自拟通络清瘀汤联合西药治疗急性脑梗死临床疗效

Clinical Effect of Tongluo Qingyu Decoction Combined with Western Medicine on Acute Cerebral Infarction

目的:探讨自拟通络清瘀汤对急性脑梗死(ACI)患者神经功能与血清细胞因子的影响。方法:选取2020年1月至2022年1月辽宁中医药大学附属第四医院收治的134例ACI患者,按随机数字表法将患者均分为对照组与观察组,各67例。对照组患者采用常规单纯西药治疗,观察组患者在对照组的基础上给予自拟通络清瘀汤治疗,比较两组患者临床指标、血清炎症因子、血清细胞因子的变化情况。结果:治疗后观察组患者梗死灶体积、美国国立卫生研究院卒中量表(NIHSS)评分、残障程度改良Rankin修订量表(mRS)评分低于对照组,Barthel指数(BI)评分高于对照组,差异具有统计学意义(P<0.05)。治疗后观察组患者血清超敏C反应蛋白(hs–CRP)、肿瘤坏死因子–α(TNF–α)、白细胞介素–6(IL–6)水平均低于对照组,差异具有统计学意义(P<0.05)。治疗后观察组患者神经元特异性烯醇化酶(NSE)、中枢神经特异蛋白(S–100β)、基质金属蛋白酶–9(MMP–9)水平低于对照组,血管内皮生长因子(VEGF)高于对照组,差异具有统计学意义(P<0.05)。结论:通络清瘀汤可更好的改善ACI患者的神经功能,调节相关细胞因子水平。

Objective The effects of the neurofunction and serum cytokines of patients with acute cerebral infarction(ACI) were discussed.Methods A total of 134 ACI patients admitted to the Fourth Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from January 2020 to January 2022 were selected.According to the random number table method,all patients were divided into control group and observation group,with 67 cases in each group.The control group was treated with conventional simple western medicine,and the observation group was treated with self-prepared Tongluo Qingyu decoction on the basis of the control group.The changes of clinical indicators,serum inflammatory factors and serum cytokines were compared between the two groups.Results After treatment,the infarct volume,the National Institutes of Health Stroke Scale(NIHSS)score and the Modified Rankin Modified Scale of Disability(mRS)score in the observation group were lower than those in the control group,and the Barthel index(BI)was higher than that in the control group,with statistical significance(P<0.05).After treatment,the serum levels of hypersensitive C-reactive protein(Hs-CRP),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of neuron specific enolase(NSE),central nervous system protein(S-100β)and matrix metalloproteinase-9(MMP-9)in the observation group were lower than those in the control group,and the levels of vascular endothelial growth factor(VEGF)was higher than that in the control group,the differences were statistically significant(P<0.05).Conclusion Tongluo Qingyu decoction can better improve the nerve function and regulate the level of related cytokines in ACI patients.