| 引用本文:崔春丽，李文磊，骆守真.天麻钩藤饮辅助治疗痰瘀阻络型急性脑梗死及对血管内皮功能、Hcy、D-二聚体和hs-CRP水平影响的临床研究[J].世界中医药,2019,(04):. |
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| 天麻钩藤饮辅助治疗痰瘀阻络型急性脑梗死及对血管内皮功能、Hcy、D-二聚体和hs-CRP水平影响的临床研究 |
| Clinical Efficacy of Tianma Gouteng Decoction as Auxiliary Treatment in Treating Acute Cerebral Infarction with TCM Pattern of Phlegm and Stasis Blocking Collaterals and the Study of Changes of Patient's Vascular Endothelial Function，Hcy，D-dimer and hs-CRP Levels |
| 投稿时间：2018-07-06 |
| DOI：10.3969/j.issn.1673-7202.2019.04.022 |
| 中文关键词: 天麻钩藤饮 痰瘀阻络型 急性脑梗死 疗效 血管内皮功能 同型半胱氨酸 D-二聚体 超敏C-反应蛋白 |
| English Keywords:Tianma Gouteng Decoction Phlegm and stasis blocking collaterals Acute cerebral infarction Therapeutic effect Vascular endothelial function Homocysteine D-dimer Hypersensitivity C-reactive protein |
| 基金项目:国家自然科学基金项目（81100907） |
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| 中文摘要: |
| 目的：观察天麻钩藤饮辅助治疗痰瘀阻络型急性脑梗死患者的临床疗效，及对患者血管内皮功能、同型半胱氨酸（Hcy）、D-二聚体和超敏C-反应蛋白（hs-CRP）水平的影响。方法：选取2016年3月至2018年3月江苏省中医院收治的急性脑梗死患者102例作为研究对象，按照随机数字表法随机分为对照组和观察组，每组51例。对照组采用常规西医治疗，观察组在对照组基础上结合天麻钩藤饮治疗。2组疗程均为14 d。比较2组治疗疗效，以及治疗前后NIHSS评分、Balthel指数评分、血管内皮功能、Hcy、D-二聚体和hs-CRP水平的变化。结果：观察组治疗总有效率（92.16%）高于对照组（70.59%），差异有统计学意义（P<0.05）。2组治疗后NIHSS评分较治疗前降低（P<0.05），而Balthel指数评分较治疗前增加（对照组：t＝13.427、17.445，观察组：t＝22.986、22.959，P<0.05）；观察组治疗后NIHSS评分低于对照组，而Balthel指数评分高于对照组（t＝17.375、12.702，P<0.05）。2组治疗后ET-1水平较治疗前降低，而NO水平较治疗前增加（对照组：t＝11.236、7.209，观察组：t＝16.042、19.336，P<0.05）；观察组治疗后ET-1水平低于对照组，而NO水平高于对照组（t＝8.159、7.801，P<0.05）。2组治疗后血清Hcy、D-二聚体和hs-CRP水平较治疗前降低（对照组：t＝10.854、8.630、12.002，观察组：t＝24.812、20.559、18.890，P<0.05）；观察组治疗后血清Hcy、D-二聚体和hs-CRP水平低于对照组（t＝10.642、12.775、10.884，P<0.05）。结论：天麻钩藤饮辅助治疗痰瘀阻络型急性脑梗死患者临床疗效显著，可改善患者血管内皮功能，降低Hcy、D-二聚体和hs-CRP水平，值得临床借鉴。 |
| English Summary: |
| To investigate the clinical efficacy of Tianma Gouteng Decoction as auxiliary treatment in the treatment of acute cerebral infarction with TCM pattern of phlegm and stasis blocking collaterals，and to study the changes in patient's vascular endothelial function，levels of homocysteine(Hcy)，D-dimer and hypersensitivity C-reactive protein(hs-CRP).Methods:A total of 102 patients with acute cerebral infarction treated in Jiangsu Province Hospital of Chinese Medicine from March 2016 to March 2018 were selected.According to the random number table method，the patients were divided into two groups，with 51 cases in the control group and 51 cases in the treatment group.The control group was treated with conventional western medicine，while the treatment group was treated with Tianma Gouteng Decoction on top of the treatment performed in the control group.The treatment course of both groups were 14 d.The therapeutic effect，NIHSS score，Balthel index，endothelial function，Hcy，D-dimer and hs-CRP levels before and after treatment were compared between the 2 groups.Results:The total effective rate of the treatment group(92.16%）was higher than that of the control group(70.59%)，and the difference was statistically significant(P<0.05).After the treatment，in both groups，the score of NIHSS was lower than that before the treatment，and the score of Balthel index was increased compared with that before the treatment(the control group：t=13.427，17.445，the treatment group：t=22.986，22.959，P<0.05); and after the treatment，the NIHSS score in the treatment group was lower than that of the control group，while its Balthel index score was higher than that of the control group(t=17.375，12.702，P<0.05).The levels of ET-1 in the 2 groups were lower than that before the treatment，and the levels of NO were increased compared with that before treatment(control group：t=11.236，7.209，treatment group：t=16.042，19.336，P<0.05); and after the treatment，the level of ET-1 in the treatment group was lower than that of the control group，while the NO level was higher than that of the control group(t=8.159，7.801，P<0.05).After the treatment，the levels of serum Hcy，D-dimer and hs-CRP were lower in the 2 groups than before the treatment(control group：t=10.854，8.630，12.002，treatment group：t=24.812，20.559，18.890，P<0.05); after the treatment，the serum Hcy，D-dimer and hs-CRP levels were lower in the treatment group than in the control group(t=10.642，12.775，10.884，P<0.05).Conclusion:The clinical efficacy of Tianma Gouteng Decoction as auxiliary treatment in the treatment of acute cerebral infarction with TCM pattern of phlegm and stasis obstructing collaterals is significant.It can improve patient's vascular endothelial function and reduce the levels of Hcy，D-dimer and hs-CRP，which is worthy of clinical reference. |
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