Effect of Tongqiao Huoxuefang Combined with Flunarizine on Prognosis of Qixu Xueyu Type Ischemic Stroke Patients

JIANG Ying; WANG Kai-hua; ZHANG Yong-quan; FANG Xing; WEN Xiao-dong; OU Li-yu

doi:10.13422/j.cnki.syfjx.20181027

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Effect of Tongqiao Huoxuefang Combined with Flunarizine on Prognosis of Qixu Xueyu Type Ischemic Stroke Patients

更新时间：2024-01-04

- Effect of Tongqiao Huoxuefang Combined with Flunarizine on Prognosis of Qixu Xueyu Type Ischemic Stroke Patients
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 24, Issue 11, Pages: 156-162(2018)
- 作者机构：
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- 基金信息：
- DOI：10.13422/j.cnki.syfjx.20181027
  CLC： R743.3
- Published：2018
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JIANG Ying, WANG Kai-hua, ZHANG Yong-quan, et al. Effect of Tongqiao Huoxuefang Combined with Flunarizine on Prognosis of Qixu Xueyu Type Ischemic Stroke Patients[J]. Chinese journal of experimental traditional medical formulae, 2018, 24(11): 156-162.
DOI：

JIANG Ying, WANG Kai-hua, ZHANG Yong-quan, et al. Effect of Tongqiao Huoxuefang Combined with Flunarizine on Prognosis of Qixu Xueyu Type Ischemic Stroke Patients[J]. Chinese journal of experimental traditional medical formulae, 2018, 24(11): 156-162. DOI： 10.13422/j.cnki.syfjx.20181027.

摘要

目的：评价应用通窍活血汤剂联合氟桂利嗪对气虚血瘀型缺血性脑卒中患者预后的改善作用，并探究钙调蛋白激酶Ⅱ（CaMKⅡ）水平预测治疗效果和远期预后的效能。方法：选择2015年1月至2016年6月于广西中医药大学附属瑞康医院就诊的100例缺血性脑卒中患者，随机分为对照组（30例），治疗组A（35例）和治疗组B（35例），并选择50例健康体检者作为健康组，对照组给予抗血小板和抗凝等治疗，在对照组的基础上，治疗组A和治疗组B分别给予通窍活血汤剂和通窍活血汤剂联合氟桂利嗪治疗，比较3组患者治疗前后的证候积分，美国国立卫生研究院卒中量表（NIHSS）评分，梗死体积，临床疗效，检测缺血性脑卒中和健康人群的血小板最大聚集率（MAR），血清钙离子和CaMKⅡ的水平；治疗后随访1年并绘制Kaplan-Meier生存曲线，比较两组患者预后情况（改良Rankin量表）、生活能力（IADL评分）和生活质量（脑卒中专门生活质量量表SS-QOL）间的差异，并探究治疗后CaMKⅡ水平预测治疗效果和远期预后的效能。结果：治疗2周后治疗A，B组患者的证候积分，NIHSS评分和梗死体积较治疗前均有明显降低，其中治疗B组在治疗4周后较治疗A组更为明显（P<0.05）。治疗2个月后治疗AB组的生活能力和生活质量明显升高（P<0.05），其中治疗B组在治疗4个月后较治疗A组更为明显（P<0.05）。治疗A，B组治疗总有效率和预后良好率不存在明显差异，但均高于对照组。对照组和治疗组的CaMKⅡ和MAR较治疗前明显降低，Ca2+水平明显升高，其中治疗B组最为明显（P<0.05）。结论：在缺血性脑卒中患者治疗中应用通窍活血汤剂联合氟桂利嗪能够显著改善患者的神经功能损伤，提高患者的生活能力和生活质量，具有较好的预后；应用血清CaMKⅡ水平预测缺血性脑卒中患者的治疗效果和远期预后的效能较高。

Abstract

Objective: To observe the effect of Tongqiao Huoxuefang combined with flunarizine on the prognosis of Qixu Xueyu type ischemic stroke patients. Method: A total of 100 ischemic stroke patients treated in our hospital January 2015 to June 2016 were randomly divided into control group (30 cases)

and treatment A and B groups (35 cases in each group)

and 50 health cases were selected into the control group. Patients in control group were treated with antiplatelet and anticoagulant treatment; in addition to the therapy of control group

treatment A and B groups were also treated with Tongqiao Huoxuefang alone as well as Tongqiao Huoxuefang combined with flunarizine. The symptom score

National Institute of Health Stroke Scale (NIHSS) score

infarct volume

clinical efficacy

max platelet aggregation rate (MAR)

living ability (IADL score) and quality of life (SS-QOL)

serum calcium and calmodulin kinase Ⅱ (CaMKⅡ) levels were compared and analyzed. Kaplan-Meier survival curves were drawn to compare the differences in the prognosis (improved Rankin scale)

living ability (IADL score) and quality of life (SS-QOL) between the two groups

and explore CaMKⅡ-based efficacy and long-term prognosis after treatment. Result: After treatment

the scores of NIHSS and infarct volume were significantly lower than those before treatment

and the treatment group B was more obvious (P<0.05) than that in group A after 4 weeks of treatment (P<0.05). After 2 months of treatment

the living ability and quality of life in treatment A and B groups were significantly higher than those of the control group. Among them

treatment group B after 4 months of treatment was more obvious than group A (P<0.05). There was no significant difference in the total effective rate and the good prognosis rate in the treatment groups

but they were higher than those in control group. CaMKⅡ and MAR in control group and the treatment groups were significantly lower than those before treatment

and Ca2+ level was significantly higher

particularly in treatment group B (P<0.05). Conclusion: Tongqiao Huoxuefang combined with flunarizine have a better prognosis in the treatment of ischemic stroke

and can significantly alleviate the patient's neurological impairment and improve the living ability and quality of life. CaMKⅡ shows a higher predictive efficacy and long-term prognosis.

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