血府逐瘀汤辅助治疗缺血性脑卒中偏瘫临床效果

Effect of Xuefu Zhuyu Decoction(血府逐瘀汤)on Ischemic Stroke Hemiplegia

目的 探究血府逐瘀汤联合依达拉奉治疗缺血性脑卒中偏瘫对患者MMP-9、EPO、Hcy水平及颅内血流动力学的影响。方法 入组患者共56例,均为2019年1月—2020年2月于医院内科进行治疗的缺血性脑卒中偏瘫患者,通过随机数字表法将其分为观察组(n=28)和对照组(n=28)。对照组静脉滴注依达拉奉,观察组在对照组基础上加用血府逐瘀汤,两组均治疗4周。比较两组治疗前后的神经功能及自理能力、颅内血流动力、血清指标,治疗后的疗效。结果 治疗后两组血清MMP-9、NIHSS评分、EPO以及Hcy水平降低,且观察组更低(P<0.05)。治疗后两组ADL评分、ACA、MCA、PCA的Vm提高,观察组更高(P<0.05)。治疗后,观察组的有效率[92.86%(26/28)]高于对照组[71.43%(20/28)](P<0.05)。结论 血府逐瘀汤联合依达拉奉治疗缺血性脑卒中偏瘫,可降低患者血清MMP-9、EPO、Hcy水平,抑制血管损伤,改善颅内血流动力,进而提高患者神经功能及自理能力,疗效确切,值得临床推广应用。

Objective To investigate the effect of Xuefu Zhuyu Decoction(血府逐瘀汤)combined with edaravone on ischemic stroke hemiplegia on levels of matrix metalloproteinase 9(MMP-9),erythropoietin(EPO),homocysteine(Hcy)and intracranial hemodynamics.Methods A total of 104 patients with ischemic stroke hemiplegia who were treated in the internal medicine department of the hospital from January 2019 to February 2020 were enrolled.They were divided into the observation group(28 cases)and the control group(28 cases)by random number table method.The control group received intravenous infusion of edaravone,and the observation group added Xuefu Zhuyu Decoction on the basis of the control group.Both groups were treated for 4 weeks.The nerve function and self-care ability,intracranial hemodynamics and serum indexes before and after treatment,and the effect after treatment of the two groups were compared.Results After treatment,the levels of serum MMP-9,EPO and Hcy decreased than those before treatment,and those of the observation group were lower than those of the control group(P<0.05).After treatment,the National Institutes of Health Stroke Score(NIHSS)scores of the two groups reduced than those before treatment,the the score of the observation group was lower than that of the control group(P<0.05),and the ADL scores of the two groups increased than those before treatment,the score of the observation group was higher than that of the control group(P<0.05).After treatment,the levels of Vm of ACA,MCA and PCA in both groups were increased than those before treatment,and the levels of the observation group were higher than those of the control group(P<0.05).After treatment,the effective rate of the observation group(92.86%)was higher than that of the control group(71.43%,P<0.05).Conclusion Xuefu Zhuyu Decoction(血府逐瘀汤)combined with edaravone in the treatment of ischemic stroke hemiplegia can reduce the serum levels of MMP-9,EPO and Hcy,inhibit vascular injury and improve intracranial blood flow,thereby improving the patients’neurological function and self-care ability.The curative effect is definite and it is worthy of clinical application.