活血通络汤联合常规西药治疗脑梗死后遗症临床研究

Clinical Study on Huoxue Tongluo Tang Combined with Conventional Western Medicine for Sequelae of Cerebral Infarction

目的:观察活血通络汤联合常规西药治疗脑梗死后遗症的临床疗效。方法:选取脑梗死后遗症患者82例,按随机数字表法分为对照组和研究组各41例。对照组应用常规西药治疗,研究组应用自拟活血通络汤联合常规西药治疗。比较2组临床疗效、血液流变学指标、美国国立卫生研究院卒中量表(NIHSS)评分、日常生活活动能力量表(ADL)评分、炎症因子水平、并发症及不良反应发生情况。结果:研究组总有效率为97.6%,对照组为75.6%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组全血高切黏度、血浆黏度、全血低切黏度、纤维蛋白原水平均较治疗前降低(P<0.05),且研究组上述各项指标均低于对照组(P<0.05)。治疗后,2组ADL评分较治疗前升高(P<0.05),NIHSS评分较治疗前降低(P<0.05);且研究组2项指标改善较对照组更显著(P<0.05)。治疗后,2组血清肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、超敏C-反应蛋白(hs-CRP)水平均较治疗前降低(P<0.05),且研究组上述各项指标均低于对照组(P<0.05)。治疗期间,研究组并发症发生率为4.9%,对照组为26.8%,2组比较,差异有统计学意义(P<0.05);研究组不良反应发生率为7.3%,对照组为24.4%,2组比较,差异有统计学意义(P<0.05)。结论:活血通络汤联合常规西药治疗脑梗死后遗症疗效显著,可有效改善血液流变学指标和炎症因子水平,提高患者日常生活活动能力,减轻神经功能损伤程度,且并发症及不良反应均较少。

Objective: To observe the clinical effect of Huoxue Tongluo tang combined with conventional western medicine on sequelae of cerebral infarction. Methods: A total of 82 patients with sequelae of cerebral infarction were selected and divided into the control group and study group by random number table method, with 41 cases in each group. The control group was treated with conventional western medicine,and the study group was treated with self-designed Huoxue Tongluo tang combined with conventional western medicine.The clinical effects,hemorheology indexes,the score of National Institutes of Health Stroke Scale(NIHSS),the score of Activity of Daily Living(ADL),levels of inflammatory factors, complication and the incidence of adverse reactions were compared between the two groups.Results: The total effective rate was 97.6% in the study group and 75.6% in the control group, the difference being significant(P<0.05). After treatment, the levels of whole blood high shear viscosity,plasma viscosity,whole blood low shear viscosity and fibrinogen in the study group were lower than those in the control group(P<0.05). After treatment, the levels of whole blood high shear viscosity, plasma viscosity, whole blood low shear viscosity and fibrinogen were increased when compared with those before treatment(P<0.05), and the above four levels in the study group were lower than those in the control group(P<0.05).After treatment,the scores of ADL increased when compared with those before treatment(P<0.05),and the scores of NIHSS were decreased(P<0.05);the improvement of above two indexs in the study group was significant than that in the control group(P<0.05). After treatment, the levels of serum tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β) and hypersentive C-reactive protein(hs-CRP) in the two groups were decreased when compared with those before treatment(P<0.05),and the above three levels in the study group were lower than those in the control group(P<0.05).During the treatment, the incidence of complications was 4.9% in the study group and 26.8% in the control group,the difference being significant(P<0.05). The incidence of adverse reactions was 7.3% in the study group and 24.4% in the control group,the difference being significant(P<0.05). Conclusion:The therapy of Huoxue Tongluo tang combined with conventional western medicine has a significant effect on the treatment of sequelae of cerebral infarction, which can effectively improve hemorheology indexes and levels of inflammatory factors, enhance the ability of daily living of patients and reduce the degree of neurological impairment,with less complication and adverse reactions.