化痰祛瘀汤联合康复治疗对缺血性中风偏瘫患者血清神经细胞因子、氧化应激及血液流变学的影响

A Study on the Serum Neurocytokines,Oxidative Stress,and Hemorheology of Ischemic Stroke Hemiplegia Patients treated with Huatan Quyu Decoction and Rehabilitation Therapy

目的观察分析缺血性中风后偏瘫患者接受化痰祛瘀汤联合常规康复治疗对其血清神经细胞因子、氧化应激、血液流变学的影响。方法收集2020年10月—2022年10月于我院进行治疗的缺血性中风后偏瘫患者90例,随机分为治疗组(45例,化痰祛瘀汤+常规康复治疗)、对照组(45例,常规康复治疗)。评估康复疗效,对比治疗前、治疗后组间肢体功能、血液流变学、血清氧化应激指标及神经细胞因子水平。结果治疗组康复总有效率显著高于对照组(P<0.05);治疗后治疗组Fugl-Meyer运动功能评定量表(Fugl-Meyer Assessment,FMA)上肢、下肢评分均显著高于对照组(P<0.05);治疗后治疗组全血高切、低切黏度均显著低于对照组(P<0.05);治疗后治疗组血清丙二醛(malondialdehyde,MDA)水平低于对照组,超氧化物歧化酶(Superoxide dismutase,SOD)高于对照组(P<0.05);治疗后治疗组血清基质金属蛋白酶-9(matrix metalloproteinase.9,MMP-9)显著低于对照组,血管生成素1(angiopoietin-1,Ang-1)水平显著高于对照组(P<0.05);治疗后治疗组脑源性神经营养因子(brainderived neuro-trophic factor,BDNF)及神经生长因子(nerve growth factor,NGF)水平显著高于对照组(P<0.05)。结论缺血性中风后偏瘫患者接受化痰祛瘀汤联合常规康复治疗疗效显著,可有效恢复患者肢体功能,其生效机制可能与改善患者血液流变学,减轻氧化应激反应,调节MMP-9、Ang-1水平及提高神经细胞因子水平有关。

Objective To analyze the effects of Huatan Quyu decoction combined with conventional rehabilitation treatment on serum neurocytokines,oxidative stress,and hemorheology in patients with hemiplegia after ischemic stroke.Methods Ninety patients with post-stroke hemiplegia who underwent treatment in our hospital from October 2020 to October 2022 were randomly divided into a treatment group(45 cases,treated with Huatan Quyu decoction+conventional rehabilitation treatment)and a control group(45 cases,treated with conventional rehabilitation treatment).Evaluate rehabilitation efficacy,compare limb function,hemorheology,serum oxidative stress indicators,and neurocytokine levels between groups before and after treatment.Results The total effective rate of rehabilitation in the treatment group was significantly higher than that in the control group(P<0.05);After treatment,the Fugl Meyer Motor Function Assessment(FMA)scores of the upper and lower limbs in the treatment group were significantly higher than those in the control group(P<0.05);After treatment,the whole blood high shear and low shear viscosity in the treatment group were significantly lower than those in the control group(P<0.05);After treatment,the serum malondialdehyde(MDA)level in the treatment group was lower than that in the control group,and the superoxide dismutase(SOD)was higher than that in the control group(P<0.05);After treatment,the serum levels of matrix metalloproteinase-9(MMP-9)in the treatment group were significantly lower than those in the control group,and the levels of angiopoietin-1(Ang-1)were significantly higher than those in the control group(P<0.05);After treatment,the levels of brain-derived neurotrophic factor(BDNF)and nerve growth factor(NGF)in the treatment group were significantly higher than those in the control group(P<0.05).Conclusion The combination of Huatan Quyu decoction and conventional rehabilitation therapy has a significant therapeutic effect on hemiplegia patients after ischemic stroke,which can effectively restore limb function.The effective mechanism may be related to improving the patient s hemorheology,reducing oxidative stress response,regulating MMP-9 and Ang-1 levels,and increasing the level of neurocytokines.