半夏白术天麻汤加味治疗缺血性中风风痰瘀阻证疗效研究

Efficacy of modified Banxia Baizhu Tianma decoction in treatment of ischemic stroke of Fengtan Yuzu syndrome

目的:观察加味半夏白术天麻汤在缺血性中风风痰瘀阻证中的疗效及对患者血脂代谢、神经功能、血清炎症因子的影响。方法:将102例缺血性中风风痰瘀阻证患者按随机数字表法分为联合组、对照组。联合组采用常规西药联合半夏白术天麻汤加味治疗,对照组给予常规西药治疗。治疗2周后,比较两组患者临床疗效、血脂代谢[总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL)、低密度脂蛋白胆固醇(LDL)]、神经功能[美国国立卫生院卒中量表(NIHSS)、神经元特异性烯醇化酶(NSE)、S100β蛋白、血管内皮生长因子(VEGF)]、血清炎症因子[白介素-6(IL-6)、白介素-18(IL-18)、肿瘤坏死因子-α(TNF-α)、金属基质蛋白酶-9(MMP-9)]水平。结果:治疗2周后,联合组总有效率96.08%,高于对照组84.31%,差异有统计学意义(P<0.05)。治疗后联合组TC、TG、HDL、LDL、NSE、S100β蛋白、IL-6、IL-18、TNF-α、MMP-9均低于对照组,差异有统计学意义(均P<0.05)。治疗后联合组NIHSS评分低于对照组,差异有统计学意义(P<0.05)。治疗后联合组VEGF高于对照组,差异有统计学意义(P<0.05)。结论:半夏白术天麻汤联合西药治疗缺血性中风风痰瘀阻证疗效较好,能有效改善患者血脂水平,促进神经功能恢复,减轻炎症反应。

Objective:To observe efficacy of modified Banxia Baizhu Tianma decoction on ischemic stroke of Fengtan Yuzu syndrome and its effects on blood lipid metabolism,neurological function and serum inflammatory factors.Methods:102 patients with ischemic stroke of Fengtan Yuzu syndrome were divided into combined group and control group by means of the random number table method.The combined group were given conventional western medicine combined with modified Banxia Baizhu Tianma decoction while the control group were given conventional western medicine therapy.After 2 weeks of treatment,clinical efficacy,blood lipid metabolism[total cholesterol(TC),triglyceride(TG),high-density lipoprotein(HDL),low-density lipoprotein(LDL)],neurological function[NIHSS,neuron-specific enolase(NSE),S100βprotein,vascular endothelial growth factor(VEGF)]and serum inflammatory factors(IL-6,IL-18,TNF-α,MMP-9)were compared between the two groups.Results:After two weeks of treatment,the total effective rate in the combined group 96.08%was higher than that in the control group 84.31%,difference statistically significant(P<0.05).After treatment,levels of TC,TG,HDL,LDL,NSE,S100βprotein,IL-6,IL-18,TNF-αand MMP-9 in the combined group were lower than those in the control group,difference statistically significant(all P<0.05).After treatment,NIHSS score in the combined group was lower than that in the control group,difference statistically significant(P<0.05).After treatment,VEGF level was higher in the combined group than that in the control group,difference statistically significant(P<0.05).Conclusion:Banxia Baizhu Tianma decoction combined with western medicine has better efficacy on ischemic stroke.It can effectively improve levels of blood lipids,promote recovery of neurological function,and relieve inflammatory response.