[1]赵月臣,马 兰.痰瘀阻络方联合丁苯酞治疗脑梗死急性期疗效及对患者脑血流灌注及血清6-k-PGF1a、Hcy、sICAM-1水平影响*[J].陕西中医,2020,(2):174-179.
 ZHAO Yuechen,MA Lan..Effect of phlegm stasis blocking collateral combined with butylphthalide on cerebral blood flow perfusion and serum 6-k-PGFla,Hcy and sICAM-1 level in patients with acute cerebral infarction[J].,2020,(2):174-179.
点击复制

痰瘀阻络方联合丁苯酞治疗脑梗死急性期疗效及对患者脑血流灌注及血清6-k-PGF1a、Hcy、sICAM-1水平影响*
分享到:

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2020年2期
页码:
174-179
栏目:
临床研究
出版日期:
2020-02-05

文章信息/Info

Title:
Effect of phlegm stasis blocking collateral combined with butylphthalide on cerebral blood flow perfusion and serum 6-k-PGFla,Hcy and sICAM-1 level in patients with acute cerebral infarction
文章编号:
DOI:〖HT5K〗10.3969/j.issn.10007369.2020.02.010
作者:
赵月臣1马 兰2
1.辽宁省朝阳市第二医院神经内科(朝阳 122000); 2.辽宁省中医院神经内科(沈阳 112099)
Author(s):
ZHAO YuechenMA Lan.
Department of Neurology,Chaoyang Second Hospital(Chaoyang 122000)
关键词:
脑梗死 急性期 痰瘀阻络方 丁苯酞 脑血流灌注 6-酮-前列腺素F1α 同型半胱氨酸 细胞间黏附因子
Keywords:
Cerebral infarction Acute phase Phlegm stasis blocking collateral Butylphthalide Cerebral blood flow perfusion 6-k-PGF1a Hcy sICAM-1
分类号:
R743.3
文献标志码:
A
摘要:
目的:研究痰瘀阻络方联合丁苯酞治疗脑梗死急性期患者对脑血流灌注及血清6-醛前列环素F1a(6-k-pGF1a)、同型半胱氨酸(HCY)、可溶性细胞间黏附分子(sICAM-1)水平影响。方法:选择脑梗死急性期患者92例,随机分为观察组和对照组各46例。入组患者均给予常规治疗,对照组同时口服丁苯酞,观察组在对照组基础上给予痰瘀阻络方,两组均治疗28 d。观察治疗后临床疗效,对比治疗前后脑血流动力指标(双侧脑动脉峰流速及平均流速)、血流灌注指数(PI)、脑血管储备能力(CVR),统计血清6-k-PGF1a、Hcy、sICAM-1水平,记录美国国立卫生研究院卒中量表(NIHSS)、改良Rankin量表、Barthel指数评分量表评分情况,统计药物不良反应发生情况。结果:观察组治疗后临床总有效率为89.13%,高于对照组71.74%(P<0.05)。观察组治疗后PI、CVR、双侧动脉各流速改善情况均优于对照组(P<0.05); 观察组治疗后血清6-k-pGF1a、HCY、sICAM-1水平改善情况均优于对照组(P<0.05); 观察组治疗后NIHSS量表、改良Rankin量表、Barthel指数评分改善情况均优于对照组(P<0.05); 两组患者治疗期间其他检查结果均正常,轻微不良反应发生率相当(P>0.05)。结论:痰瘀阻络方联合丁苯酞对脑梗死急性期治疗效果较好,其能明显改善患者脑血流灌注情况,同时对血清6-k-PGF1a、Hcy、sICAM-1指标具有较好改善作用,有助于患者神经功能的提高。
Abstract:
Objective:To study the effect of phlegm stasis blocking collateral combined with butylphthalide on cerebral blood flow perfusion and serum 6-k-PGFla,Hcy and sICAM-1 level in patients with acute cerebral infraction.Methods:Selected 92 patients with acute cerebral infarction,and divided them into the observation group(46 patients)and the control group(46 patients).All patients received routine treatment,meanwhile,the control group received butylphthalide,and the observation group received phlegm stasis blocking collateral besides butylphthalide,which lasted 28 days for both groups.Observed the clinical curative effect after treatment,compared the blood flow dynamic index(bilateral cerebral artery peak flow rate and mean flow rate),PI and CVR,made statistics on the levels of 6-k-PGF1a,Hcy and slCAM-1,recorded the scores of NIHSS,modified Rankin scale,Barthel scale,and collected the occurrence of adverse drug reactions.Results:The total effective rate in the observation group after treatment ws 89.13%,which was higher than that in the control group(71.74%,P<0.05).After treatment,PI,CVR and velocity of bilateral arteries in the observation group were better than those in the control group(P<0.05); the levels of 6-k-pGF1a,HCY and sICAM-1 in the observation group were better than those in the control group(P<0.05); the scores of NIHSS,modified Rankin and Barthel in the observation group were better than those in the control group(P<0.05); the other examination results were normal during the treatment period and the incidence of minor adverse reactions was comparable(P>0.05).Conclusions:Phlegm stasis blocking collateral combined with butylphthalide is effective in the treatment of acute cerebral infarction.It can significantly improve the cerebral blood flow perfusion of patients with cerebral infarction,meanwhile,it can improve the indexes of 6-k-PGF1a,Hcy,sICAM-1,and can help to improve the neurological function of patients.

参考文献/References:

[1] 周志梅,买 雷,李艳红.消栓肠溶胶囊治疗脑梗死疗效及对患者NIHSS评分的影响[J].陕西中医,2019,40(6):696-699.
[2] 贺龙梅,王 禺,王 凌,等.血清同型半胱氨酸、血浆纤维蛋白原与尿微量白蛋白联合检测预测脑梗死风险评估临床研究[J].陕西医学杂志,2019,48(7):903-905.
[3] 陈克尚.丁苯酞治疗对脑梗死患者血清炎性因子和S-100A12水平的影响[J].中国地方病防治杂志,2017,32(8):955-956.
[4] 王子亮.补阳还五汤联合尼麦角林对脑梗死病人血清氧自由基和颅内血流的影响[J].中西医结合心脑血管病杂志,2018,16(11):1605-1607.
[5] 肖 波,刘 鸣.中国脑血管病大会2014会议纪要[J].中华神经科杂志,2015,48(8):732-733.
[6] 国家中医药管理局脑病急症协作组.中风病诊断与疗效评定标准[J].北京中医药大学学报,1996,19(1):55.
[7] Alexandrov AV,Hall CE,Labiche LA,et al.Ischemic stunning of the brain early recanalization without immediate clinical improvement in acute ischemic stroke[J].Stroke; a Journal of Cerebral Circulation,2004,35(2):449-452.
[8] Muir KW,Weir CJ,Murray GD,et al.Comparison of neurological scales and scoring systems for acute stroke prognosis[J].Stroke,1996,27(10):1817-1820.
[9] 闵 瑜,吴媛媛,燕铁斌.改良Barthel指数(简体中文版)量表评定脑卒中患者日常生活活动能力的效度和信度研究[J].中华物理医学与康复杂志,2008,30(3):185-188.
[10] 徐 珺,周 洁.通窍活血汤合星香散化裁联合“通督开窍”针法治疗痰瘀互结证脑梗死后吞咽障碍患者的临床疗效[J].实用心脑肺血管病杂志,2019,27(4):64-68.
[11] 杨中林,朱 谧,顾 萱.天南星各种炮制品的药效学初步研究[J].中国药科大学学报,1998,29(5):22-24.
[12] 曹瑞珍,白 靓,张国文,等.蒙药德都红花-7味散各组方的化学成分和现代药理作用研究进展[J].内蒙古民族大学学报:自然科学版,2018,33(1):79-84.
[13] 冀兰鑫,黄 浩,李长志,等.赤芍药理作用的研究进展[J].药物评价研究,2010,33(3):233-236.
[14] 张雪琴,赵庭梅,刘 静,等.石斛化学成分及药理作用研究进展[J].中草药,2018,49(13):3174-3182.
[15] 张成宸,石京山.天麻的酚类成分及其中枢神经药理作用研究进展[J].中药药理与临床,2019,35(2):167-174.
[16] 罗仁书,何治勇.川芎有效成分药理作用的研究进展[J].中国医院用药评价与分析,2018,18(9):1294-1296.
[17] 高晓宇,丁 茹,王道平,等.钩藤化学成分及药理作用研究进展[J].天津医科大学学报,2017,23(4):380-382.
[18] 黄敬文,高宏伟,段剑飞.地龙的化学成分和药理作用研究进展[J].中医药导报,2018,24(12):104-107.

相似文献/References:

[1]郭 辉,裴 育,熊伟华,等.血府逐瘀汤联合阿替普酶静脉溶栓对急性脑梗死患者 神经功能及日常生活能力的影响*[J].陕西中医,2019,(2):214.
 GUO Hui,PEI Yu,XIONG Weihua,et al.Effect of Xuefu Zhuyu decoction combined with intravenous thrombolysis on the neurological function and activities of daily living in patients with acute cerebral infarction[J].,2019,(2):214.
[2]陈 晨.补阳还五汤对急性脑梗死患者血管内皮生长因子、血管生成素2及神经功能影响的研究*[J].陕西中医,2019,(1):28.
[3]王艳民.开窍活血汤对脑梗死患者血清前白蛋白、MCP1及MMP9的影响*[J].陕西中医,2019,(1):34.
[4]贾东佩,李春雷△.调神通络针刺法对脑梗死后血管性痴呆患者血清BDNF、VEGF、MMP9的影响*[J].陕西中医,2019,(1):119.
 JIA Dongpei,LI Chunlei..Effect of Tiaoshen Tongluo acupuncture in patients with vascular dementia after cerebral infarction and its effects on serum BDNF, VEGF and MMP9[J].,2019,(2):119.
[5]周志梅,买 雷,李艳红.消栓肠溶胶囊治疗脑梗死疗效及对患者NIHSS评分的影响*[J].陕西中医,2019,(6):696.
 ZHOU Zhimei,MAI Lei,LI Yanhong..Effect of Xiaoshuan enteric-coated capsule on patients with cerebral infarction and its influence on NIHSS score of patients[J].,2019,(2):696.
[6]项广宇.化痰通络方治疗短暂性脑缺血发作后脑梗死疗效及对患者氧化应激和血清相关细胞因子水平的影响*[J].陕西中医,2019,(7):864.
[7]陈 静,陈 炜,伍 媛,等.小续命汤及其组分治疗急性脑梗死研究进展*[J].陕西中医,2019,(12):1818.
[8]张 蕾.血府逐瘀汤联合糖皮质激素治疗急性期气滞血瘀证糜烂型口腔扁平苔藓疗效及作用机制分析[J].陕西中医,2020,(3):346.
 ZHANG Lei..Therapeutic effect and mechanism of Xuefu Zhuyu decoction combined with glucocorticoid on erosive oral lichen planus in Qizhi Xueyu type syndrome[J].,2020,(2):346.
[9]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,(2):815.[doi:DOI:10.3969/j.issn.10007369.2020.06.033]
[10]韩 慧,赖智勇,蒲建萍,等.头穴丛刺法联合川芎嗪对大鼠脑梗死后神经元突触重建的影响*[J].陕西中医,2020,(7):860.[doi:DOI:10.3969/j.issn.10007369.2020.07.006]
 HAN Hui,LAI Zhiyong,PU Jianping,et al.Effect of scalp acupuncture combined with ligustrazine on synaptic reconstruction of neurons after cerebral infarction in rats[J].,2020,(2):860.[doi:DOI:10.3969/j.issn.10007369.2020.07.006]
[11]常 红,陈 颖,邢惠娟,等.活血化瘀汤对脑梗死急性期患者颅内血流动力学及血清神经递质的影响[J].陕西中医,2021,(2):156.[doi:DOI:10.3969/j.issn.1000-7369.2020.02.005]
 CHANG Hong,CHEN Ying,XING Huijuan,et al.Effect of Huoxue Huayu decoction on intracranial hemodynamics and serum neurotransmitters in acute cerebral infarction[J].,2021,(2):156.[doi:DOI:10.3969/j.issn.1000-7369.2020.02.005]
[12]邢惠娟,黄乾坤,马效麟,等.黄角汤治疗脑梗死急性期临床研究[J].陕西中医,2021,(11):1536.[doi:DOI:10.3969/j.issn.1000-7369.2020.11.009]
 XING Huijuan,HUANG Qiankun,MA Xiaolin,et al.Clinical study on Huangjiao decoction in the treatment of acute cerebral infarction[J].,2021,(2):1536.[doi:DOI:10.3969/j.issn.1000-7369.2020.11.009]

备注/Memo

备注/Memo:
*辽宁省科学技术计划项目(2016021075)
更新日期/Last Update: 2020-03-31