安脑化瘀汤联合丹参注射液治疗急性脑梗死临床研究

Clinical Study on Annao Huayu Decoction Combined with Danshen Injection for Acute Cerebral Infarction

目的:观察安脑化瘀汤联合丹参注射液治疗急性脑梗死(ACI)的临床疗效。方法:选择112例ACI患者,随机分为对照组与治疗组各56例。所有患者均接受阿司匹林肠溶片、阿托伐他汀钙片口服及依达拉奉注射液静脉滴注等常规西医治疗,对照组在此基础上加用丹参注射液治疗,治疗组在对照组基础上联合安脑化瘀汤治疗。2组均治疗2周,评价2组临床疗效,以及治疗前后中医证候评分、中国卒中量表(CSS)评分、血流变学指标[血浆黏度、血细胞比容(HCT)、纤维蛋白原(Fib)]及血清炎症因子[白细胞介素(IL)-1β、可溶性细胞间黏附分子-1(sICAM)-1]水平。结果:治疗后,治疗组总有效率为94.64%,对照组为78.57%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组中医证候评分、CSS评分均较治疗前降低(P<0.05),且治疗组2项评分均低于对照组(P<0.05)。治疗后,2组血浆黏度、HCT、Fib水平均较治疗前降低(P<0.05),且治疗组上述3项指标均低于对照组(P<0.05)。治疗后,2组血清IL-1β、ICAM-1水平均较治疗前降低(P<0.05),且治疗组IL-1β、ICAM-1水平均低于对照组(P<0.05)。结论:安脑化瘀汤联合丹参注射液治疗ACI疗效肯定,可有效改善机体血流变学状态及炎症反应,明显减轻神经功能缺损相关症状及中医证候。

Objective:To observe the clinical effect of Annao Huayu Decoction combined with Danshen Injection on acute cerebral infarction(ACI).Methods:A total of 112 cases of patients with ACI were randomly divided into the control group and the treatment group,with 56 cases in each group.All patients received routine western medicine treatment such as the oral administration of Aspirin Enteric-Coated Tablets and Atorvastatin Calcium Tablets and the intravenous infusion of Edaravone Injection;the control group was additionally treated with Danshen Injection,and the treatment group was additionally treated with Annao Huayu Decoction based on the treatment of the control group.Both groups were treated for 2 weeks.The traditional Chinese medicine(TCM)syndrome scores,Chinese Stroke Scale(CSS)scores,hemorheology indexes[plasma viscosity,hematocrit(HCT),fibrinogen(Fib)]and levels of inflammatory factors in serum[interleukin(IL)-1β,soluble intercellular adhesion molecule-1(sICAM)-1]before and after treatment as well as the clinical effects in the two groups were evaluated.Results:After treatment,the total effective rate was 94.64%in the treatment group and 78.57%in the control group,the difference being significant(P<0.05).After treatment,TCM syndrome scores and CSS scores in the two groups were decreased when compared with those before treatment(P<0.05),and the above two scores in the treatment group were lower than those in the control group(P<0.05).After treatment,the levels of plasma viscosity,HCT and Fib in the two groups were decreased when compared with those before treatment(P<0.05),and the above three indexes in the treatment group were lower than those in the control group(P<0.05).After treatment,the levels of IL-1βand ICAM-1 in serum in the two groups were decreased when compared with those before treatment(P<0.05),and the levels of IL-1βand ICAM-1 in the treatment group were lower than those in the control group(P<0.05).Conclusion:Annao Huayu Decoction combined with Danshen Injection has a definite curative effect in the treatment of ACI,which can effectively improve the hemorheological state and inflammatory responses of patients and significantly reduce the related symptoms of neurologic impairment and TCM syndromes.