丁苯酞联合通心络胶囊治疗对慢性脑供血不足患者血液流变学及临床疗效的影响分析

Effect of Butylphthalide Combined with Tongxinluo Capsule Treatment on Blood Rheology and Clinical Efficacy in Patients with Chronic Cerebral Circulation Insuffciency

目的:探讨通心络胶囊联合丁苯酞治疗对慢性脑供血不足(CCCI)患者血液流变学的影响。方法:回顾性分析选取2019年10月—2021年3月武陟济民医院收治的90例气虚血瘀型CCCI患者。根据用药方式不同分为研究组(46例)与对照组(44例),对照组给予西药丁苯酞治疗,研究组采用丁苯酞联合中成药通心络胶囊,均治疗2个月。对比两组患者治疗前后的血管紧张素Ⅱ(ANGⅡ)、同型半胱氨酸(Hcy)肿瘤坏死因子α (TNF-α)和椎、颈动脉舒张末期流速(EDV)、阻力指数(RI)、收缩期峰值流速(PSV),以及治疗期间的不良反应。结果:治疗前两组患者Hcy、ANGⅡ、TNF-α及颈、椎动脉EDV、RI、PSV比较,差异无统计学意义(P>0.05),治疗后研究组Hcy、ANGⅡ、TNF-α及颈、椎动脉RI数值小于对照组,差异有统计学意义(t=22.318、12.883、3.775、2.207、2.995,P<0.05);颈、椎动脉EDV、PSV数值大于对照组,差异有统计学意义(t=2.220、2.131、3.158、2.264,P<0.05);研究组总不反应率[13.04%(6/46)]与对照组[11.36%(5/44)]比较,差异无统计学意义(P>0.05)。结论:丁苯酞联合通心络胶囊可有效改善CCCI患者临床症状及脑供血动脉血液流变学,降低患者脑循环障碍发生风险。

Objective:To investigate the effect of Tongxinluo capsule combined with butylphthalide on Hemorheology in patients with chronic cerebral circulation insufficiency(CCCI).Methods:A retrospective analysis of 90 patients with CCCI with qi deficiency and blood stasis admitted to the hospital from October 2019 to March 2021 was selected and divided into a study group(46 cases) and a control group(44 cases) according to the way of medication administration. The control group was treated with the western drug butalbital and the study group was treated with butalbital combined with the Chinese medicine Tongxinluo capsule,both for 2 months. Angiotensin Ⅱ(ANG Ⅱ), homocysteine(Hcy), tumor necrosis factor alpha(TNF-α) and vertebral and carotid end-diastolic flow velocity(EDV), resistance index(RI), peak systolic flow velocity(PSV), and adverse events during treatment were compared between the two groups before and after treatment.Results:The differences in Hcy, ANG Ⅱ, TNF-α and EDV, RI and PSV of carotid and vertebral arteries between the two groups before treatment were not statistically significant(P>0.05). Hcy,ANG Ⅱ, TNF-α and carotid and vertebral artery RI values were lower in the study group than in the control group after treatment,and the differences were statistically significant(t=22.318, 12.883, 3.775, 2.207, 2.995, P<0.05). The carotid and vertebral artery EDV and PSV values were higher than those of the control group, with statistically significant differences(t=2.220, 2.131,3.158, 2.264, P<0.05). The overall non-response rate in the study group(13.04% [6/46]) compared with the control group(11.36% [5/44]) was not statistically significant(P>0.05).Conclusion:Butylphthalide combined with Tongxinluo capsule can effectively improve the clinical symptoms and blood rheology of cerebral blood supply arteries in patients with CCCI and reduce the risk of cerebral circulation disorders in patients.