补阳还五汤治疗急性脑梗死的临床疗效及对患者炎症相关指标和血液流变学的影响

Clinical efficacy of Buyang Huanwu Decoction on acute cerebral infarction and how to impact on inflammation-related indexes and hemorheology

目的 观察补阳还五汤治疗急性脑梗死的疗效及对患者炎症相关指标和血液流变学的影响。方法 选取2019年6月至2021年12月南方医科大学附属花都医院急性脑梗死住院患者90例,按随机数字表法分为对照组和观察组,各45例。对照组予以口服阿司匹林肠溶片、阿托伐他汀钙片治疗,并给予常规降血压、降血糖、降颅内压以及对症支持治疗,观察组在对照组治疗基础上联合补阳还五汤治疗,连续治疗2周。采用美国国立卫生研究院卒中量表(NIHSS)评估患者治疗前后神经功能缺损情况,采用蒙特利尔认知评估量表(MoCA)评价患者的认知功能。治疗前后测定炎症相关指标血清淀粉样蛋白A(SAA)、糖化血清蛋白(GSP)、肿瘤坏死因子α(TNF-α)水平及血液流变学指标。比较临床疗效。结果 治疗后2组患者NIHSS评分较治疗前降低(P<0.05),MoCA评分较治疗前升高(P<0.05),且观察组治疗后NIHSS评分低于对照组(P<0.05),MoCA评分高于对照组(P<0.05)。治疗后2组患者血清SAA、GSP、TNF-α水平及血液全血黏度(高切)、全血黏度(低切)、血浆黏度、红细胞比容水平均较治疗前降低(P<0.05),且观察组低于对照组(P<0.05)。观察组总有效率95.56%(43/45),对照组总有效率82.22%(37/45),治疗组疗效优于对照组(P<0.05)。结论 补阳还五汤治疗急性脑梗死疗效确切,可有效减低炎性反应,改善血液流变学指标,改善患者神经功能缺损与认知功能,具有较好的使用价值。

Objective To observe the curative effect of Buyang Huanwu Decoction on acute cerebral infarction(ACI) and how to impact on their inflammation-related indexes and hemorheology. Methods Totally 90 ACI inpatients admitted to Huadu Hospital Affiliated to Southern Medical University from June 2019 to December 2021 were randomly enrolled and divided into the observation group and the control group, with 45 cases in each group. On the basis of conventional therapy, the observation group was additionally given Buyang Huanwu Decoction. The continuous treatment for 2 weeks in both group, the neurological deficit and cognitive function of patients were evaluated by the National Institutes of Health Stroke Scale(NIHSS)and Montreal Cognitive Assessment Scale(MoCA). Fasting venous blood was drawn from patients before and after treatment, and inflammation-related indexes of serum amyloid A(SAA), glycated serum protein(GSP), tumor necrosis factor-α(TNF-α) levels and hemorheological indexes were detected before and after treatment. The clinical efficacy was compared. Results After treatment, the NIHSS scores in both groups were decreased, which in the observation group were lower than control group(P<0.05);the MoCA scores were increased(P<0.05), which in the observation group were higher than control group(P<0.05). The levels of serum SAA, GSP, TNF-α and whole blood viscosity(WBV) at high and low shear rates, plasma viscosity and hematocrit in both groups were lower than those before treatment(P<0.05), while the observation group were more common(P<0.05). The overall effective rate in the observation group was better than that in the control group(95.56% [43/45] vs 82.22% [37/45], [P<0.05], respectively). Conclusion For ACI patients, Buyang Huanwu Decoction has definite effect, which can effectively reduce inflammatory response, improve blood rheology index, and improve neurological deficit and cognitive function of patients, with better use value.