| 引用本文:张明明1，班文明2，童伟伟2.补气通滞方联合丁苯酞对气虚血瘀型短暂性脑缺血发作患者的疗效及机制[J].世界中医药,2019,(11):. |
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| 补气通滞方联合丁苯酞对气虚血瘀型短暂性脑缺血发作患者的疗效及机制 |
| Effects and Mechanism of Buqi Tongzhi Decoction Combined with Butylphthalide on Transient Ischemic Attack with Qi Deficiency and Blood Stasis Syndrome |
| 投稿时间：2019-08-09 |
| DOI：10.3969/j.issn.1673-7202.2019.11.043 |
| 中文关键词: 短暂性脑缺血发作 补气通滞方 丁苯酞 炎性反应 机制 |
| English Keywords:Transient ischemic attack Buqi Tongzhi Decoction Butylphthalide Inflammation Mechanism |
| 基金项目:安徽省卫计委2014年度中医药科技计划项目(2014N013) |
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| 中文摘要: |
| 目的：探讨补气通滞方联合丁苯酞对气虚血瘀型短暂性脑缺血发作（TIA）患者的疗效。方法：选取2016年7月至2017年11月安徽中医药大学附属太和中医院收治的气虚血瘀型TIA患者156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78例。2组接受常规对症治疗，对照组在常规治疗基础上给予丁苯酞，观察组在对照组的基础上加用补气通滞方。2组均以14 d为1个治疗周期，连续治疗3个周期后进行临床疗效观察，并定期随访6个月。比较2组临床疗效，检测并比较2组患者治疗前后血清炎性反应递质、血液流变学指标及血流动力学指标变化，随访期间比较2组患者预后。结果：治疗后观察组治疗有效率（73.08%）高于对照组治疗有效率（56.41%），差异有统计学意义（P<0.05）。2组治疗后血清C反应蛋白及纤维蛋白原水平较治疗前显著降低，且观察组低于对照组，差异有统计学意义（P<0.05）。与治疗前比较，2组治疗后纤维蛋白原水平、低切全血黏度及高切全血黏度降低，且观察组低于对照组，差异有统计学意义（P<0.05）。2组治疗后平均血流速度（Vmean）、平均血流量（Qmean）均较治疗前显著上升，脑血管阻力（R）较治疗前显著下降，且2组间差异有统计学意义（P<0.05）。随访期间观察组复发率、脑梗死发生率显著低于对照组，差异有统计学意义（P<0.05），但2组死亡率差异无统计学意义（P>0.05）。结论：补气通滞方联合丁苯酞治疗气虚血瘀型TIA疗效显著，可降低机体炎性反应和血液黏度，改善脑部血液流速，且临床复发率、脑梗死发生率较低。 |
| English Summary: |
| To explore the effects and mechanism of Buqi Tongzhi Decoction combined with butylphthalide on transient ischemic attack(TIA)with qi deficiency and blood stasis syndrome.Methods:A total of 156 cases of TIA patients with qi deficiency and blood stasis type in Taihe Hospital Affiliated to Anhui University of Chinese Medicine from July 2016 to November 2017 were selected and randomly divided into an observation group and a control group，with 78 cases in each group.The 2 groups received routine symptomatic treatment，while the control group was given butylphthalide on the basis of conventional treatment.The observation group was additionally given Buqi Tongzhi Decoction on the basis of the control group.The 2 groups were treated with 14 d for 1 cycle，and the clinical efficacy was observed after 3 cycles of treatment.The patients in the 2 groups were followed-up regularly for 6 months.The clinical efficacy of the 2 groups was compared，and the changes of serum inflammatory factors，hemorheology indexes and hemodynamic indexes of the 2 groups were compared before and after treatment.The prognosis of patients in 2 groups was compared during the follow-up period.Results:After treatment，the total effective rate of the observation group(73.08%)was higher than that of the control group(56.41%)(P<0.05).After treatment，the levels of CRP and PCT in serum of the 2 groups were significantly lower than those before treatment(P<0.01)，and the level of CRP and PCT in the observation group was lower than that in the control group(P<0.01).Compared with before treatment，the fibrinogen level，low shear whole blood viscosity and high shear whole blood viscosity of the 2 groups decreased after treatment(P<0.01)，and that of the observation group was lower than that of the control group(P<0.01).After treatment，Vmean and Qmean increased significantly，R decreased significantly(P<0.01)，and there was a significant difference between the 2 groups(P<0.01).During the follow-up period，the recurrence rate and the incidence of cerebral infarction in the observation group were significantly lower than those in the control group(P<0.05)，but there was no significant difference in mortality between the 2 groups(P > 0.05).Conclusion:The combination of Buqi Tongzhi Decoction combined with butylphthalide is effective in the treatment of TIA with qi deficiency and blood stasis syndrome.It can reduce the inflammatory degree and blood viscosity of the body，improve the blood flow velocity of the brain，and the rate of clinical recurrence and cerebral infarction is lower.It is worthy of clinical popularization. |
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