摘要
目的:探讨搜剔祛风、化瘀通络论治中风后遗症对神经功能恢复的疗效及对血液流变性的影响。方法:86例缺血性中风后遗症患者随机按入院前后分为对照组和观察组各43例。两组均按常规康复治疗,包括肢体康复锻炼、局部按摩、针灸等。对照组服用脑心通胶囊,4粒/次,3次/d。观察组以搜剔祛风、化瘀通络法进行辨证论治。汤药1剂/d。两组疗程均为12周。进行治疗前后神经功能缺损程度(NDS)评分,采用肌痉挛评定(Ashworth)评分法评价治疗前后痉挛程度,采用巴塞尔指数(Barthel)记分评价治疗前后患者日常生活能力,进行治疗前后血液流变学、血脂四项和血栓素(TXB2)和6-酮-前列腺素F_(1a)(6-Keto-PGF_1a)水平检测。结果:观察组疾病疗效总有效率为88.37%优于对照组的69.77%(P<0.05);治疗后观察组NDS和Ashworth评分低于对照组,Barthel指数评分高于对照组(P<0.01);治疗后两组TXB2水平下降,观察组TXB2低于对照组(P<0.01);治疗后两组6-Keto-PGF_1a水平上升,观察组6-Keto-PGF_1a高于对照组(P<0.01);治疗后观察组全血黏度(低切、高切)、红细胞聚集指数、血小板聚集率、血浆黏度、纤维蛋白原及全血还原黏度(低切、高切)的改善优于对照组(P<0.01);治疗后观察组甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)水平低于对照组(P<0.01)。结论:搜剔祛风、化瘀通络论治中风后遗症能促进神经缺损功能的恢复,缓解肌张力痉挛程度,提高患者活动能力和生活自理能力,其作用机制可能改善患者血液高凝状态,促进脑部的血液供应,改善脑循环有关。
Objective ： Discuss curative effect of Souti Qufeng and Huayu Tongluo theories on recovery of neurological function in treating sequela of apoplexy and influence to blood rheology. Method： Eighty-six cases with sequela of ischemic apoplexy were randomly divided into control group （43 cases） and observation group （43 cases） according to the order of admission. Both groups＇ patients received conventional rehabilitation including rehabilitation exercise of limbs, local massage and acupuncture and moxibustion. Patients in control group received Naoxin Tong capsules, taken orally, 4 grains/time, 3 times/day. Patients in observation group received dialectical theory of governance by Souti Qufeng and Huayu Tongluo methods and received decoction, 1 dose/day. Course of treatment in two groups were 12 weeks. Nerve deficiency scale （NDS） was graded before and after treatment, degree of blepharospasm was evaluated by Ashworth scale method before and after treatment, patients＇ daily life ability was evaluated by Barthel index score before and after treatment and blood rheology, blood rheology and the level of thromboxane （ TXB2 ） and 6-Ketone prostaglandin F- （ 1 a） were detected. Result： The total effective rate of disease curative effect in the observation group was 88.37% superior to 69. 77% in the controlgroup （ P 〈 0.05 ）. After treatment, the scores of NDS and Ashworth in the observation group were lower than the control group and Barthel index score was higher than the control group （ P 〈 0. 01 ）. Both groups＇ levels of TXB2 decreased and the level of TXB2 in the observation group was lower than he control group （P 〈 0.0! ）. Both groups＇ levels of 6-Keto-PGF_ la increased and the level of 6-Keto-PGF_ la in the observation group was higher than he control group （P 〈 0. 01 ）. The amelioration of whole blood viscosity （low or high shearing）, erythro- agglutation index, platelet aggregation rate, plasma viscosity, fibrinogen and whole blood reduced viscosity （low or high shearing） in the observation group were superior to the control group （P 〈 0. 01 ）. The levels of triglyceride （TG）, total cholesterol （TC） and low density lipoprotein cholesterol （LDL-C） in the observation group were lower than the control group （P 〈 0. 01 ）. Conclusion ： Souti Qufeng and Huayu Tongluo theories can promote nerve deficiency function to recover in treating sequela of apoplexy, relief degree of blepharospasm of muscle tension and improve patients＇ activity ofand ability of daily life, and the mechanism of action may related to promoting blood supply in brain and ameliorating cerebral circulation.
出处
《中国实验方剂学杂志》
CAS
北大核心
2014年第12期217-221,共5页
Chinese Journal of Experimental Traditional Medical Formulae
基金
国家教育部博士点新青年教师基金项目(200804871112)
