通窍活血汤加减联合Solitaire AB支架取栓术治疗急性缺血性脑卒中的临床研究

Clinical study of modified Tongqiao Huoxue Decoction combined with Solitaire AB stent thrombectomy in the treatment of acute ischemic stroke

目的:探讨通窍活血汤加减联合Solitaire AB支架取栓术治疗急性缺血性脑卒中(AIS)的临床疗效。方法:将98例AIS患者随机平行分为治疗组与对照组。对照组给予Solitaire AB支架取栓术,治疗组在对照组的基础上给予通窍活血汤加减治疗,两组均连续治疗14d后判定疗效。比较两组患者治疗前后的神经功能缺损评分(NIHSS),日常生活能力(ADL),血清血管内皮生长因子(VEGF),血清一氧化氮合酶(NOS)和血清内皮素-1(ET-1),并比较两组临床疗效。结果:治疗组临床总有效率为95.92%(47/49),在第3个月的预后良好率73.47%(36/49),均显著优于对照组[81.63%(40/49)和48.98%(24/49)](P<0.05);两组治疗后NIHSS评分和血清ET-1均较治疗前显著降低(P<0.05),治疗组ADL评分、VEGF和NOS较治疗前显著升高(P<0.05),且治疗组各项指标改善均优于对照组(P<0.05)。结论:通窍活血汤加减联合Solitaire AB支架取栓术治疗AIS疗效显著,可有效改善神经功能、日常生活能力和血管内皮功能,提高远期疗效。

Objective: To explore the clinical effect of modified Tongqiao Huoxue Tang combined with Solitaire AB stent thrombectomy for acute ischemic stroke(AIS). Methods: A total of 98 patients with AIS were randomly divided into a treatment group and a control group. The control group was given Solitaire AB stent thrombectomy, and the treatment group was treated with Jiajian Tongqiao Huoxue Decoction on the basis of the control group. The neurological deficit score(NIHSS),daily living ability(ADL), serum vascular endothelial growth factor(VEGF), serum nitric oxide synthase(NOS) and serum endothelin-1(ET-1) Compare the clinical efficacy of the two groups. Results: The total clinical effective rate in the treatment group was 95.92%(47/49), and the good prognosis rate in the third month was 73.47%(36/49), which was significantly better than that in the control group[81.63%(40/49) and 48.98%(24/49)](P<0.05);the NIHSS score and ET-1 of the two groups after treatment were significantly reduced than before treatment, ADL score, VEGF and NOS of the treatment group were significantly higher than those before treatment(P<0.05), and the improvement of each index in the treatment group was better than that in the control group(P<0.05). Conclusion: Modified Tongqiao Huoxue Decoction combined with Solitaire AB stent thrombectomy have a significant effect on AIS, which can effectively improve nerve function, daily life ability and vascular endothelial function, and improve the long-term curative effect.