和血生络方联合早期康复训练对缺血性脑卒中偏瘫患者肢体功能的影响及机制探讨

目的:研究和血生络方联合早期康复训练对缺血性脑卒中偏瘫患者肢体功能的影响。方法:选取缺血性脑卒中偏瘫患者98例,采用随机数字表法将所有患者分为对照组(49例)及治疗组(49例)。2组均给予早期康复训练及其相应常规治疗,治疗组增加和血生络方口服,2组患者均连续治疗6周。所有患者均在治疗前及治疗后,采用酶联免疫吸附试验法(ELISA)测定外周血血管内皮生长因子(VEGF)、脑源性神经营养因子(BDNF)、基质细胞衍生因子-1α(SDF-1α)的含量,采用流式细胞仪测定外周血骨髓内皮祖细胞(EPCs)相对数量。应用Fugl-Meyer运动功能量表(FMA)、Berg平衡量表(BBS)和改良的Barthel指数(MBI)分别评估2组患者的运动功能和日常生活活动能力,并记录不良反应及再次脑卒中发病情况。结果:与治疗前比较,2组治疗后的FMA、BBS、MBI评分均出现显著升高;治疗后各时间点比较,治疗组均优于对照组(P<0.05),2组安全性评价差异无显著性(P>0.05)。治疗后,2组VEGF、BDNF、SDF-1α、EPCs水平均出现显著升高,且治疗组高于对照组(P<0.05)。结论:和血生络方联合早期康复训练能够显著改善缺血性脑卒中偏瘫患者肢体运动功能,明显提高其生活质量并具有良好的安全性,其机制可能与和血生络方联合早期康复训练能够促进外周血VEGF、BDNF、SDF-1α、EPCs表达有关。

Effect of Hexue Shengluo Formula Combined with Early Rehabilitation Training on Limb Function of Hemiplegic Patients with Ischemic Stroke and Its Mechanism

Objective:To study the effect of Hexue Shengluo Formula combined with early rehabilitation training on limb function of hemiplegic patients with ischemic stroke.Methods:98 patients with hemiplegia after ischemic stroke were divided into control group(49 cases)and treatment group(49 cases).The two groups were given early rehabilitation training and the corresponding routine treatment,while the treatment group took Hexue Shengluo Formula orally;the two groups were treated for 6 weeks.Before and after treatment,the levels of VEGF,BDNF and SDF-1αwere measured by enzyme-linked immunosorbent assay(ELISA),and the relative numbers of EPCs were determined by flow cytometry.Fugl Meyer motor function scale(FMA),Berg Balance Scale(BBS)and modified Barthel Index(MBI)were used to evaluate the motor function and activities of daily life of the two groups respectively,and adverse reactions and the incidence of recurrent stroke were recorded.Results:The scores of FMA,BBS and MBI in the two groups increased significantly after treatment;compared with each time point after treatment,the scores in the treatment group were better than those in the control group(P<0.05),and there was no significant difference in the safety evaluation between the two groups(P>0.05).After treatment,the levels of VEGF,BDNF,SDF-1αand EPCs in the two groups were significantly higher than those in the control group(P<0.05).Conclusion:Hexue Shengluo Formula combined with early rehabilitation training can significantly improve the limb motor function of hemiplegic patients with ischemic stroke;significantly improve their quality of life with better safety.The mechanism may be related to the fact that Hexue Shengluo Formula combined with early rehabilitation training can promote the expression of VEGF,BDNF,SDF-1αand EPCs in peripheral blood.