通腑醒神开窍方灌肠联合西药治疗缺血性脑卒中疗效及对血管内皮功能的影响

Clinical Effect of Enema with Tongfu Xingshen Kaiqiao Prescription Combined with Western Medicine for Ischemic Stroke and Its Effect on Vascular Endothelial Function

目的:观察通腑醒神开窍方灌肠联合西药治疗缺血性脑卒中的疗效及对血管内皮功能的影响。方法:选取63例缺血性脑卒中患者,按随机数字表法分为观察组32例及对照组31例。对照组给予常规现代医学治疗,观察组在对照组基础上联合通腑醒神开窍方行保留灌肠治疗,2组均持续治疗1周。比较2组临床疗效及神志清醒时间,比较2组治疗前后美国国立卫生研究院卒中量表(NIHSS)评分、全面无反应性量表(FOUR)评分、血管性假血友病因子(vWF)、血浆内皮素(ET-1)、一氧化氮(NO)、C-反应蛋白(CRP)、超氧化物歧化酶(SOD)、丙二醛(MDA)水平的变化,观察2组并发症发生情况。结果:观察组临床疗效总有效率为96.88%,对照组为80.65%,2组比较,差异有统计学意义(P<0.05)。观察组清醒时间短于对照组,差异有统计学意义(P<0.05)。治疗后,2组NIHSS评分均较治疗前下降,FOUR评分均较治疗前上升,差异均有统计学意义(P<0.05);观察组NIHSS评分低于对照组,FOUR评分高于对照组,差异均有统计学意义(P<0.05)。治疗后,2组vWF、ET水平均较治疗前下降,NO水平均较治疗前上升,差异均有统计学意义(P<0.05);观察组vWF、ET水平低于对照组,NO水平高于对照组,差异均有统计学意义(P<0.05)。治疗后,2组CRP、MDA水平均较治疗前下降,SOD水平均较治疗前上升,差异均有统计学意义(P<0.05);观察组CRP、MDA水平低于对照组,SOD水平高于对照组,差异均有统计学意义(P<0.05)。观察组并发症发生率为12.50%,对照组为35.48%,2组比较,差异有统计学意义(P<0.05)。结论:通腑醒神开窍方灌肠联合西药治疗缺血性脑卒中可提高临床疗效,有效缩短患者清醒时间,改善血管内皮功能,降低并发症发生率。

Objective:To observe the clinical effect of enema with Tongfu Xingshen Kaiqiao Prescription combined with western medicine on ischemic stroke,and its effect on vascular endothelial function.Methods:A total of 63 cases with ischemic stroke were selected and randomly divided into the observation group and the control group,with 32 and 31 cases in each group,respectively.The control group was given routine modern medicine,and the observation group was additionally treated with enema with Tongfu Xingshen Kaiqiao Prescription based on the treatment of the control group.The two groups were treated for one week.The clinical effects and the conscious time in both groups were compared.Before and after treatment,the changes of scores of National Institute of Health Stroke Scale(NIHSS),and Full Outline of Unresponsiveness Scale(FOUR),as well as the levels of von willebrand factor(vWF),endothelin-1(ET-1),nitrogen monoxide(NO),C-reactive protein(CRP),superoxide dismutase(SOD)and malondialdehyde(MDA) in both groups were compared.The complications in the two groups were observed.Results:The total clinical effective rate was 96.88% in the observation group,higher than that of 80.65% in the control group,the difference being significant(P<0.05).The conscious time in the observation group was shorter than that in the control group,the difference being significant(P<0.05).After treatment,the NIHSS scores in both groups were decreased when compared with those before treatment,and the FOUR scores were increased,differences being significant(P<0.05);the NIHSS scores in the observation group were lower than those in the control group,and the FOUR scores were higher than those in the control group,differences being significant(P<0.05).After treatment,the levels of vWF and ET-1 in both groups were decreased when compared with those before treatment,and the NO levels were increased,differences being significant(P<0.05);the levels of vWF and ET-1 in the observation group were lower than those in the control group,and the NO level was higher than that in the control group,differences being significant(P<0.05).After treatment,the levels of CRP and MDA in both groups were decreased when compared with those before treatment,and the SOD levels were increased,differences being significant(P<0.05);the levels of CRP and MDA in the observation group were lower than those in the control group,and the SOD level was higher than that in the control group,differences being significant(P<0.05).The incidence of complications was 12.5% in the observation group,lower than that of 35.48% in the control group,the difference being significant(P<0.05).Conclusion:Enema with Tongfu Xingshen Kaiqiao Prescription combined with western medicine for ischemic stroke can improve the clinical effect,well shorten the conscious time,enhance the vascular endothelial function and decrease the incidence of complications.