益气祛浊方治疗卒中后丘脑痛患者的临床疗效及对血清皮质醇、5-羟色胺、去甲肾上腺素的影响

Clinical Efficacy of Yiqi Quzhuo Decoction on Post-Stroke Thalamic Pain and the Effect on Serum Cortisol,Serotonin,and Norepinephrine

目的观察益气祛浊方治疗卒中后丘脑痛患者的临床疗效及对血清皮质醇,5-羟色胺(5-hydroxy tryptamine,5-HT),去甲肾上腺素(Norepinephrine,NE)的影响。方法选取2020年3月—2021年3月期间河北中医学院第二附属医院收治的102名脑卒中后丘脑痛患者作为研究对象,采用随机数字表法将其分为对照组和治疗组,每组各51例。对照组患者采用常规西医治疗,治疗组患者采用益气祛浊方联合常规西药治疗。治疗8周后,观察比较两组患者临床疗效、不良反应情况,治疗前后中医症状评分(肢体疼痛、感觉减退、手足拘挛、头晕目眩)、简化McGill疼痛问卷评分[视觉模拟评分(Visual analogue scale,VAS)、疼痛分级指数(Pain rating index,PRI)、现时疼痛强度(Present pain intensity,PPI)]及空腹静脉血皮质醇、NE、5-HT水平。结果治疗后治疗组总有效率95.92%(47/49)明显高于对照组78.00%(39/50),,差异有统计学意义(P<0.05)。治疗后两组患者中医症状肢体疼痛、感觉减退、手足拘挛、头晕目眩评分均较治疗前明显降低,差异有统计学意义(P<0.05);且治疗组中医症状肢体疼痛、感觉减退、感觉减退、手足拘挛、头晕目眩评分均较对照组明显降低,差异有统计学意义(P<0.05)。治疗后两组患者VAS,PRI和PPI评分均较治疗前降低,差异有统计学意义(P<0.05),且治疗组VAS,PRI和PPI评分均较对照组明显降低,差异有统计学意义(P<0.05)。治疗后两组患者皮质醇水平均较治疗前降低,NE、5-HT水平均较治疗前升高,差异有统计学意义(P<0.05);且治疗组皮质醇水平较对照组明显降低,NE、5-HT水平均较对照组明显升高,差异有统计学意义(P<0.05)。治疗期间,两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论益气祛浊方联合西药能够有效改善脑卒中后丘脑痛患者的临床症状及血清皮质醇、NE、5-HT水平。

Objective To investigate the clinical efficacy of Yiqi Quzhuo Decoction on post-stroke thalamic pain and the effect on serum cortisol,serotonin,and norepinephrine.Methods A total of 102 patients with post-stroke thalamic pain who were treated in the Second Affiliated Hospital of Hebei University of Chinese Medicine from March 2020 to March 2021 were included and randomized into the control group(n=51)and treatment group(n=51)with the random number table.The control group was treated with conventional western medicine,and the treatment group was treated with Yiqi Quzhuo Decoction and conventional western medicine treatment.After 8 weeks of intervention,the clinical efficacy and incidence of adverse reactions were observed and compared between the two groups,and traditional Chinese medicine(TCM)symptom score(limb pain,hypesthesia,contracture of feet and hands,and dizziness),Short-form McGill Pain Questionnaire[visual analogue scale(VAS)score,painrating index(PRI)score,present pain intensity(PPI)score],and levels of cortisol,norepinephrine(NE),and 5-hydroxytryptamine(5-HT)in fasting venous blood were compared between the two groups before and after treatment.Results The total effective rate in the treatment group was 95.92%(47/49),as compared with the 78.00%(39/50)in the control group(P<0.05).After treatment,the scores of limb pain,hypesthesia,contracture of feet and hands,and dizziness were lower than those before treatment in both groups(P<0.05),and lower in the treatment group than in the control group(P<0.05).The scores of VAS,PRI,and PPI decreased after treatment in both groups(P<0.05),and the scores were lower in the treatment group than in the control group(P<0.05).Levels of cortisol decreased and levels of NE and 5-HT increased in the two groups after treatment,and the cortisol level was lower and levels of NE and 5-HT were higher in the treatment group than in the control group after treatment(P<0.05).The incidence of adverse reactions showed no significant difference between the two groups(P>0.05).Conclusion The combination of YiqiQuzhuo Decoction and western medicine can improve the clinical symptoms of patients with post-stroke thalamic pain and regulate the levels of cortisol,NE,and 5-HT.