[1]李 莲,田 军,张秋媛,等.补阳还五汤联合醒脑开窍针刺治疗高血压性基底节区脑出血临床研究[J].陕西中医,2025,46(3):403-407.[doi:DOI:10.3969/j.issn.1000-7369.2025.03.025]
　LI Lian,TIAN Jun,ZHANG Qiuyuan,et al.Clinical study on treatment of hypertensive basal ganglia hemorrhage by Buyang Huanwu decoction combined with Xingnao Kaiqiao acupuncture[J].,2025,46(3):403-407.[doi:DOI:10.3969/j.issn.1000-7369.2025.03.025]
点击复制

补阳还五汤联合醒脑开窍针刺治疗高血压性基底节区脑出血临床研究
分享到：

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
46
期数:
2025年3期
页码:
403-407
栏目:
针灸经络
出版日期:
2025-03-05

文章信息/Info

Title:
Clinical study on treatment of hypertensive basal ganglia hemorrhage by Buyang Huanwu decoction combined with Xingnao Kaiqiao acupuncture
作者:
李 莲; 田 军; 张秋媛; 李 青
(石家庄市人民医院,河北 石家庄 050011)
Author(s):
LI Lian; TIAN Jun; ZHANG Qiuyuan; LI Qing
(Shijiazhuang People's Hospital,Shijiazhuang 050011,China)
关键词:
高血压性基底节区脑出血;  补阳还五汤;  醒脑开窍针刺;  气虚血瘀证;  神经功能;  预后
Keywords:
Hypertensive basal ganglia hemorrhage;  Buyang Huanwu decoction;  Xingnao Kaiqiao acupuncture;  Qixu Xueyu syndrome;  Neurological function;  Prognosis
分类号:
R 255.2
DOI:
DOI:10.3969/j.issn.1000-7369.2025.03.025
文献标志码:
A
摘要:
目的:探讨补阳还五汤联合醒脑开窍针刺治疗高血压性基底节区脑出血(HBGH)疗效。方法:回顾性研究95例HBGH气虚血瘀证患者,按治疗方式不同分成两组。中药汤剂组(n=47)应用补阳还五汤治疗; 针药组(n=48)在中药汤剂组基础上联合醒脑开窍针刺治疗,均治疗4周。比较两组患者临床疗效、气虚血瘀证积分、美国国立卫生院卒中量表(NIHSS)、血清基质金属蛋白酶9(MMP-9)、转化生长因子-β1(TGF-β1)水平及患者预后。结果:针药组总有效率93.75%,高于中药汤剂组的74.47%,差异有统计学意义(P<0.05)。治疗后,两组气虚血瘀证积分、NIHSS 评分、血清MMP-9水平均低于治疗前,且针药组低于中药汤剂组(均P<0.05)。治疗后,两组血清TGF-β1水平均高于治疗前,且针药组高于中药汤剂组(均P<0.05)。针药组预后良好率72.92%高于中药汤剂组的48.94%(P<0.05)。结论:对HBGH患者应用补阳还五汤联合醒脑开窍针刺治疗疗效较好,可有效调节患者血清MMP-9、TGF-β1水平,改善神经功能及相关症状,提高预后良好率。
Abstract:
Objective:To explore effects of Buyang Huanwu decoction combined with Xingnao Kaiqiao acupuncture on hypertensive basal ganglia hemorrhage(HBGH).Methods:Retrospective analysis was conducted on 95 HBGH patients with Qixu Xueyu syndrome.According to different treatment methods,the patients were separated into two groups.The traditional Chinese medicine decoction group(n=47)were treated with Buyang Huanwu decoction,and the acupuncture medication group(n=48)were treated on the basis of the traditional Chinese medicine decoction group combined with Xingnaokai acupuncture treatment,both treated for 4 weeks.The two groups were compared in terms of efficacy,Qixu Xueyu syndrome score,neurological function NIHSS,MMP-9,TGF-β1 levels,and prognosis.Results:The total effective rate of the acupuncture medication group was higher than that in the traditional Chinese medicine decoction group(93.75% vs 74.47%),difference statistically significant(P<0.05).After treatment,the scores of Qixu Xueyu syndrome,NIHSS scores,and serum MMP-9 level in both groups were lower than before treatment,and the acupuncture medication group were lower than those in the traditional Chinese medicine decoction group(all P<0.05).After treatment,the serum TGF-β1 level in both groups were higher than before treatment,and the acupuncture medication group was higher than that in the traditional Chinese medicine decoction group(all P<0.05).The good prognosis rate of the acupuncture medication group was higher than that in the traditional Chinese medicine decoction group(72.92% vs 48.94%),difference statistically significant(P<0.05).Conclusion:Application of Buyang Huanwu decoction combined with Xingnao Kaiqiao acupuncture in treating HBGH patients had better effect.It can effectively regulate serum MMP-9 and TGF-β1 levels,obviously improve neurological function and related symptoms and obviously increase good prognosis rate.

参考文献/References:

[1] 高海东,寿记新,程森,等.3D打印技术辅助下微创穿刺治疗自发性脑出血的疗效分析[J].中国实用神经疾病杂志,2021,24(3):202-207.
[2] HOU H,LI X.Clinical changes of serum melatonin and ICAM-1 levels in patients with basal ganglia hypertensive intracerebral hemorrhage[J].Pak J Med Sci,2023,39(4):1024-1028.
[3] 林洋,段继新,杨斯斯.醒脑开窍针法对高血压脑出血微创钻孔引流术后患者的疗效观察[J].中国医药科学,2022,12(18):131-135.
[4] 孙龙,董致郅,王革生,等.凉血散瘀汤对高血压脑出血微创术后患者中医症候积分、神经功能缺损评分的影响[J].陕西中医,2023,44(8):1061-1064.
[5] 殷志锋,蒋宝华,许国峰,等.补阳还五汤治疗恢复期气虚血瘀型高血压脑出血的临床疗效观察[J].中西医结合心脑血管病杂志,2021,19(17):3020-3022.
[6] WEI F,CUI Y,GUO X,et al.Correlations of inflammatory factors CCCK-18 MMP-9 and D-Dimer with APACHE Ⅱscore and prognosis of patients with acute cerebral hemorrhage[J].Minerva Med,2023,114(2):162-168.
[7] YANG Y,CHEN L,SI J,et al.TGF-β3/Smad3 contributes to isoflurane postconditioning against cerebral ischemia-reperfusion injury by upregulating MEF2C[J].Cell Mol Neurobiol,2020,40(8):1353-1365.
[8] 中华医学会神经外科学分会,中国医师协会急诊医师分会,中华医学会神经病学分会脑血管病学组,等.高血压性脑出血中国多学科诊治指南[J].中华神经外科杂志,2020,36(8):757-770.
[9] 国家中医药管理局.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:162-167.
[10] 蔡业峰,贾真,张新春,等.美国国立卫生院卒中量表(NIHSS)中文版多中心测评研究——附537例缺血中风多中心多时点临床测评研究[J].北京中医药大学学报,2008,31(7):494-498.
[11] 宋乐欣,黄勤,曹国彬,等.颅脑损伤后血糖变化和格拉斯哥评分与病人预后相关性[J].广州医药,2001,32(1):25-26.
[12] 吴林,张光彩,周晓晖,等.温针灸对高血压脑出血恢复期气虚血瘀患者S100B、MMP-9、Hcy及炎性因子水平的影响[J].上海针灸杂志,2021,40(8):907-912.
[13] 梁更新,田中华.针灸结合益气活血汤辅治急性脑出血微创术后气虚血瘀证临床观察[J].实用中医药杂志,2023,39(4):737-739.
[14] 黄志强,曹朝霞,崔晓娟,等.补阳还五汤治疗气虚血瘀证急性缺血性脑卒中的临床研究[J].中国中西医结合杂志,2022,42(1):24-28.
[15] 吴娇,仝芳超.黄芪的化学成分、药理作用及临床应用[J].滨州医学院学报,2024,47(1):68-75.
[16] 李晓雨,李双凤,刘晓美,等.当归-川芎药对的化学成分、药理作用及临床应用研究进展[J].中草药,2024,55(4):1415-1426.
[17] 王艳丽,宁宇,丁莹.地龙的化学成分及药理作用研究进展[J].中医药信息,2022,39(12):86-89.
[18] 赵雪玲,喻坚柏.基于网络药理学研究补阳还五汤治疗高血压性脑出血的作用机制[J].湖南中医杂志,2023,39(6):154-161.
[19] 苗志凯,王艳,夏清岫.醒脑开窍针刺法对急性脑出血患者微创血肿清除术后神经功能、MMPS及Cysc的影响[J].中国中医急症,2020,29(7):1172-1175.
[20] 倪思铭,吕鹤群,徐疏影,等.电针对急性脑出血患者疗效及血清AQP4含量的影响[J].中国针灸,2023,43(10):1099-1103.
[21] 高佳秀,周鸿飞.项丛刺疗法结合吞咽功能训练治疗脑卒中吞咽障碍疗效观察[J].中国针灸,2020,40(6):586-590.
[22] 袁巧,谢丽英,陈朝俊.黄芪多糖减轻大脑中动脉闭塞模型大鼠的血脑屏障损伤:基于抑制P2X7R通道[J].南方医科大学学报,2022,42(11):1705-1711.
[23] 邓畅,邹莹洁,张泓,等.电针对血管性痴呆大鼠血脑屏障及海马促炎细胞因子的影响[J].针刺研究,2022,47(10):885-890.
[24] CAO D,LIU F,LIU Q,et al.Correlation analysis between TSP2 MMP-9 and perihematoma edema as well as the short-term prognosis of patients with hypertensive intracerebral hemorrhage[J].Ann Palliat Med,2021,10(10):10930-10937.
[25] 白玉玲,刘泓渊.高血压脑出血患者血清IL-6和TGF-β1水平与脑出血量及神经功能损伤的相关性[J].标记免疫分析与临床,2021,28(12):2050-2054.

相似文献/References:

[1]黄英媛,宋振华△,徐焕杰,等.补阳还五汤联合梅花针叩刺治疗脑梗死偏瘫疗效研究*[J].陕西中医,2020,(6):815.[doi:DOI:10.3969/j.issn.10007369.2020.06.033]
　HUANG Yingyuan,SONG Zhenhua,XU Huanjie,et al.Clinical effect of Buyang Huanwu decoction combined with plum flower needle tapping on cerebral infarction hemiplegia[J].,2020,(3):815.[doi:DOI:10.3969/j.issn.10007369.2020.06.033]
[2]向宪文,刘西建.补阳还五汤联合经颅磁刺激治疗脑卒中后认知功能障碍临床研究*[J].陕西中医,2020,(7):885.[doi:DOI:10.3969/j.issn.10007369.2020.07.013]
[3]梁春玲,陈晓杰,刘祖发,等.补阳还五汤联合西药治疗急性脑梗死疗效及对患者血管斑块稳定性及血清因子水平的影响*[J].陕西中医,2020,(9):1200.[doi:DOI:10.3969/j.issn.1000-7369.2020.09.006]
　LIANG Chunling,CHEN Xiaojie,LIU Zufa,et al.Effect of Buyang Huanwu decoction combined with western medicine on stability of vascular plaque and serum factor levels in patients with acute cerebral infarction[J].,2020,(3):1200.[doi:DOI:10.3969/j.issn.1000-7369.2020.09.006]
[4]刘 俊,华自森,李诚诚,等.补阳还五汤加伸筋草治疗脑梗死后痉挛型偏瘫疗效研究[J].陕西中医,2020,(12):1759.[doi:DOI:10.3969/j.issn.1000-7369.2020.12.020]
　LIU Jun,HUA Zisen,LI Chengcheng,et al.Efficacy study on Buyang Huanwu decoction with lycopodium clavatum on spastic hemiplegia after cerebral infarction[J].,2020,(3):1759.[doi:DOI:10.3969/j.issn.1000-7369.2020.12.020]
[5]王红燕,朱卫华,刘小峰.补阳还五汤加减联合激光治疗糖尿病性黄斑水肿临床研究[J].陕西中医,2021,(7):896.[doi:DOI:10.3969/j.issn.1000-7369.2020.07.022]
[6]张新波,郑 伟.补阳还五汤联合西药对面部缺损皮瓣修复术后恢复临床研究[J].陕西中医,2022,(4):461.[doi:DOI:10.3969/j.issn.1000-7369.2022.04.012]
　ZHANG Xinbo,ZHENG Wei.Effect of Buyang Huanwu decoction combined with western medicine in the treatment of facial defect skin flap repair[J].,2022,(3):461.[doi:DOI:10.3969/j.issn.1000-7369.2022.04.012]
[7]韦茂英,赵琦瑶,高云逸,等.补阳还五汤联合西医治疗糖尿病脑病Meta分析[J].陕西中医,2022,(9):1310.[doi:DOI:10.3969/j.issn.1000-7369.2022.09.040]
[8]李倩宇,卢健棋,温志浩,等.基于PI3K/Akt通路探讨补阳还五汤对急性心肌梗死大鼠内皮祖细胞凋亡的影响[J].陕西中医,2023,(7):827.[doi:DOI:10.3969/j.issn.1000-7369.2023.07.001]
　LI Qianyu,LU Jianqi,WEN Zhihao,et al.Effect of Buyang Huanwu prescription on apoptosis of endothelial progenitor cells in rats with acute myocardial infarction based on PI3K/Akt pathway[J].,2023,(3):827.[doi:DOI:10.3969/j.issn.1000-7369.2023.07.001]
[9]杨竣然,徐子文,陈 遒,等.补阳还五汤有效组分抗缺血性脑卒中研究进展[J].陕西中医,2024,(7):995.[doi:DOI:10.3969/j.issn.1000-7369.2024.07.030]
　YANG Junran,XU Ziwen,CHEN Qiu,et al.Research progress on anti-ischemic stroke of effective components of Buyang Huanwu decoction[J].,2024,(3):995.[doi:DOI:10.3969/j.issn.1000-7369.2024.07.030]
[10]张建平,王 文,屈阳柳,等.补阳还五汤通过调控miR-210减轻大鼠脑缺血再灌注损伤的实验研究[J].陕西中医,2024,(9):1176.[doi:DOI:10.3969/j.issn.1000-7369.2024.09.005]
　ZAHNG Jianping,WANG Wen,QU Yangliu,et al.Experimental study on reducing cerebral ischemia-reperfusion injury in rats by regulating miR-210 with Buyang Huanwu decoction[J].,2024,(3):1176.[doi:DOI:10.3969/j.issn.1000-7369.2024.09.005]

备注/Memo

备注/Memo:
[基金项目]河北省中医药管理局科研计划项目(2024383)
更新日期/Last Update: 2025-03-10