益气通窍活血汤联合丁苯酞氯化钠注射液治疗老年急性脑梗死的临床研究

Clinical Study on Yiqi Tongqiao Huoxue Decoction Combined with Butylphthalide and Sodium Chloride Injection in the Treatment of Acute Cerebral Infarction in the Elderly

目的:观察益气通窍活血汤联合丁苯酞氯化钠注射液对老年急性脑梗死(ACI)患者的临床疗效,并观察该治疗方案对患者血管内皮功能和氧化应激的影响。方法:将河北以岭医院2020年8月—2022年8月收治的80例ACI患者以随机数字表法分为两组,对照组40例给予丁苯酞氯化钠注射液治疗,观察组40例给予益气通窍活血汤联合丁苯酞氯化钠注射液治疗。两组以1周为1个疗程,治疗2个疗程。比较两组疗效、中医证候积分、血管内皮功能及氧化应激水平变化。结果:观察组总有效率优于对照组(P<0.05);两组治疗后中医主症与次症评分、NIHSS评分均降低(P<0.05),观察组低于对照组(P<0.05);两组治疗后ADL评分、Fugl-Meyer评分均提高(P<0.05),观察组高于对照组(P<0.05);两组治疗后血清内皮素-1(ET-1)水平均降低,一氧化氮(NO)水平均提高,观察组ET-1水平低于对照组,NO水平高于对照组(P<0.05);两组治疗后髓过氧化物酶(MPO)水平均降低,超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)水平均提高(P<0.05),观察组MPO水平低于对照组,SOD、GSH-Px水平高于对照组(P<0.05)。结论:益气通窍活血汤联合丁苯酞氯化钠注射液治疗老年ACI可减轻患者临床症状,更好地恢复患者神经功能、生活自理能力及运动能力,减轻血管内皮损伤,纠正氧化应激状态,疗效显著,可供临床参考。

Objective:To observe the clinical efficacy of Yiqi Tongqiao Huoxue Decoction combined with butylphthalide and sodium chloride injection in elderly patients with acute cerebral infarction(ACI).Methods:A total of 80 ACI patients treated at Hebei Yiling Hospital between August 2020 and August 2022 were randomly assigned into two groups.The control group(40 cases)received butylphthalide and sodium chloride injection alone,while the observation group(40 cases)received the same plus Yiqi Tongqiao Huoxue Decoction.Each group received treatment in two courses,and each course lasted one week.The efficacy,TCM syndrome scores,vascular endothelial function,and oxidative stress levels of the two groups were compared.Results:The overall effectiveness rate was higher in the observation group than in the control group(P<0.05).After treatment,TCM syndrome scores,NIH Stroke Scale(NIHSS)scores,primary and secondary symptom scores decreased in both groups,with lower scores in the observation group(P<0.05).ADL and Fugl-Meyer scores increased in both groups,with higher scores in the observation group(P<0.05).Serum endothelin-1(ET-1)levels decreased,while nitric oxide(NO)levels increased in both groups;ET-1 was lower and NO was higher in the observation group than in the control group(P<0.05).After treatment,myeloperoxidase(MPO)levels decreased,and superoxide dismutase(SOD)and glutathione peroxidase(GSH-Px)levels increased in both groups(P<0.05),with lower MPO and higher SOD and GSH-Px levels in the observation group(P<0.05).Conclusion:Yiqi Tongqiao Huoxue Decoction combined with butylphthalide and sodium chloride injection can significantly alleviate clinical symptoms in elderly ACI patients,promote recovery of neurological function,improve self-care and motor abilities,reduce vascular endothelial damage,and correct oxidative stress,offering notable therapeutic benefits for clinical reference.