益气化瘀通络汤治疗气虚血瘀型缺血性脑卒中的临床研究

Clinical study of Yiqi Huayu Tongluo Decoction in the treatment of patients with ischemic stroke of Qi deficiency and blood stasis type

目的观察益气化瘀通络汤治疗气虚血瘀型缺血性脑卒中患者的临床效果。方法回顾性分析渭南市中心医院2018年2月至2020年12月收治的124例气虚血瘀型缺血性脑卒中患者的临床资料。按照不同治疗方法分为A组65例(常规西医+益气化瘀通络汤治疗)和B组59例(常规西医治疗)。两组均连续治疗两周后,比较其临床疗效、中医证候积分、神经功能缺损积分、氧化应激[超氧化物歧化酶(SOD)、丙二醛(MDA)、基质金属蛋白酶-9(MMP-9)]、血液流变学(全血高、低切黏度、红细胞压积、纤维蛋白)及不良反应发生情况。结果A组患者的治疗总有效率为93.85%,明显高于B组的71.19%,差异有统计学意义(P<0.05);治疗后,两组患者的中医证候积分、NIHSS评分、全血高、低切黏度、红细胞压积、纤维蛋白原水平、SOD、MDA及MMP-9水平均较治疗前显著下降,且A组患者的上述各项指标明显低于B组,差异均有统计学意义(P<0.05);两组患者治疗期间均未发生明显不良反应。结论益气化瘀通络汤治疗气虚血瘀型缺血性脑卒中可有效提高患者的神经功能,降低氧化应激反应,改善其脑血管微循环,临床应用效果显著,且安全性较高。

Objective To analyze the clinical effect of Yiqi Huayu Tongluo Decoction in the treatment of patients with ischemic stroke of Qi deficiency and blood stasis type.Methods The clinical data of 124 patients with ischemic stroke admitted to Weinan Central Hospital from February 2018 to December 2020 were retrospectively analyzed.According to different treatment methods,they were divided into 65 cases in group A(conventional western medicine+Yiqi Huayu Tongluo Decoction)and 59 cases in group B(conventional western medicine treatment).After 2 weeks of continuous treatment in both groups,the clinical efficacy,TCM syndrome score,neurological deficit score,oxidative stress[superoxide dismutase(SOD),malondialdehyde(MDA),and matrix metalloproteinase-9(MMP-9)],hemorheology(whole blood high-shear viscosity,whole blood low-shear viscosity,hematocrit,fibrin),and the incidence of adverse reactions between the two groups were compared.Results The total effective rate of group A was 93.85%,which was significantly lower than 71.19%of group B(P<0.05).After treatment,the score of TCM syndromes,NIHSS score,whole blood high shear viscosity,whole blood low shear viscosity,hematocrit,fibrinogen levels,SOD,MDA,and MMP-9 levels in the two groups were significantly lower than those before treatment;the above levels in group A were significantly lower than those in group B(P<0.05).No obvious adverse reactions occurred in the two groups during treatment.Conclusion Yiqi Huayu Decoction can effectively improve the neurological function of patients with ischemic stroke of Qi deficiency and blood stasis type,reduce oxidative stress,and improve their cerebral vascular microcirculation,with significant clinical effect and high safety.