化痰通络汤对风痰阻络型脑梗死病人神经功能及血清淀粉样蛋白A、糖化血清蛋白的影响

Effect of Huatan Tongluo decoction on neurological function and SAA and GSP in patients with wind-phlegm blocking cerebral infarction

目的探讨化痰通络汤对风痰阻络型脑梗死病人神经功能及血清淀粉样蛋白A(SAA)、糖化血清蛋白(GSP)的影响。方法选取南方医科大学附属花都医院2020年1月至2021年12月收治的84例风痰阻络型脑梗死病人,采用随机数字表法分为对照组与观察组,均42例。对照组行阿司匹林肠溶片、银杏叶注射液治疗,并予以常规降血压血糖、降颅内压以及对症支持治疗。观察组在此基础上联合化痰通络汤治疗,连续治疗2周。测定血清SAA、GSP、视黄醇结合蛋白4(RBP4)、胶质纤维酸性蛋白(GFAP)、血管紧张素-Ⅱ(Ang-Ⅱ)、血管内皮生长因子(VEGF)。采用美国国立卫生研究院卒中量表(NIHSS)评估病人治疗前后神经功能缺损情况,并比较血液流变学指标与临床疗效。结果治疗后观察组总有效率(92.86%)显著高于对照组(76.19%,P<0.05);观察组NIHSS评分低于对照组(P<0.05)。治疗后观察组血清SAA、GSP、RBP4、GFAP、Ang-Ⅱ水平低于对照组,VEGF水平高于对照组(P<0.05)。观察组高切全血黏度、低切全血黏度、血浆黏度以及血细胞比容水平低于对照组(P<0.05)。观察组与对照组不良反应发生率相当(11.90%、7.14%,P>0.05)。结论化痰通络汤对风痰阻络型脑梗死病人疗效确切,可有效降低血清SAA、GSP水平,从而降低炎症反应,改善病人神经功能缺损与血液黏滞性,有较高推广价值。

Objective To explore the effect of Huatan Tongluo decoction on neurological function,serum amyloid A(SAA)and glycosylated serum protein(GSP)in patients with wind phlegm blocking cerebral infarction.Methods A total of 84 patients with windphlegm obstructive cerebral infarction admitted to the Affiliated Huadu Hospital of Southern Medical University from January 2020 to December 2021 were selected and divided into a control group and an observation group,with 42 cases each.The control group was treated with aspirin enteric-coated tablets and ginkgo biloba injection,and routine hypotensive and hypoglycemic,and intracranial hypotensive and symptomatic supportive treatments were given.The observation group was treated with the combination of Huatan Tongluo Decoction for 2 weeks.The levels of serum SAA,GSP,retinol-binding protein 4(RBP4),glial fibrillary acidic protein(GFAP),angiotensin-Ⅱ(Ang-Ⅱ),and vascular endothelial growth factor(VEGF)were measured.The National Institutes of Health Stroke Scale(NIHSS)was used to assess patients'neurological deficits before and after treatment,and to compare blood rheological indices with clinical efficacy.Results The total effective rate of the observation group(92.86%)was significantly higher than that of the control group(76.19%,P<0.05)after treatment.The NIHSS score of the observation group was lower than that of the control group(P<0.05).The serum SAA,GSP,RBP4,GFAP,and Ang-II levels in the observation group were lower than those in the control group,and the VEGF levels were higher than those in the control group(P<0.05).The high-cut whole blood viscosity,low-cut whole blood viscosity,plasma viscosity and hematocrit levels in the observation group were lower than those in the control group(P<0.05).The incidence of adverse reactions in the observation group and the control group was equivalent(11.90%,7.14%,P>0.05).Conclusions Huatan Tongluo decoction has a definite effect on patients with wind-phlegm blocking cerebral infarction.It can effectively reduce the serum SAA and GSP levels,thereby reducing the inflammatory response and improving the neurological deficits and blood viscosity of patients,and has high promotion value.