补阳还五汤辅治缺血性脑血管病效果及对脑血流灌注和外周血Hcy、Vaspin水平的影响

Effects of Buyang Huanwu Decoction(补阳还五汤)Adjuvant Therapy on Ischemic Cerebrovascular Disease and Its Influence on Cerebral Blood Perfusion and Levels of Hcy and Vaspin in Peripheral Blood

目的探讨补阳还五汤辅治缺血性脑血管病效果及对脑血流灌注和外周血同型半胱氨酸(Hcy)、内脏脂肪组织丝氨酸蛋白酶抑制因子(vaspin)水平的影响。方法将100例缺血性脑血管疾病患者随机分为对照组和观察组,每组50例,对照组给予常规西药治疗,观察组基于对照组的用药基础上加予补阳还五汤辅助治疗,观察两组患者治疗前及治疗28d后的中医证候总积分、神经功能缺损程度和痉挛程度,评估两组患者的中医证候疗效,对比治疗前及治疗28d后的脑血流灌注情况和血清Hcy及Vaspin水平变化。结果两组患者治疗28d后的中医证候总积分、美国国立卫生研究院卒中量表(NIHSS)评分及肌张力评分量表(Ashworth)评分均显著低于治疗前(P<0.05),观察组上述评分均显著低于对照组(P<0.05);观察组的中医证候总有效率为[92.00%(46/50)],显著高于对照组的[76.00%(38/50)](P<0.05);两组患者治疗后的峰流速(Vp)、平均流速(Vm)及脑血管阻力(CVR)较治疗前有明显提高(P<0.05),脉动指数(PI)较治疗前有所减少,观察组上述指标变化幅度显著大于对照组(P<0.05);治疗28d后,两组患者的血清Hcy及Vaspin水平均显著降低(P<0.05),观察组降低幅度显著大于对照组(P<0.05)。结论补阳还五汤辅治缺血性脑血管病的中医证候疗效颇著,能明显改善患者的临床症状体征、神经功能缺损程度、肌肉痉挛程度和脑血流灌注,并对其血清Hcy及Vaspin水平起到抑制作用。

Objective To investigate the effects of Buyang Huanwu Decoction(补阳还五汤) adjuvant therapy on ischemic cerebrovascular disease and its influence on cerebral blood perfusion and peripheral blood homocysteine(Hcy) and visceral adipose tissue derived serine protease inhibitor(Vaspin).Methods One hundred patients with ischemic cerebrovascular disease were randomly divided into the control group and the observation group,with 50 cases in each group.The control group was treated with conventional western medicine,and the observation group was supplemented with Buyang Huanwu Decoction adjuvant therapy based on the control group.The total score of TCM syndromes,degree of neurological deficits and degree of spasm were observed in the two groups before and after 28 d of treatment.The efficacy of TCM syndromes was evaluated in the two groups.The cerebral blood perfusion and levels of serum Hcy and Vaspin were compared before treatment and after 28 d of treatment.Results The total scores of TCM syndromes,National Institutes of Health Stroke Scale(NIHSS) score and Ashworth score after 28 d of treatment in the two groups were significantly lower than those before treatment(P<0.05),and the above scores in the observation group were significantly lower than those in the control group(P<0.05).The total effective rate of TCM syndromes in the observation group was significantly higher than that in the control group[92.00%(46/50) vs 76.00%(38/50)](P<0.05).The peak flow velocity(Vp),mean flow velocity(Vm) and cerebrovascular resistance(CVR) after treatment in the two groups were significantly improved compared with those before treatment(P<0.05) while the pulsation index(PI) was decreased compared with that before treatment,and the changes of the above indicators in the observation group were significantly greater than those in the control group(P<0.05).After 28 d of treatment,the levels of serum Hcy and Vaspin were significantly decreased in the two groups(P<0.05),and the decreases in the observation group were significantly greater than those in the control group(P<0.05).Conclusion Buyang Huanwu Decoction(补阳还五汤) adjuvant therapy has quite significant efficacy in the treatment of ischemic cerebrovascular disease.And it can significantly improve the clinical symptoms and signs,neurological deficits,muscle spasm and cerebral blood perfusion,and it can inhibit the levels of serum Hcy and Vaspin.