摘要
目的:探讨通痹活络汤联合依达拉奉治疗急性脑梗死的临床疗效及其对血清CXC趋化因子16(CXC chemokine 16,CXCL-16)、单核细胞趋化蛋白1(monocyte chemoattractant protein-1,MCP-1)和血清生长分化因子15(growth differentiation factor 15,GDF-15)的影响。方法:将急性脑梗死患者112例按照随机数字表法分为观察组和对照组各56例。对照组予依达拉奉治疗,观察组在对照组基础上口服通痹活络汤。观察两组临床疗效及治疗前后脑梗死面积、Barthel指数、综合痉挛量表(composite spasticity scale,CSS)与运动功能评分量表(Fugl-Meyer motor function assessment,FMA)、大脑中动脉血液动力学、血液黏度及CXCL-16、MCP-1、GDF-15水平。结果:总有效率观察组为87.50%,优于对照组的69.64%(χ^(2)=4.296,P<0.05)。治疗后两组患者脑梗死面积、CSS评分、阻力指数(resistance index,RI)、脉动指数(pulsatility index,PI)及全血高、低切黏度与血浆黏度、红细胞压积、CXCL-16、MCP-1、GDF-15水平较治疗前降低(P<0.01),Barthel指数、FMA评分、平均血流速度(mean flow velocity,Vm)较治疗前升高(P<0.01),观察组较对照组变化更明显(P<0.01)。结论:通痹活络汤联合依达拉奉治疗急性脑梗死疗效确切,通过降低机体血液黏度改善脑部血液循环,提高患者生活质量,其机制可能与降低机体CXCL-16、MCP-1和GDF-15水平有关。
Objective:To discuss curative effects of Tongbi Huoluo decoction combined with edaravone in treating acute cerebral infarction(ACI),and its impacts on the levels of CXC chemokine 16(CXCL-16),monocyte chemoattractant protein-1(MCP-1)and growth differentiation factor 15(GDF-15).Methods:All 112 ACI patients were divided into the observation group and the control group according to random number table method,with 56 cases in each group.The control group was treated with edaravone,and the observation group was given Tongbi Huoluo decoction on the basis of edaravone.To observe clinical effects of the two groups,cerebral infarction area,Barthel index,CSS and FMA scores,middle cerebral artery hemodynamics,the levels of blood viscosity,CXCL-16,MCP-1 and GDF-15 before and after treatment.Results:Total effective rate of the observation group was 87.50%,higher than 69.64%of the control group(χ^(2)=4.296,P<0.05).After treatment,cerebral infarction area,CSS scores,RI,PI,whole blood high and low shear viscosity,plasma viscosity,hemotocrit,the levels of CXCL-16,MCP-1 and GDF-15 of the two groups lowered compared with before treatment(P<0.01).BI,FMA scores and Vm increased(P<0.01),the changes of the observation group were more notable than these of the control group(P<0.01).Conclusion:Tongbi Huoluo decoction combined with edaravone could obtain definite clinical effects in treating ACI by lowering blood viscosity of the body,improving cerebral blood circulation and lifting quality of life,and its mechanism might be related to lowering the levels of CXCL-16,MCP-1 and GDF-15.
作者
赵琴
ZHAO Qin(Pharmacy Department,Shanghai City Fengxian District TCM Hospital,Shanghai 201400,China)
出处
《西部中医药》
2022年第1期16-20,共5页
Western Journal of Traditional Chinese Medicine
基金
奉贤区科委基金项目(20170902)。
关键词
急性脑梗死
炎症反应
血液黏度
通痹活络汤
依达拉奉
临床观察
acute cerebral infarction
inflammatory reaction
blood viscosity
Tongbi Huoluo decoction
edaravone
clinical observation
