化瘀通络法联合西医治疗气虚血瘀型脑卒中的临床疗效

Clinical efficacy of combining Western medicine with the method of resolving blood stasis from collaterals in the treatment of qi deficiency and blood stasis type stroke

目的探讨化瘀通络法联合西医治疗气虚血瘀型脑卒中的临床疗效。方法选择2019年6月至2020年6月陕西省乾县中医医院收治的气虚血瘀型脑卒中患者120例,采用随机数字表法将其分为对照组及观察组,每组60例。其中对照组给予西医治疗,观察组在对照组的基础上给予化瘀通络汤治疗。采集两组患者清晨空腹静脉血,采用酶联免疫吸附试验检测血清脑源性神经营养因子(BDNF)、单核细胞趋化蛋白-1(MCP-1)水平,比较两组临床疗效及治疗前后中医症候得分、美国国立卫生研究院卒中量表(NIHSS)评分及日常生活能力评定量表(BI)评分。结果观察组患者治疗总有效率为91.67%,明显高于对照组的75.00%(P<0.05)。治疗后两组患者血清BDNF水平明显高于治疗前,MCP-1水平明显低于治疗前,且观察组血清BDNF水平明显高于对照组,MCP-1水平明显低于对照组,差异均有统计学意义(P<0.05)。治疗后两组患者BI评分明显高于治疗前,中医症候得分、NIHSS评分明显低于治疗前,且观察组患者BI评分明显高于对照组,中医症候得分、NIHSS评分明显低于对照组,差异均有统计学意义(P<0.05)。结论化瘀通络法联合西医治疗气虚血瘀型脑卒中患者疗效较好,可调控血清BDNF、MCP-1水平,减轻炎症反应,改善患者神经功能损伤及生活质量,可在临床中广泛应用。

Objective To investigate the clinical efficacy of combining Western medicine with the method of resolving blood stasis from collaterals in the treatment of qi deficiency and blood stasis type of stroke.Methods One hundred and twenty patients with qi deficiency and blood stasis stroke,who were admitted to Shaanxi Ganxian County Traditional Chinese Medicine Hospital from June 2019 to June 2020,were selected and divided into the control group and the observation group by random number table method,60 cases in each group.The control group was given Western medicine treatment and the observation group was given Huayu Tongluo Tang treatment on the basis of the control group.The venous blood in the two groups was collecetd on empty stomach at early morning to detect the levels of serum brain-derived neurotrophic factor(BDNF)and monocyte chemotactic protein-1(MCP-1)by enzyme linked immunosorbent assay.The clinical efficacy and the TCM symptom scores,Nationd Institute of Health stroke scale(NIHSS)score and ability of daily living(BI)scores were compared before and after treatment.Results The total effective rate in the observation group was 91.67%,which was significantly higher than that of 75.00%in the control group(P<0.05).The serum BDNF levels in both groups after treatment were significantly higher than those before treatment,and the MCP-1 levels were significantly lower than those before treatment,and the serum BDNF level in the observation group after treatment was significantly higher than that in the control group,and the MCP-1 level was significantly lower than that in the control group,the difference had statistical significance(P<0.05).After treatment,the BI scores in both groups were significantly higher than those before treatment,and the TCM symptom score and NIHSS score were significantly lower than those before treatment,while the BI score in the observation group was significantly higher than that in the control group,and the TCM symptom score and NIHSS score were significantly lower than those in the control group after treatment,the difference had statistical significance(P<0.05).Conclusion The combination of Western medicine with the method of resolving blood stasis from collaterals,which can regulate serum BDNF and MCP-1 levels,reduce inflammatory response and improve patients′neurological impairment and quality of life,is effective in treating patients with qi deficiency and blood stasis type stroke and worthy of clinical application.