小半夏加茯苓汤联合泽泻汤治疗慢性脑供血不足临床研究

Clinical Study on the Treatment of Chronic Cerebral Insufficiency with Pinellia plus Poria Decoction Combined with Rhizoma Alismatis Decoction

目的:观察小半夏加茯苓汤联合泽泻汤治疗慢性脑供血不足的临床疗效。方法:将92例慢性脑供血不足患者按照随机数字表法分为对照组和观察组,每组各46例。对照组给予常规西药治疗,观察组在对照组治疗的基础上给予小半夏加茯苓汤联合泽泻汤。比较两组治疗前后中医证候积分、血脂水平[血清总胆固醇(total cholesterol, TC)、三酰甘油(triacylglycerol, TG)、低密度脂蛋白(low density lipoprotein cholesterol, LDL-C)和高密度脂蛋白(high density lipoprotein cholesterol, HDL-C)]、血液流变学指标(全血低切黏度、全血高切黏度、血浆黏度)及血管内皮功能[血栓素B2(thromboxane B2,TXB2)、可溶性髓细胞触发受体样转录因子-1(soluble myelocyte trigger receptor-like transcription factor-1,sTLT-1)、内皮素-1(endothelin-1 ET-1)、降钙素基因相关肽(calcitonin gene related peptide, CGRP)]变化情况。结果:两组患者治疗后中医证候积分低于本组治疗前,且治疗后观察组低于对照组,差异具有统计学意义(P<0.05)。两组患者治疗后TC、TG、LDL-C水平低于本组治疗前,HDL-C水平高于本组治疗前,且治疗后组间比较,差异均有统计学意义(P<0.05)。两组患者治疗后全血低切黏度、全血高切黏度、血浆黏度水平低于本组治疗前,且治疗后观察组低于对照组,差异具有统计学意义(P<0.05)。两组患者治疗后sTLT-1、TXB2、ET-1水平低于本组治疗前,CGRP水平高于本组治疗前,且治疗后组间比较,差异均有统计学意义(P<0.05)。结论:小半夏加茯苓汤联合泽泻汤治疗慢性脑供血不足,可改善患者的临床症状、血脂水平及血液流变学指标,也可有效调节血管内皮功能水平。

Objective: To observe the clinical efficacy of Pinellia plus Poria Decoction combined with Rhizoma Alismatis Decoction on chronic cerebral insufficiency.Methods: A total of 92 patients with chronic cerebral insufficiency were divided into the control group and the observation group according to random number table method, with 46 cases in each group.The control group was given conventional Western medicine, while the observation group was given Pinellia plus Poria Decoction combined with Rhizoma Alismatis Decoctionon the basis of the control group.Then the changes of the TCM syndrome score, blood lipid levels [including total cholesterol(TC),triacylglycerol(TG),low density lipoprotein cholesterol(LDL-C) and high density lipoprotein cholesterol(HDL-C) ],hemorheology indexes(including whole blood low shear viscosity, whole blood high shear viscosity, plasma viscosity) and vascular endothelial function [ including thromboxane B2(TXB2) and soluble myelocyte trigger receptor-like transcription factor-1(sTLT-1),endothelin-1(ET-1),calcitonin gene-related peptide(CGRP)] of the two groups were compared before and after treatment.Results: After treatment, the TCM syndrome score of the two groups was lower than that of the group before treatment, and the observation group′s was lower than that of the control group after treatment, and the difference was statistically significant(P<0.05);The levels of TC,TG and LDL-C in the two groups were lower than those of the same group before treatment, while the level of HDL-C was higher than that of the same groupn before treatment, and all the differences between the two groups were statistically significant(P<0.05);The whole blood low shear viscosity, whole blood high shear viscosity and plasma viscosity levels of the two groups were lower than those of the same group before treatment, and the above levels of the observation group were lower than those of the control group, and all the differences were statistically significant(P<0.05);The levels of sTLT-1,TXB2 and ET-1 in the two groups were lower than those of the same group before treatment, while the level of CGRP was higher than that of the same group before treatment, and all the differences between the two groups were statistically significant(P<0.05).Conclusion: Pinellia plus Poria Decoction combined with Rhizoma Alismatis Decoction can improve the clinical symptoms, blood lipid level and hemorheology indexes of patients with chronic cerebral insufficiency, and also effectively regulate the level of vascular endothelial function.