化瘀丸辅助治疗对气虚血瘀证急性期脑梗死神经功能恢复的影响

李朝健; 喻锦成; 王小桥; 符瑾

doi:10.13422/j.cnki.syfjx.20200533

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化瘀丸辅助治疗对气虚血瘀证急性期脑梗死神经功能恢复的影响

临床 | 更新时间：2023-07-12

- 化瘀丸辅助治疗对气虚血瘀证急性期脑梗死神经功能恢复的影响
- Effect of Adjuvant Therapy of Huayu Pills on Neurological Recovery of Patients with Acute Cerebral Infarction
- 中国实验方剂学杂志 2020年26卷第16期页码：131-136
- 作者机构：
  
  海南省人民医院 (海南医学院附属海南医院)，海口 570206
- 作者简介：
  
  李朝健，硕士，主治医师，从事中西医结合临床康复工作，E-mail：nijnijnijnij@163.com
  喻锦成，硕士，副主任医师，从事临床康复医学工作，E-mail：yjc079@163.com
- 基金信息：
  
  海南省卫生计生行业科研项目(18A200161)
- DOI：10.13422/j.cnki.syfjx.20200533
  中图分类号： R289;R24;R25;R543
- 网络出版日期：2020-03-11，
  
  纸质出版日期：2020-08-20
- 稿件说明：
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李朝健,喻锦成,王小桥等.化瘀丸辅助治疗对气虚血瘀证急性期脑梗死神经功能恢复的影响[J].中国实验方剂学杂志,2020,26(16):131-136.

LI Chao-jian,YU Jin-cheng,WANG Xiao-qiao,et al.Effect of Adjuvant Therapy of Huayu Pills on Neurological Recovery of Patients with Acute Cerebral Infarction[J].Chinese Journal of Experimental Traditional Medical Formulae,2020,26(16):131-136.
李朝健,喻锦成,王小桥等.化瘀丸辅助治疗对气虚血瘀证急性期脑梗死神经功能恢复的影响[J].中国实验方剂学杂志,2020,26(16):131-136. DOI： 10.13422/j.cnki.syfjx.20200533.

LI Chao-jian,YU Jin-cheng,WANG Xiao-qiao,et al.Effect of Adjuvant Therapy of Huayu Pills on Neurological Recovery of Patients with Acute Cerebral Infarction[J].Chinese Journal of Experimental Traditional Medical Formulae,2020,26(16):131-136. DOI： 10.13422/j.cnki.syfjx.20200533.

摘要

目的

探讨化瘀丸辅助治疗对急性期脑梗死(ACI)气虚血瘀证神经功能恢复的影响及抗氧化、抗炎和改善微循环的作用机制。

方法

将140例患者随机按数字表法分为对照组和观察组各70例。研究期间对照组脱落、失访3例，剔除2例，完成65例；观察脱落、失访1例，剔除4例，完成65例。两组患者均给予西医综合治疗。对照组口服消栓通络片，6片/次，3次/d；观察组口服化瘀丸，5 g/次，2次/d；两组疗程均连续治疗4周。于治疗前、治疗后2周和4周进行神经功能缺损(NIHSS)评分；进行治疗前后功能独立性评定量表（FIM），四肢简化Fugl-Meyer功能量表（FMA），气虚血瘀证评分；进行治疗后致残/病死情况和安全性评价；检测治疗前后全血黏度（BV），血浆黏度（PV），血小板聚集率（PAG），纤维蛋白原（FIB)，P选择素（CD62 p），

-二聚体(

-D)，超氧化物歧化酶(SOD)，丙二醛(MDA)，一氧化氮(NO)，过氧化脂质(PLO)，同型半胱氨酸（Hcy），肿瘤坏死因子-

（TNF-

），血清胱抑素C（Cys-C）和超敏C反应蛋白(hs-CRP)水平。

结果

经秩和检验分析，两组患者临床疗效，观察组优于对照组（

＝2.131，

0.05）；观察组在治疗后2周和4周NIHSS评分均低于对照组（

0.01）；观察组FIM和FMA评分均高于对照组（

0.01），气虚血瘀证评分低于对照组（

0.01）；观察组NO，PLO和MDA水平均低于对照组（

0.01），SOD水平高于对照组（

0.01）；观察组Hcy，Cys-C，hs-CRP，TNF-

水平均低于对照组（

0.01）；治疗后观察组BV，PV，PAG，FIB，CD62 p和

-D水平均低于对照组（

0.01）。

结论

在西医综合治疗措施的基础上，加服化瘀丸治疗ACI气虚血瘀证患者，可改善神经功能缺损程度，提高运动能力和日常生活能力，降低了病残程度，并可改善微循环障碍和血液流变性，减轻炎症反应，清除氧自由基，减轻了氧化应激损伤，有较好的临床疗效。

Abstract

Objective

To observe the effects of adjuvant therapy of Huayu pills on neurological recovery of patients with acute cerebral infarction (ACI) and syndrome of Qi deficiency and blood stasis

and to investigate its mechanism of action for antioxidation

anti-inflammation and improvement of microcirculation.

Method

One hundred and forty patients were randomly divided into control group (70 cases) and observation group (70 cases) by random number table. During the study period

there were 3 drop-out cases

2 excluded cases

and 65 completed cases in the control group. There were 1 drop-out cases

4 excluded case

and 65 completed cases in the observation group. Western medicine was given in both groups. Patients in control group additionally got oral administration of Xiaoshuang Tongluo tablets

6 tablets/time

3 times/day. The patients in observation group got oral administration of Huayu pills

5 g/time

2 times/days. The treatment course was 4 weeks in both groups. Before the treatment

and at the second and fourth week after treatment

scores of national institute of health stroke scale (NIHSS) were graded. Before and after treatment

scores of functional independent measures (FIM) scale

fugl-meyer assessment of motor function (FMA)

Qi deficiency and blood stasis syndrome were graded. Disability/mortality and safety were discussed after treatment. Levels of the whole blood viscosity (BV)

plasma viscosity (PV)

platelet aggregation rate (PAG)

fibrinogen (FIB)

P-selectin (CD62p)

-dimer (

-D)

superoxide dismutase (SOD)

malondialdehyde (MDA)

nitric oxide (NO)

lipid peroxide (PLO)

homocysteine (Hcy)

tumor necrosis factor -

(TNF-

)

serum cystatin C (Cys-C) and hypersensitive C-reactive protein (hs-CRP) were detected both before and after treatment.

Result

In the analysis of rank sum test

clinical efficacy in observation group was better than that in control group (

=2.131

0.05). At the second and fourth week after treatment

scores of NIHSS

Qi deficiency and blood stasis

as well as levels of NO

PLO

MDA

Hcy

Cys-C

hs-CRP

TNF-

PAG

FIB

CD62 p and

-D in observation group were lower than those in control group (

0.01)

while levels of FIM

FMA and SOD were all higher than those in control group (

0.01).

Conclusion

Based on the comprehensive treatment of Western medicine

adjuvant therapy of Huayu pills can improve the degree of nerve function defect

improve the ability of exercise and daily life

reduce the degree of disability

improve the microcirculation and hemorheology

reduce the inflammatory reaction

eliminate oxygen free radicals

and relieve the oxidative stress injury in patients with ACI and Qi deficiency and blood stasis syndrome

and the clinical efficacy is better than that of Western medicine alone.

关键词

Keywords

references

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