化浊益髓汤联合阿司匹林治疗急性脑梗死稳定期患者的效果

Effects of Huazhuo Yisui decoction combined with Aspirin in treatment of patients with acute cerebral infarction at stable period

目的:观察化浊益髓汤联合阿司匹林治疗急性脑梗死稳定期患者的效果。方法:选取2022年1—12月该院收治的88例急性脑梗死稳定期患者进行前瞻性研究,按随机数字表法将其分为研究组与对照组各44例。对照组给予阿司匹林治疗,研究组在对照组基础上联合化浊益髓汤治疗。比较两组临床疗效,治疗前后中医证候积分、神经功能缺损程度[美国国立卫生研究院卒中量表(NHISS)]评分、脑血流灌注指标[颈总动脉血流速度最大值(V_(max))、最小值(V_(min))、平均血流量(Q_(mean))、脑血管外周阻力(Rv)]水平、炎性因子[C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平,以及不良反应发生率。结果:研究组治疗总有效率为95.45%(42/44),高于对照组的81.82%(36/44),差异有统计学意义(P<0.05);治疗后,两组主、次症等中医证候积分均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);两组NHISS评分均低于治疗前,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V_(max)、V_(min)、Q_(mean)水平均高于治疗前,且研究组高于对照组,两组Rv水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);两组CRP、IL-6、TNF-α水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:化浊益髓汤联合阿司匹林治疗急性脑梗死稳定期患者可提高治疗总有效率,改善脑血流灌注指标水平,以及降低神经功能缺损程度评分与炎性因子水平,其效果优于单纯阿司匹林治疗。

Objective:To observe effects of Huazhuo Yisui decoction combined with Aspirin in treatment of patients with acute cerebral infarction at stable period.Methods:A prospective study was conducted on 88 patients with acute cerebral infarction at stable period admitted to this hospital from January to December 2022.According to the random number table method,they were divided into study group and control group,44 cases in each group.The control group was treated with Aspirin,while the study group was treated with Huazhuo Yisui decoction on the basis of that of the control group.The clinical efficacy,the TCM syndrome score,the neurological deficit score[National Institutes of Health stroke scale(NHISS)],the cerebral blood flow perfusion index[maximum(V_(max)),minimum(V_(min)),mean blood flow(Q_(mean))of common carotid artery,cerebral vascular peripheral resistance(Rv)]levels,the inflammatory factors[C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)]levels before and after the treatment,and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate of the study group was 95.45%(42/44),which was higher than 81.82%(36/44)of the control group,and the difference was statistically significant(P<0.05).After the treatment,the scores of main and secondary TCM syndromes in the two groups were lower than those before the treatment,those in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).The NHISS scores of the two groups were lower than those before the treatment,that in the study group was lower than that in the control group,and the differences were statistically significant(P<0.05).The levels of V_(max),V_(min)and Q_(mean)in the two groups after the treatment were higher than those before the treatment,and those in the study group were higher than those in the control group;the Rv levels of the two groups were lower than those before the treatment,and that in the study group was lower than that in the control group;and the differences were statistically significant(P<0.05).The levels of serum CRP,IL-6 and TNF-αin the two groups were lower than those before the treatment,those in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Huazhuo Yisui decoction combined with Aspirin in the treatment of the patients with acute cerebral infarction at stable period can improve the total effective rate of treatment,improve the levels of cerebral blood flow perfusion indexes,and reduce the nerve injury defect degree scores and the levels of inflammatory factors.Moreover,it is superior to simple Aspirin treatment.