment in two groups was statistically analyzed.Results After treatment,the total effective rate of the traditional Chinese medicine group was higher than that of the conventional group,and the difference was statistically significant(P<0.05).The FGF23,Klotho protein,hs-CRP,IL-1β,ET and MAS score of the two groups were lower than those before treatment(P<0.05).The EDHF level and BI score and FMA score were higher than those before treatment(P<0.05),the FGF23,Klotho protein,hs-CRP,IL-1β,ET and MAS score of the traditional Chinese medicine group were lower than those of the conventional group(P<0.05),and the EDHF level and BI score and FMA score were higher than those of the conventional group(P<0.05).Conclusion Western medicine assisted by modified Gancao Fuzi Decoction in the treatment of hemiplegia after stroke can regulate the expression of FGF23 and Klotho protein,inhibit the inflammatory state,and improve the curative effect.