
浏览全部资源
扫码关注微信
黑龙江中医药大学 附属第二医院,哈尔滨 150000
金泽,博士,从事神经系统疾病研究,E-mail:jinze3399@163.com
陈静,硕士,从事心脑血管疾病及周围神经病研究,E-mail:chenjing108106@163.com
网络出版日期:2021-05-20,
纸质出版日期:2021-07-05
移动端阅览
金泽,陈静,侯鑫磊等.天丹通络胶囊治疗脑梗死恢复期风痰瘀血痹阻脉络证临床疗效观察[J].中国实验方剂学杂志,2021,27(13):58-64.
JIN Ze,CHEN Jing,HOU Xin-lei,et al.Clinical Efficacy of Tiandan Tongluo Capsule Against Cerebral Infarction in Convalescence Corresponding to Stoke Due to Wind-Phlegm-Static Blood Obstructing Vessels[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(13):58-64.
金泽,陈静,侯鑫磊等.天丹通络胶囊治疗脑梗死恢复期风痰瘀血痹阻脉络证临床疗效观察[J].中国实验方剂学杂志,2021,27(13):58-64. DOI: 10.13422/j.cnki.syfjx.20211297.
JIN Ze,CHEN Jing,HOU Xin-lei,et al.Clinical Efficacy of Tiandan Tongluo Capsule Against Cerebral Infarction in Convalescence Corresponding to Stoke Due to Wind-Phlegm-Static Blood Obstructing Vessels[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(13):58-64. DOI: 10.13422/j.cnki.syfjx.20211297.
目的
2
以脑栓通胶囊为对照,评价天丹通络胶囊用于脑梗死恢复期(中风中经络风痰瘀血痹阻脉络证)的安全性和有效性。
方法
2
采用随机、双盲单模拟、阳性药、多中心临床研究,研究周期为2016年12月28日至2019年4月12日。计划纳入352例脑梗死恢复期,中医辨证属中风中经络风痰瘀血痹阻脉络证的患者,按3∶1的比例随机分为试验组与对照组。试验组给予天丹通络胶囊口服,5粒/次,3次/日;对照组同时服用脑栓通胶囊模拟剂与脑栓通胶囊,脑栓通胶囊3粒/次,3次/日,脑栓通胶囊模拟剂2粒/次,3次/d。连续服药12周,随访至发病后180 d。以日常生活活动(ADL)能力量表(Barthel指数)评分为主要疗效指标;次要疗效指标神经功能缺损评分[国立卫生研究院卒中量表(NIHSS)],改良Rankin量表(mRS),中医证候疗效,新发血管性事件患者的比例。并观察治疗过程中实验室指标变化及不良反应发生率。
结果
2
实际入组389例患者,脱落30例,脱落率7.71%;纳入全分析数据集374例,纳入安全集分析377例。与对照组比较,试验组主要疗效指标Barthel指数评分总分,Barthel指数评分≥75分的百分率均有所升高,但差异无统计学意义;与对照组比较,试验组次要疗效指标发病后180 d mRS评分≤2分的百分率明显升高(
P
<
0.05);中医证候疗效与对照组比较,试验组愈显率高于对照组(
P
<
0.05);研究期间,试验组未出现新发血管事件,发生率0.00%;对照组发生1例,发生率1.09%,与对照组比较,试验组新发血管事件比例差异无统计学意义。
结论
2
天丹通络胶囊与脑栓通胶囊治疗脑梗死恢复期(中风中经络风痰瘀血痹阻脉络证)疗效确切,与脑栓通胶囊比较,天丹通络胶囊在改善神经功能缺损、促进神经功能恢复及中医证候疗效更显著,试验期间新发血管事件比例及不良事件发生率两组差异无统计学意义,且试验组无严重不良事件发生。
Objective
2
To evaluate the safety and effectiveness of Tiandan Tongluo capsule in the treatment of cerebral infarction (CI) in convalescence (stoke involving meridians and collaterals due to wind-phlegm-static blood obstructing vessels), with Naoshuantong capsule as a control.
Method
2
A total of 352 convalescent patients with CI differentiated into stoke involving meridians and collaterals due to wind-phlegm-static blood obstructing vessels in traditional Chinese medicine (TCM) were included in this multi-center, randomized, double-blind, single-simulated, Naoshuantong capsule-controlled clinical trial, which lasted from 28 December, 2016 to 12 April, 2019. After being randomized into an experimental group and a control group at a ratio of 3∶1, patients in the experimental group were provided with oral Tiandan Tongluo capsule, five capsules per time, three times per day, whereas those in the control group received both Naoshuantong capsule simulator, two capsules per time, three times per day, and Naoshuantong capsule, three capsules per time, three times per day, for 12 successive weeks. The patients were followed up until 180 days after onset. The Barthel activities of daily living (ADL) index (BI) score was used as the primary outcome, and the secondary outcomes included neurological deficit score [assessed with National Institutes of Health Stroke Scale (NIHSS)], modified Rankin scale (mRS), TCM syndrome score, and proportion of patients with new vascular events. The changes in laboratory indexes and the incidence of adverse reactions during treatment were observed.
Result
2
Among the 389 cases enrolled, 30 dropped out, with the drop-out rate being 7.71%. There were 374 cases included in the full analysis set and 377 in the safety set. The comparison with the control group revealed that the total BI score and the percentage of BI score ≥ 75 in the experimental group were increased, but the difference was not statistically significant. The percentage of mRS score ≤ 2 within 180 days after onset in the experimental group obviously elevated in contrast to that of the control group (
P
<
0.05). As demonstrated by TCM syndrome score analysis, the markedly effective rate in the experimental group was significantly higher than that in the control group (
P
<
0.05). During the trial, the incidence rates of new vascular events in the experimental group and the control group were 0.00% and 1.09% (one case), respectively, exhibiting no statistically significant difference between the two groups.
Conclusion
2
Tiandan Tongluo capsule and Naoshuantong capsule both produce definite therapeutic effects in the treatment of CI in convalescence (stoke involving meridians and collaterals due to wind-phlegm-static blood obstructing vessels). Compared with Naoshuantong capsule, Tiandan Tongluo capsule better alleviates neurological deficit, promotes neural functional recovery, and improves TCM syndrome score, without inducing severe adverse reactions.
邓冬 , 周爽 , 叶苗青 , 等 . 中药复方治疗糖尿病合并脑梗死机制的研究进展 [J]. 中国实验方剂学杂志 , 2019 , 25 ( 13 ): 214 - 223 .
《中国脑卒中防治报告 2019 》编写组 . 《中国脑卒中防治报告 2019》概要[J].中国脑血管病杂志,2020, 17 ( 5 ): 272 - 281 .
朱慧渊 , 苗琦 , 王江 , 等 . 丹参、红花有效组分配伍对缺血性脑卒中大鼠脑组织致炎因子的作用机制 [J]. 中国脑血管病杂志 , 2020 , 26 ( 21 ): 77 - 83 .
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 - 144 .
陈炜 , 胡跃强 , 吴林 , 等 .“ 三焦次第疗法”治疗急性脑梗死的临床研究 [J]. 中国实验方剂学杂志 , 2020 , 26 ( 15 ): 110 - 115 .
张丹丹 , 富苏 , 马雪颜 , 等 . 真实世界中通络化痰胶囊治疗脑梗死恢复期痰瘀阻络证的疗效与安全性评价 [J]. 中医杂志 , 2020 , 61 ( 1 ): 42 - 47 .
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 .
杨仁义 , 周德生 , 傅馨莹 , 等 . 基于STAT3/miRNA反馈环路探讨中医药促脑梗死后血管新生的调控机制 [J]. 中国实验方剂学杂志 , 2020 , 26 ( 20 ): 221 - 228 .
喻腾云 , 吴艳华 , 孙寒静 , 等 . 缺血性脑卒中中医病因病机的层次关系 [J]. 吉林中医药 , 2016 , 36 ( 4 ): 328 - 331 .
国家药监局 , 国家卫生健康委 . 药物临床试验质量管理规范 [EB/OL].( 2020-04-23 )[ 2021-03-10 ]. http://www.gov.cn/zhengce/zhengceku/2020-04/28/content_5507145.htm http://www.gov.cn/zhengce/zhengceku/2020-04/28/content_5507145.htm
国家食品药品监督管理局 . 关于印发中药品种保护指导原则的通知 [EB/OL]. ( 2009-02-03 )[ 2021-03-10 ]. http://www.gov.cn/bumenfuwu/2016-11/30/content_5140315.htm http://www.gov.cn/bumenfuwu/2016-11/30/content_5140315.htm
郑筱萸 . 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 .
国家食品药品监督管理总局 . 中药新药治疗中风临床研究技术指导原则 [M]. 北京 : 中国中医药出版社 , 2015 .
冯梅 . 赫尔辛基宣言 [J]. 中国临床药理学杂志 , 1986 ( 1 ): 13,55 - 56 .
国家食品药品监督管理局 . 药品注册管理办法(修改草案) [EB/OL].( 2014-02-20 )[ 2021-03-10 ]. http://www.gov.cn/gzdt/2014-02/20/content_2616014.htm http://www.gov.cn/gzdt/2014-02/20/content_2616014.htm .
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]. 中华神经杂志 , 2015 , 48 ( 4 ): 246 - 257 .
国家中医药管理局医改司 . 22个专业95个病种中医诊疗方案 [M]. 北京 : 中国中医药出版社 , 2011 : 256 .
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 .
邵婧怡 , 周玲名 , 马小雅 , 等 . 虫类药治疗缺血性中风的配伍增效应用 [J]. 北京中医药大学学报 , 2019 , 42 ( 3 ): 243 - 247 .
戚明珠 , 张铌雪 , 苏晓慧 , 等 . 黄芪甲苷治疗缺血性脑卒中的网络药理学 [J]. 中国实验方剂学杂志 , 2021 , 27 ( 3 ): 163 - 170 .
张晓娟 , 张燕丽 , 左冬冬 . 川芎的化学成分和药理作用研究进展 [J]. 中医药信息 , 2020 , 37 ( 6 ): 128 - 133 .
赵帅 , 吴东 , 雪陈茜 等 . 基于网络药理学的豨莶草治疗缺血性脑卒中作用机制研究 [J]. 中国中药杂志 , 2019 , 44 ( 13 ): 2727 - 2735 .
许鑫 , 周欣 , 楚世峰 , 等 . 天麻素治疗缺血性脑卒中导致神经元死亡的作用机制研究 [J]. 中国药理学通报 , 2020 , 36 ( 11 ): 1581 - 1587
钟苗 , 雷艳 , 李尹 , 等 . 宽体金线蛭与菲牛蛭不同炮制品体内抗凝活性研究 [J]. 中药材 , 2020 ,( 6 ): 1353 - 1356 .
成颖 , 杨静 , 饶莉 , 等 . 水蛭素联合阿托伐他汀对急性心肌梗死大鼠血管内皮功能的影响 [J]. 吉林大学学报 , 2021 , 47 ( 1 ): 139 - 144 .
0
浏览量
22
下载量
1
CSCD
关联资源
相关文章
相关作者
相关机构
京公网安备11010802024621