摘要
目的观察加减枳实大黄汤对急性缺血性脑卒中(痰热腑实证)患者的临床疗效,以及对于血同型半胱氨酸(Hcy)、血栓素B2(TXB2)和6-酮-前列腺素F1α(6-Keto-PGF1α)的影响。方法选取患者60例按照随机数字表法分为对照组与观察组各30例,对照组采用常规治疗,观察组在此基础上给予加减枳实大黄汤治疗,疗程为14 d。比较治疗前后美国国立卫生研究院脑卒中量表(NIHSS)评分及Barthel指数(BI)量表、中医证候评分量表、Hcy、TXB2、6-Keto-PGF1α水平,并评价疗效。结果治疗后,两组中医证候评分、NIHSS评分均显著降低,BI评分显著增加,且治疗后观察组优于对照组,差异具有统计学意义(P<0.05)。治疗后两组言语謇涩,痰多等中医证候评分均显著降低,但总体上观察组优于对照组,差异具有统计学意义(P<0.05)。治疗后两组血浆Hcy、TXB2水平显著降低,6-Keto-PGF1α含量显著增高,且观察组优于对照组,差异具有统计学意义(P<0.05)。疗效对比:观察组总有效率为90.00%,高于对照组总有效率为73.33%(P<0.05)。结论加减枳实大黄汤可改善急性缺血性脑卒中(痰热腑实证)患者神经缺损症状,提高自主生活能力,改善近期疗效,可能与加减枳实大黄汤降低血浆中Hcy水平,抗血小板聚集,扩张血管有关。
Objective:To observe the clinical effect of Modified Zhishi Dahuang Decoction on patients with acute ischemic stroke(phlegm heat and fu stagnation syndrome),as well as on blood homocysteine(Hcy),thromboxane B2(TXB2)and 6-keto-prostaglandin F1α(6-keto-PGF1α).Methods:60 in-patients with acute ischemic stroke(phlegm heat and fu stagnation syndrome)were selected and randomly divided into the control group and observation group,30 cases in each group.The control group was treated with routine treatment,and the observation group was treated with Modified Zhishi Dahuang Decoction on the basis of the control group.The course of treatment for both groups was 14 days.The National Institutes of Health Stroke Scale(NIHSS)score,Barthel Index(BI)scale,TCM syndrome score scale,Hcy,TXB2,6-Keto-PGF1αlevels before and after treatment were compared,and the efficacy was evaluated.Results:After treatment,the TCM syndrome score,NIHSS score and TCM scores of the two groups decreased significantly,the BI score increased significantly,and the observation group was better than the control group,the differences were statistically significant(P<0.05).After treatment,the levels of Hcy and TXB2 decreased significantly and 6-Keto-PGF1αincreased significantly,and the observation group was better than the control group,the difference was statistically significant(P<0.05).Compared with the control group,the total effective rate of the observation group was 90.00%,which was higher than 73.33%of the control group(P<0.05).Conclusion:Modified Zhishi Dahuang Decoction can improve the symptoms of nerve defect in patients with acute ischemic stroke(phlegm heat and fu stagnation syndrome),improve the ability of independent living and the short-term curative effect,which may be related to the reduction of Hcy level in plasma,anti-platelet aggregation and dilating blood vessels.
作者
吕双
张敬华
曹凤娇
盛蕾
虞鹤鸣
LüShuang;Zhang Jinghua;Cao Fengjiao;Sheng Lei;Yu Heming(The Second Affiliated Hospital of Nanjing University of Chinese Medicine,Jiangsu,Nanjing 210000,China)
出处
《中国中医急症》
2022年第5期847-850,共4页
Journal of Emergency in Traditional Chinese Medicine
基金
南京市医学科技发展资金项目(YKK19098)
南京市中医药青年人才培养计划(ZYQ20004)
江苏省现代医院管理研究基金立项课题(JSY-3-2019-029)。
关键词
急性缺血性脑卒中
加减枳实大黄汤
痰热腑实
中医证候
Acute ischemic stroke
Modified Zhishi Dahuang Decoction
Phlegm heat and fu stagnation syndrome
TCM syndromes
