补阳还五汤联合西药治疗脑梗死恢复期气虚血瘀证临床研究

Clinical Study on Buyang Huanwu Decoction Combined with Western Medicine for Cerebral Infarction in Recovery Period with Qi Deficiency and Blood Stasis Syndrome

目的:观察补阳还五汤联合西药治疗脑梗死(CI)恢复期气虚血瘀证的临床疗效。方法:选取62例CI恢复期气虚血瘀证患者,按照随机数字表法分为观察组和对照组各31例。对照组给予西药(阿司匹林肠溶片、硫酸氢氯吡格雷片)治疗,观察组在对照组基础上给予补阳还五汤治疗,2组均治疗14 d。比较2组临床疗效、美国国立卫生研究院卒中量表(NIHSS)评分、血液流变学指标水平、脑损伤标志物水平及不良反应发生率。结果:治疗后,观察组总有效率93.55%,高于对照组74.19%(P<0.05)。2组NIHSS评分均较治疗前降低(P<0.05),观察组NIHSS评分低于对照组(P<0.05)。2组全血高切黏度(HSV)、全血低切黏度(LSV)、血浆黏度(PSV)及红细胞压积(HCT)水平均较治疗前降低(P<0.05),观察组HSV、LSV、PSV及HCT水平均低于对照组(P<0.05)。2组血清脑源性神经营养因子(BDNF)水平均较治疗前升高(P<0.05),血清神经元特异性烯醇化酶(NSE)及中枢神经特异性蛋白(S100-β)水平均较治疗前降低(P<0.05);观察组血清BDNF水平高于对照组(P<0.05),血清NSE、S100-β水平均低于对照组(P<0.05)。治疗期间,观察组不良反应发生率9.68%,与对照组6.45%比较,差异无统计学意义(P>0.05)。结论:补阳还五汤联合西药治疗CI恢复期气虚血瘀证疗效确切,可有效改善血液流变学指标,调节脑损伤标志物水平,促进神经功能恢复,安全性较好。

Objective:To observe the clinical effect of Buyang Huanwu Decoction combined with western medicine on cerebral infarction(CI) in recovery period with qi deficiency and blood stasis syndrome.Methods:A total of 62 cases of patients who were in the recovery period of CI with qi deficiency and blood stasis syndrome were selected and divided into the observation group and the control group according to the random number table method,with 31 cases in each group.The control group was treated with western medicine(Aspirin Enteric-Coated Tablets and Clopidogrel Bisulfate Tablets),and the observation group was additionally treated with Buyang Huanwu Decoction based on the treatment of the control group.Both groups were treated for 14 days.Clinical effects,scores of National Institute of Health Stroke Scale(NIHSS),the levels of hemorheological indicators and brain injury markers,and the incidence of adverse reactions were compared between the two groups.Results:After treatment,the total effective rate was93.55% in the observation group,higher than that of 74.19% in the control group(P<0.05).The scores of NIHSS in the two groups were decreased when compared with those before treatment(P<0.05),and the NIHSS score in the observation group was lower than that in the control group(P<0.05).The levels of whole blood high-shear viscosity(HSV),whole blood low-shear viscosity(LSV),plasma viscosity(PSV),and hematocrit(HCT) in the two groups were decreased when compared with those before treatment(P<0.05),and the above four levels in the observation group were lower than those in the control group(P<0.05).The levels of brain derived neurotrophic factor(BDNF) in serum in the two groups were increased when compared with those before treatment(P<0.05),and the levels of neuron specific enolase(NSE) and central nervous system-specific protein(S100-β) in serum were decreased when compared with those before treatment(P<0.05);serum BDNF level in the observation group was higher than that in the control group(P<0.05),and the levels of NSE and S100-β in serum in the observation group were lower than those in the control group(P<0.05).During treatment,the incidence of adverse reactions was 9.68% in the observation group and 6.45% in the control group,there being no significance in the difference(P>0.05).Conclusion:Buyang Huanwu Decoction combined with western medicine has a definite curative effect on CI in recovery period with qi deficiency and blood stasis syndrome,and can effectively improve hemorheological indicators,regulate the level of brain injury markers,and promote neural function recovery,with good safety.