| 引用本文:柏江锋1，曹福建1，高思宇1，黄鑫1，张永刚1，孟凡冰2.自拟益气活络汤辨治气虚血瘀证缺血性脑卒中的临床研究[J].世界中医药,2016,(12):. |
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| 自拟益气活络汤辨治气虚血瘀证缺血性脑卒中的临床研究 |
| Clinical Research on Treating Qi Deficiency and Blood Stasis Syndrome Ischemic Stroke Patients with Self-made Qi-Replenishing and Collaterals-Activating Decoction |
| 投稿时间：2016-08-14 |
| DOI：10.3969/j.issn.1673-7202.2016.12.034 |
| 中文关键词: 缺血性脑卒中 气虚血瘀证 自拟益气活络汤 临床研究 |
| English Keywords:Ischemic stroke Qi deficiency and blood stasis syndrome Qi-Replenishing and Collaterals-Activating Decoction Clinical research |
| 基金项目:陕西省卫生厅科学研究基金资助项目(编号:2011E08) |
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| 中文摘要: |
| 目的:观察自拟益气活络汤治疗气虚血瘀证缺血性脑卒中患者的临床疗效。方法:选取2014年7月至2016年3月就诊于榆林市中医医院就诊的136例气虚血瘀证缺血性脑卒中患者随机分为对照组和观察组,每组68例。对照组患者给予阿司匹林肠溶片联合阿托伐他汀钙片治疗;观察组患者则加用自拟益气活络汤内服,2组均连续用药4周。对比2组治疗的有效率,评价中医证候积分,评定治疗前后神经功能缺损程度及日常生活能力的改善情况,监测治疗前后患者血液流变及血清因子一氧化氮(NO)、基质金属蛋白酶-9(MMP-9)、超敏C反应蛋白(Hs-CRP)水平变化。结果:观察组有效率为92.6%,显著高于对照组77.9%(χ2=5.862,P<0.05);观察组患者经治疗后的中医证候积分(4.62±1.23)分与对照组(8.77±2.04)分相比明显降低(P<0.05);观察组患者治疗后神经功能缺损NFDS评分与对照组相比显著降低,而日常活动能力Barthel指数显著升高(P<0.05);观察组患者血液流变学各指标显著低于对照组患者(P<0.05);观察组患者经治疗后NO水平显著升高,MMP-9、Hs-CRP水平则显著下降,其水平变化较对照组明显(P<0.05)。结论:自拟益气活络汤治疗气虚血瘀证缺血性脑卒中患者疗效肯定,利于改善患者的临床症状,提高患者的神经功能及日常活动能力,其机制可能与改善血液流变以增加脑血液灌注及调控NO、MMP-9、Hs-CRP等因子水平以保护神经元有一定相关性,值得临床深入研究。 |
| English Summary: |
| To investigate the clinical efficacy of treating qi deficiency and blood stasis syndrome ischemic stroke patients with Qi-Replenishing and Collaterals-Activating Decoction. Methods:A total of 136 patients were randomly divided into control group (68 cases) and observation group (68 cases). Patients in the control group were given aspirin enteric-coated tablets and atorvastatin calcium tablets; while patients in the observation group were treated with Qi-Replenishing and Collaterals-Activating Decoction. The treatment lasted for 4 weeks. Then the efficacy, syndrome integral, degree of nerve function defect and daily life ability, the changes of hemorheology, NO, MMP-9and Hs-CRP levels were observed. Results:The effective rate of patients in the observation group was 92.6%, which was higher than that of the control group’s 77.9% (χ2=5.862，P<0.05); The symptoms scores for the patients in the observation group (4.62±1.23)were lower than that of the control group(8.77±2.04)(P<0.05); The NFDS scores were lower than that of the control group, while the Barthel index was higher than that of the control group (P<0.05); The blood rheology indicators for patients in the observation were lower than that of the control group (P<0.05); The NO level for patients in the observation was higher than that of the control group, while the MMP-9 and Hs-CRP levels of the patients in the observation group was lower than that of the control group after treatment (P<0.05).Conclusion:Treating qi deficiency and blood stasis syndrome ischemic stroke patients with Qi-Replenishing and Collaterals-Activating Decoction has good effect, and it has clear effect in relieving the patients’clinical symptoms and improving the patients’nerve function and daily activity ability. The mechanism may be associated with improving the blood rheology to increase cerebral blood perfusion and regulating the NO, MMP-9and Hs-CRP levels to protect the neurons, which is worthy of further research. |
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