芪龙祛瘀合剂对气虚血瘀型急性脑梗死患者胰岛素抵抗的影响

Influence of “Qilong Quyu Mixture”on Insulin Resistance in Patients with Acute Cerebral Infarction of Qi-deficiency and Blood-stasis Type

目的:观察芪龙祛瘀合剂治疗气虚血瘀型急性脑梗死的疗效及其对胰岛素抵抗的影响。方法:将160例气虚血瘀型脑梗死急性期患者随机分为治疗组80例和对照组80例。两组患者均采用西医常规治疗,治疗组患者加服芪龙袪瘀合剂治疗,治疗周期为4周。采用美国国立卫生研究院卒中量表(NIHSS)与改良Rankin评分量表(mRS)评价患者的神经功能,检测两组患者的空腹血糖(FPG)、胰岛素(FINS)水平,计算胰岛素抵抗指数(HOMA-IR)。结果:治疗2周末、4周末,两组患者的NIHSS评分较治疗前均显著降低(P<0.05,P<0.01),且治疗组患者的评分低于对照组(P<0.05,P<0.01)。治疗2周末,治疗组患者的mRS评分分级情况较治疗前即显著改善(P<0.05);治疗4周末,两组患者的mRS评分分级情况较治疗前均显著改善(P<0.05,P<0.01),且治疗组患者的mRS评分分级情况优于对照组(P<0.05)。治疗2周末、4周末,治疗组患者的FINS水平及HOMA-IR较治疗前显著降低(P<0.05,P<0.01),且治疗4周末,治疗组患者的FINS水平及HOMA-IR明显低于对照组(P<0.05)。结论:芪龙袪瘀合剂联合西医常规疗法治疗气虚血瘀型急性脑梗死患者,可有效改善患者的神经功能及胰岛素抵抗状态。

Objective: To investigate the clinical effect of'Qilong Quyu Mixture'in treating patients with acute cerebral infarction of qi-deficiency and blood-stasis type and its influence on insulin resistance. Methods: One hundred and sixty patients with acute cerebral infarction of qi-deficiency and blood-stasis type were randomly divided into treatment group( n =80) and control group( n = 80). All the patients were treated by conventional western medicine and the patients in the treatment group were treated by 'Qilong Quyu Mixture 'additionally,with a course of 4 weeks. The neural function was evaluated by National Institutes of Health Stroke Scale( NIHSS) and modified Rankin scale( mRS),the levels of fasting plasma glucose( FPG) and fasting insulin( FINS) were detected and the insulin resistance( HOMA-IR) was calculated.Results: Two weeks and four weeks after treatment,the NIHSS scores of both groups were obviously decreased( P < 0. 05,P < 0. 01),and the scores of treatment group were lower than those of the control group( P < 0. 05,P < 0. 01). Two weeks after treatment,the mRS scores of treatment group were significantly improved( P < 0. 05); four weeks after treatment,the mRS scores of both groups were markedly improved( P < 0. 05,P < 0. 01),and the mRS scores of treatment group were superior to the control group( P < 0. 05). Two weeks and four weeks after treatment,the levels of FINS and HOMA-IR were decreased( P < 0. 05,P < 0. 01),and four weeks after treatment,the levels of FINS and HOMA-IR of treatment group were lower than those of the control group( P < 0. 05). Conclusion: 'Qilong Quyu Mixture'combined with conventional western medicine can improve the neural function and insulin resistance in patients with acute cerebral infarction of qi-deficiency and blood-stasis type.