Clinical Efficacy of Modified Tongqiao Huoxuetang Combined with Stent Thrombectomy in Treatment of Acute Cerebrovascular Occlusion

Gai-feng WANG; Zhi-hua LIU; Ling-shan JI; Shuai-fang CHENG

doi:10.13422/j.cnki.syfjx.20200121

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Clinical Efficacy of Modified Tongqiao Huoxuetang Combined with Stent Thrombectomy in Treatment of Acute Cerebrovascular Occlusion

Clinic | 更新时间：2021-02-09

- Clinical Efficacy of Modified Tongqiao Huoxuetang Combined with Stent Thrombectomy in Treatment of Acute Cerebrovascular Occlusion
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 26, Issue 6, Pages: 79-84(2020)
- 作者机构：
  
  河南省中医院，郑州　 450002
- 作者简介：
- 基金信息：
- DOI：10.13422/j.cnki.syfjx.20200121
  CLC： R22; R242; R2-031;R287
- Received：16 June 2019，
  
  Published Online：12 September 2019，
  
  Published：20 March 2020
- 稿件说明：
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Gai-feng WANG, Zhi-hua LIU, Ling-shan JI, et al. Clinical Efficacy of Modified Tongqiao Huoxuetang Combined with Stent Thrombectomy in Treatment of Acute Cerebrovascular Occlusion[J]. Chinese journal of experimental traditional medical formulae, 2020, 26(6): 79-84.
DOI：

Gai-feng WANG, Zhi-hua LIU, Ling-shan JI, et al. Clinical Efficacy of Modified Tongqiao Huoxuetang Combined with Stent Thrombectomy in Treatment of Acute Cerebrovascular Occlusion[J]. Chinese journal of experimental traditional medical formulae, 2020, 26(6): 79-84. DOI： 10.13422/j.cnki.syfjx.20200121.

摘要

目的：

观察通窍活血汤加减联合支架取栓术治疗急性脑血管闭塞的临床疗效，并探讨其机制。

方法：

120例患者按照随机数字表法随机分为对照组和观察组，各60例。对照组给予支架取栓术，观察组给予加减通窍活血汤联合支架取栓术。观察两组患者的临床症状[神经功能缺损评分(NIHSS)，日常生活能力量表(ADL)和简易智力筛查量表(MMSE)]；检测血流动力学指标[高切还原黏度(HSRV)，中切还原黏度(MSRV)，低切还原黏度(LSRV)和血浆黏度(WBV)]；血管内皮功能[一氧化氮合酶(NOS)，内皮素-1(ET-1)和血管内皮生长因子(VEGF)]；比较两组临床疗效；观察治疗期间两组患者血、尿常规、心肝肾功能、脑出血发生率等。

结果：

研究期间对照组脱落4例，观察组脱落2例。观察组总有效率94.8%(55/58)，高于对照组的83.9%(47/56)(

0.05)；与对照组比较，观察组NIHSS评分明显降低(

0.05)，ADL和MMSE评分明显升高(

0.05)；观察组血流变学指标较对照组明显降低(

0.05)；观察组NOS和VEGF较对照组明显升高(

0.05)，ET-1较对照组明显降低(

0.05)；研究期间对照组患者脑出血发生率7.14%(4/56)，观察组患者脑出血发生率8.6%(5/58)，两组无统计学差异。

结论：

加减通窍活血汤联合支架取栓术可明显改善急性脑血管闭塞患者的临床症状、血流变学指标和血管内皮功能，值得临床推广应用。

Abstract

Objective:

To observe the effect of modified Tongqiao Huoxuetang combined with stent thrombectomy in treating acute cerebrovascular occlusion.

Method:

A total of 120 cases were randomly divided into control group and observation group

with 60 cases in each group. The control group received stent thrombectomy

while the observation group received modified Tongqiao Huoxuetang combined with stent thrombectomy. The clinical symptoms [health neural function defect scale stroke scale scores(NIHSS)

activities of daily living(ADL)

mini mental state examination(MMSE)]

hemodynamic indexes [high-shear reduction viscosity(HSRV)

medium-shear reduction viscosity(MSRV)

low-shear reduction viscosity(LSRV)

whole blood plasma viscosity(WBV)]

vascular endothelial functions [serum nitric oxide synthase(NOS)

endothelin-1(ET-1)

vascular endothelial growth factor(VEGF)] were observed. The clinical efficacy and the incidence of adverse reactions were compared between two groups. The blood routine

urine routine

heart

liver and kidney function

incidence of cerebral hemorrhage in two groups were observed during the treatment.

Result:

There were 4 cases were shed in control group and 2 cases in observation group during the study period. The total effective rate in observation group was 94.8%(55/58)

which was higher than 83.9% of the control group(47/56)(

0.05). The NIHSS in observation group was lower than that in control group(

0.05)

whereas ADL and MMSE were higher than those in control group(

0.05). The hemorheological indexes in observation group were lower than those in control group(

0.05)

NOS and VEGF in observation group were higher than those in control group(

0.05)

and ET-1 score was lower than that in control group(

0.05). During the study period

the incidence of cerebral hemorrhage was 7.14%(4/56) in control group and 8.6%(5/58) in observation group

with no significant difference.

Conclusion:

Modified Tongqiao Huoxuetang combined with stent thrombectomy could significantly improve the clinical symptoms

hemorheology and vascular endothelial function of patients with acute cerebrovascular occlusion

and so is worthy of clinical promotion and application.

关键词

Keywords

references

刘宁宁 . 对老年急性脑血管闭塞患者进行介入治疗的效果及安全性分析 [J]. 当代医药论丛， 2017 , 15 ( 7 ): 99 - 100 .

许岗勤，王子亮，汪勇锋，等 . 导丝留置技术在急性脑动脉闭塞机械取栓中的应用 [J]. 介入放射学杂志， 2017 , 26 ( 3 ): 202 - 205 .

王林 . 动脉溶栓联合介入方法治疗老年急性脑血管闭塞患者临床研究 [J]. 现代诊断与治疗， 2017 , 28 ( 10 ): 1872 - 1873 .

A RAI , B CLINE , E WILLIAMS , et al . Intravenous thrombolysis outcomes in patients presenting with large vessel acute ischemic strokes-ct angiography-based prognosis [J]． J Neuroimaging , 2015 , 25 ( 2 ): 238 - 242 .

W J POWERS , C P DERDEYN , J BILLER , et al . 2015 American heart association/american stroke association focused update of the 2013 guidelines for the early management of patients with acute ischemic stroke regarding endovascular treatment: a guideline for healthcare professionals from the american heart association/american stroke association [J]. Stroke , 2015 , 46 ( 10 ): 3020 - 3035 .

李培圣，潘溶溶，袁莉，等 . 动脉溶栓联合介入方法治疗老年急性脑血管闭塞临床研究 [J]. 现代诊断与治疗， 2017 , 28 ( 2 ): 214 - 216 .

王乐园，贺爱荣，尹丽丽，等 . 新型支架取栓术治疗急性脑动脉闭塞的疗效评估 [J]. 中国现代医生， 2017 , 55 ( 27 ): 73 - 75 .

张红星，张桂莲，贾颐 . 接触溶栓与支架取栓对急性脑血管闭塞患者术后NIHSS评分、临床疗效及生存质量的影响 [J]. 血栓与止血学， 2017 , 23 ( 3 ): 376 - 378 .

于海龙，徐俊，李晓波，等 . 血管事件健康风险评分对急性脑血管闭塞患者Solitaire AB支架取栓术预后的预测价值 [J]. 中华老年心脑血管病杂志， 2017 , 19 ( 11 ): 1170 - 1175 .

王玉，李晓强，孔咏梅，等 . 静脉rt-PA溶栓联合Solitaire支架取栓治疗急性颅内大动脉闭塞的临床观察 [J]. 疑难病杂志， 2017 , 16 ( 5 ): 461 - 464 .

中华医学会神经病学分会，中华医学会神经病学分会脑血管病学组 . 中国急性缺血性脑卒中诊治指南 [J]. 中华神经科杂志， 2018 , 51 ( 9 ): 666 - 682 .

中华人民共和国卫生部 . 中药新药临床研究指导原则 [M]. 北京：中国医药科技出版社， 2002 : 292 - 318 .

D G ALICIA , N P ROCÍO , G M SERGI , et al . Premio poster comite científico: inclusión de la escala neurologica del national institute of health(nihss) en la clínica de la unidad de ictus del hospital del mar [J]. Revi Cientí Soci Española , 2009 , 30 ( 1 ): 15 - 21 .

G I WOLFE , L HERBELIN , S P NATIONS , et al . Myasthenia gravis activities of daily living profile [J]. Neurology , 1999 , 52 ( 7 ): 1487 - 1489 .

A BRUGNOLOA , F NOBILIA , M P BARBIERIB , et al . The factorial structure of the mini mental state examination (mmse) in Alzheimer' s disease [J]． Arch Gerontol Geriatr , 2009 , 49 ( 1 ): 180 - 185 .

P GULATI , N SINGH , A MUTHURAMAN , et al . Pharmacologic evidence for role of endothelial nitric oxide synthase in neuroprotective mechanism of ischemic postconditioning in mice [J]. J Surg Res , 2014 , 188 ( 1 ): 349 - 360 .

彭俊平 . 于脑血管造影的急性缺血性脑血管病临床治疗模式的疗效及安全性研究 [J]. 世界最新医学信息文摘， 2017 , 17 ( 63 ): 12 - 14 .

王林 . 动脉溶栓联合介入方法治疗老年急性脑血管闭塞患者临床研究 [J]. 现代诊断与治疗， 2017 , 28 ( 10 ): 1872 - 1873 .

盛杰，李月春，姜长春，等 . 支架取栓治疗脑前循环急性大血管闭塞型中重度缺血性脑卒中的疗效分析 [J]. 脑与神经疾病杂志， 2018 , 26 ( 1 ): 21 - 25 .

N HORIE , Y TATEISHI , M MORIKAWA , et al . Acute stroke with major intracranial vessel occlusion：characteristics of cardioembolism and atherosclerosisrelated in situ stenosis/occlusion [J]. J Clin Neurosci , 2016 , 32 ( 11 ): 24 - 29 .

李桂林，杜世伟，李静伟，等 . Solitaire FR支架机械取栓联合5F Navien导管抽吸技术治疗大脑中动脉急性闭塞的效果分析 [J]. 中国脑血管病杂志， 2017 , 14 ( 1 ): 37 - 42 .

孙凤皇 . 动脉溶栓联合介入治疗老年急性脑血管闭塞的疗效及安全性 [J]. 临床医药文献电子杂志， 2017 , 4 ( 10 ): 1829 - 1831 .

秦臻，韦正新，黄水清 . 当归补血汤对低流体剪切应力作用下内皮细胞功能损伤的保护作用 [J]. 中国实验方剂学杂志， 2019 , 25 ( 16 ): 12 - 16 .

贾琳，李博林，魏莉瑛，等 . 金水六君煎加味联合沙美特罗替卡松粉吸入剂对慢性持续期老年哮喘患者血清VEGF, TGF- β 1 的影响 [J]. 中国实验方剂学杂志， 2019 , 25 ( 14 ): 119 - 124 .

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