
浏览全部资源
扫码关注微信
1.忻州职业技术学院,山西 忻州 034007
2.山西中医学院 第三中医院,太原 034006
3.山西省忻州市 中医医院,山西 忻州 034007
4.大同大学医学院 附属医院,山西 原平 034100
王燕珍,硕士,讲师,主治医师,从事中医临床、教学、科研工作,E-mail:jiangxillwyz01@163.com
* 王维峰,教授,主任医师,从事中医临床、教学、科研工作,E-mail:hnzslnx998@163.com
收稿日期:2020-03-06,
网络出版日期:2020-05-08,
纸质出版日期:2020-12-05
移动端阅览
王燕珍,王维峰,安玉兰等.补阳还五汤合四君子汤加减治疗中风后疲劳气虚血瘀证和抗氧化及抗炎的作用[J].中国实验方剂学杂志,2020,26(23):131-136.
WANG Yan-zhen,WANG Wei-feng,AN Yu-lan,et al.Addition and Subtraction Therapy of Buyang Huanwutang Combined with Si Junzitang to Poststroke Fatigue and Antioxidant and Anti-inflammatory with Syndrome of Qi Deficiency and Blood Stasis[J].Chinese Journal of Experimental Traditional Medical Formulae,2020,26(23):131-136.
王燕珍,王维峰,安玉兰等.补阳还五汤合四君子汤加减治疗中风后疲劳气虚血瘀证和抗氧化及抗炎的作用[J].中国实验方剂学杂志,2020,26(23):131-136. DOI: 10.13422/j.cnki.syfjx.20200732.
WANG Yan-zhen,WANG Wei-feng,AN Yu-lan,et al.Addition and Subtraction Therapy of Buyang Huanwutang Combined with Si Junzitang to Poststroke Fatigue and Antioxidant and Anti-inflammatory with Syndrome of Qi Deficiency and Blood Stasis[J].Chinese Journal of Experimental Traditional Medical Formulae,2020,26(23):131-136. DOI: 10.13422/j.cnki.syfjx.20200732.
目的
2
评价补阳还五汤合四君子汤加减联合针刺治疗中风后疲劳(PSF)气虚血瘀证及抗氧化和抗炎作用。
方法
2
将144例患者根据随机数字表法,按1∶1分为对照组和观察组各72例。试验期间对照组脱落/失访和剔除病例分别有4例和2例,最终完成66例;观察组脱落/失访和剔除病例分别有2例和3例,最终完成67例。对照组采用针刺治疗,每日1次,6次/周;和口服葛芪通脉颗粒,10 g/次,3次/d;观察组针刺同对照组,并内服补阳还五汤合四君子汤加减,1剂/d。两组疗程均为连续治疗4周。进行治疗前后疲劳严重度量表(FSS),脑卒中专用生活质量量表(SS-QOL),气虚血瘀证,神经功能缺损(NIHSS)和日常生活能力(ADL)评分;检测治疗前后超氧化物歧化酶(SOD),同型半胱氨酸(Hcy),丙二醛(MDA)和谷胱甘肽过氧化物酶(GSH-Px),白细胞介素-1
β
(IL-1
β
),IL-6,肿瘤坏死因子-
α
(TNF-
α
)和C反应蛋白(CRP)水平;进行安全性评价。
结果
2
观察组疾病疗效优于对照组(
Z
=2.118,
P
<
0.05);观察组中医证候疗效优于对照组(
Z
=2.046,
P
<
0.05);观察组患者FSS和气虚血瘀证评分均低于对照组(
P
<
0.01);观察组SS-QOL和ADL评分均高于对照组(
P
<
0.01),NIHSS评分低于对照组(
P
<
0.01);治疗后观察组GSH-Px和SOD水平均高于对照组(
P
<
0.01),IL-1
β
,IL-6,Hcy,CRP,TNF-
α
和MDA水平均低于对照组(
P
<
0.01)。两组患者均未发现与药物相关安全性问题。
结论
2
采用补阳还五汤合四君子汤联合针刺治疗PSF气虚血瘀证患者,具有抗氧化和抗炎作用的效果,可明显减轻疲劳程度和神经功能缺损程度,提高日常生活能力和生活质量,临床疗效显著且安全,值得进一步的研究与应用。
Objective
2
To evaluate effect of addition and subtraction therapy of Buyang Huanwutang combined with Si Junzitang and acupuncture to poststroke fatigue (PSF) and syndrome of Qi deficiency and blood stasis, at the same time we studied the antioxidant and anti-inflammatory effects.
Method
2
One hundred and forty-four patients were randomly divided into control group and observation group (1∶1) by random number table. 66 patients in control group completed the therapy (4 patients were falling off or missing visit, 2 patients were eliminate), 67 patients in observation group completed the therapy (2 patients were falling off or missing visit, 3 patients were eliminate). In control group, patinets got acupuncture, 1 time/day, 6 times/week, they also got Geqi Tongmai grain, 10 g/time, 3 times/day. Patients in observation group got acupuncture (the same as which in control group), and addition and subtraction therapy of Buyang Huanwutang combined with Si Junzitang, 1 dose/day, and courses of treatment in two groups were 4 weeks. Before and after treatment, fatigue severity scale (FSS), NIH stroke scale (NIHSS), syndrome of Qi deficiency and blood stasis, stroke specific quality of life scale (SS-QOL), and scores of ability of daily life (ADL) were recorded. And levels of superoxide dismutase (SOD), malondialdehyde (MDA), glutathione peroxidase (GSH-Px), homocysteine (Hcy), interleukin-1
β
(IL-1
β
), IL-6, tumor necrosis factor-
α
(TNF-
α
) and C-reactive protein (CRP) were detected. And the safety evaluated.
Result
2
Disease effect in observation group was better than which in control group (
Z
=2.118,
P
<
0.05). And effect after using traditional Chinese medicine (TCM) was also better than that in control group (
Z
=2.046,
P
<
0.05). Scores of FSS, syndrome of Qi deficiency and blood stasis, NIHSS, and levels of IL-1
β
, IL-6, Hcy, CRP, TNF-
α
and MDA in observation group were all lower than those in control group (
P
<
0.01), and scores of SS-QOL, ADL, and levels of GSH-Px and SOD were all higher than those in control group (
P
<
0.01). Then there was no related safety issues caused by drug.
Conclusion
2
Addition and subtraction therapy of Buyang Huanwutang combined with Si Junzitang and acupuncture had effect of anti-oxidation and anti-inflammatory, and can significantly reduce fatigue and degree of neurological impairment and can improve patients' quality of life and daily life ability. The clinical effect is significant and safe, which is worthy of further research and application.
CHOI-KWON S , KIM J S . Poststroke fatigue: An emerging, critical issue in stroke medicine [J]. Int J Stroke , 2011 , 6 ( 4 ): 328 - 336 .
KHAN A , DELARGY M . Post stroke fatigue, point prevalence, characterization, associations and radiological correlation in a rehabilitation hospital [J]. Ir Med J , 2017 , 110 ( 10 ): 650 - 656 .
王凌立 . 中风后疲劳的中西医研究进展 [J]. 临床医学研究与实践 , 2019 , 4 ( 8 ): 197 - 198 .
尹洪娜 , 郭玉怀 , 李全 . 中医治疗卒中后疲劳刍议 [J]. 辽宁中医药大学学报 , 2016 , 18 ( 8 ): 98 - 100 .
袁清洁 , 王嘉麟 , 贺立娟 , 等 . 补阳还五汤治疗缺血性中风疗效机制研究进展 [J]. 环球中医药 , 2017 , 10 ( 12 ): 1537 - 1542 .
叶财德 , 段锦绣 , 薛武更 , 等 . 补阳还五汤治疗社区脑卒中后疲劳效果观察 [J]. 中国中医药现代远程教育 , 2016 , 14 ( 19 ): 126 - 128 .
熊山 , 丁晓晨 . 四君子汤化学成分和药理作用研究进展 [J]. 山东医学高等专科学校学报 , 2017 , 39 ( 5 ): 371 - 374 .
饶明俐 . 中国脑血管病防治指南 [M]. 北京 : 人民卫生出版社 , 2007 : 31 - 39 .
LYNCH J , MEAD G , GREIG C , et al . Fatigue after stroke: The development and evaluation of a case definition [J]. J Psychosom Res , 2007 , 63 ( 5 ): 539 - 544 .
中国中西医结合学会神经科专业委员会 . 中国脑梗死中西医结合诊治指南(2017) [J]. 中国中西医结合杂志 , 2018 , 38 ( 2 ): 136 - 145 .
LERDAL A , JOHANSSON S , KOTTORP A , et al . Psychometric properties of the fatigue severity scale: Rasch analyses of responses in a norwegian and a swedish MS cohort [J]. Mult Scler , 2010 , 16 ( 6 ): 733 - 741 .
李军涛 , 王伊龙 , 于进洪 , 等 . 脑卒中专门化生存质量量表(SS-QOL)中译本在冀南地区效度的研究 [J]. 脑与神经疾病杂志 , 2007 , 15 ( 3 ): 177 - 179 .
中华神经科学会 . 脑卒中患者临床神经功能缺损程度评分标准(1995) [J]. 中华神经科杂志 , 1996 , 29 ( 6 ): 381 - 383 .
NAESS H , LUNDE L , BROGGER J . The effects of fatigue, pain, and depression on quality of life in ischemic stroke patients: The bergen stroke study [J]. Vasc Health Risk Manag , 2012 , 8 : 407 - 413 .
赵茂晶 , 张咏梅 , 陈俊希 , 等 . 卒中后疲劳危险因素及其症状管理方案研究进展 [J]. 实用心脑肺血管病杂志 , 2019 , 27 ( 3 ): 6 - 9 .
刘瑞 . 针灸疗法治疗运动性疲劳的抗氧化应激机制探索 [J]. 广州中医药大学学报 , 2019 , 36 ( 7 ): 1029 - 1034 .
戴玥 , 郑佳 , 郑黎强 . 抗氧化物质和自由基产物与脑卒中关系的研究进展 [J]. 实用医学杂志 , 2019 , 35 ( 3 ): 489 - 491 .
于学涛 , 徐海 . 老年缺血性脑卒中后疲劳与缺血性脑卒中血清白细胞介素1 β ,C反应蛋白、同型半胱氨酸水平的相关性分析 [J]. 国际检验医学杂志 , 2018 , 39 ( 13 ): 1590 - 1592,1596 .
李欣 , 张彦红 , 聂拴锁 , 等 . 脑卒中后疲劳与缺血性脑卒中患者血清白介素1 β ,C反应蛋白、同型半胱氨酸水平及预后的相关性研究 [J]. 实用心脑肺血管病杂志 , 2017 , 25 ( 8 ): 15 - 19 .
0
浏览量
16
下载量
5
CSCD
关联资源
相关文章
相关作者
相关机构
京公网安备11010802024621