芪参祛瘀方治疗缺血性中风气虚血瘀证患者的临床疗效及对其血清神经细胞因子、血小板聚集功能的影响

Clinical Efficacy of Qishen Quyu Formula in Treating Patients with Ischemic Stroke of Qi Deficiency and Blood Stasis Syndrome and Its Influence on Serum Nerve Cytokines and Platelet Aggregation Function

目的探讨芪参祛瘀方对缺血性中风气虚血瘀证患者血清神经细胞因子及血小板聚集功能的影响。方法选取2019年1月—2021年1月期间河南省安阳市中医院收治的缺血性中风气虚血瘀证患者90例作为研究对象,按随机数字表法分为对照组和研究组,每组各45例。对照组予常规西药治疗,研究组在对照组基础上加用芪参祛瘀方治疗。治疗2周后,观察比较两组患者临床疗效、不良反应发生率,治疗前后中医证候积分、神经功能缺损积分、血清神经细胞因子[脑源性神经细胞营养因子(Brain derived neurotrophic factor,BDNF)、神经生长因子(Nerve growth factor,NGF)]水平及血小板聚集功能[二磷酸腺苷(Adenosine diphosphate,ADP)、花生四烯酸(Arachidonic acid,AA)]。结果治疗后研究组临床总有效率91.11%(41/45)高于对照组73.33%(33/45),差异有统计学意义(P<0.05)。治疗后两组患者中医证候积分及NIHSS评分较治疗前降低,差异有统计学意义(P<0.05);且研究组低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血清BDNF及NGF水平较治疗前升高,差异有统计学意义(P<0.05);且研究组高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血小板聚集功能指标ADP及AA较治疗前降低,差异有统计学意义(P<0.05);且研究组低于对照组,差异有统计学意义(P<0.05)。治疗期间,研究组不良反应发生率11.11%与对照组8.90%比较,差异无统计学意义(P>0.05)。结论芪参祛瘀方是治疗缺血性中风气虚血瘀证的有效方案,能明显改善临床症状,能提高血清神经细胞因子水平,改善神经缺损功能及血液流变学,且具有良好的安全性。

Objective To explore the effects of Qishen Quyu Formula on serum neurocytokines and platelet aggregation function in patients with ischemic stroke of Qi deficiency and blood stasis syndrome.Methods Ninety patients with ischemic stroke of Qi deficiency and blood stasis syndrome admitted to Anyang Hospital of Traditional Chinese Medicine from January 2019 to January 2021 were selected as the research subjects.They were randomly divided into a control group and a study group using a random number table method,with 45 cases in each group.The control group was treated with conventional Western medicine,while the study group was treated with Qishen Quyu Formula on the basis of the control group.Both groups were treated continuously for two weeks.The clinical efficacy,incidence of adverse reactions,traditional Chinese medicine syndrome score,neurological deficit score,serum levels of neurotrophic factors[brain-derived neurotrophic factor(BDNF)and nerve growth factor(NGF)],and platelet aggregation function[adenosine diphosphate(ADP)and arachidonic acid(AA)]of the two groups before and after treatment were compared.Results The total clinical effective rate of the study group after treatment was 91.11%(41/45),which was higher than that of the control group at 73.33%(33/45),and the difference was statistically significant(P<0.05).After treatment,the traditional Chinese medicine syndrome score and NIHSS score of the two groups decreased(P<0.05),and the study group was lower than the control group(P<0.05).After treatment,the serum levels of BDNF and NGF in the two groups increased significantly(P<0.05),and the study group was higher than the control group(P<0.05).After treatment,the platelet aggregation function indicators ADP and AA in the two groups decreased(P<0.05),and the study group was lower than the control group(P<0.05).During the treatment,the incidence of adverse reactions in the study group was 11.11%.Compared with the control group of 8.90%,the difference was not statistically significant(P>0.05).Conclusion Qishen Quyu Formula is an effective treatment for ischemic stroke of Qi deficiency and blood stasis syndrome.It can significantly improve clinical symptoms,increase serum neurocytokine levels,improve nerve defect function and blood rheology,and has good safety.