黄芪桂枝五物汤辅助治疗对脑梗死恢复期患者的影响

目的:观察黄芪桂枝五物汤辅助治疗对脑梗死恢复期患者神经功能及脑血流动力学的影响。方法:选取2014年4月至2017年3月在大庆油田脑血管医院神经内科收治的脑梗死恢复期气虚血瘀证患者100例,采用随机数字表法随机分为观察组和对照组,每组50例,对照组采用常规脑梗死恢复期治疗,包括脑细胞营养药物和常规康复训练;观察组在对照组基础上,予以黄芪桂枝五物汤辅助治疗。早晚各温服1次,5 d为1个疗程,治疗3个疗程。所有患者治疗前后测定神经功缺损程度评分(CNDS评分)和NIHSS评分(美国国立卫生研究院卒中量表),评估患者的神经功能改变情况。采用Fugl-Meyer量表评定患者治疗前后的运动功能情况;采用MBI量表评定患者治疗前后日常生活能力情况;同时采用智能经颅多普勒超声分析仪记录患者脑血流动力学改变。结果:1)治疗后2组CNDS和NIHSS均较治疗前降低(P0.05),且观察组的下降程度较对照组更低(P0.05)。2)治疗后2组Fugl-Meyer和MBI均较治疗前升高(P0.05),且观察组的升高程度较对照组更高(P0.05)。3)治疗后随着Vm明显较治疗前增加(P0.05),PI和RI则较治疗前减少(P0.05),且观察组优于对照组(P0.05)。4)CNDS与Vm呈正相关,与PI、RI呈负相关。结论:黄芪桂枝五物汤辅助治疗能有效脑梗死恢复期患者神经功能、运动功能和日常生活能力,同时在脑血流动力学中提升评价血流量Vm,降低阻力指数和搏动指数。

The Effect of Huangqiguizhiwuwu Decoction in the Treatment of Cerebral Infarction and Neurological Function Patients

To observe the effect of Huangqiguizhiwuwu Decoction in the treatment of patients with cerebral infarction at recovery stage.Methods:From April 2014-May 2017,in 100 cases of stroke patients in our hospital department of ENT in our hospital,by selecting were randomly divided into observation group and control group,50 cases in each group,the control group with routine treatment including cerebral infarction,brain cells nutrition drugs and routine rehabilitation training; the observation group in the control group based on the given Huangqiguizhiwuwu Decoction in adjuvant therapy.1 time each day,5 days for 1 courses,3 courses of treatment.Neurologic impairment score(CNDS score)and NIHSS score(US National Institutes of Health Stroke Scale)were measured before and after treatment to evaluate the changes of neurological function.Using Fugl-Meyer scale to evaluate the motor function of patients before and after treatment; using MBI scale evaluation of the ability of daily life of patients before and after treatment; at the same time using intelligent transcranial Doppler ultrasound records of patients with cerebral hemodynamics analyzer.Results:1)After treatment,the CNDS and NIHSS in the two groups were lower than those before treatment(P<0.05),and the decline of the observation group was lower than that of the control group(P<0.05).2)After treatment,the Fugl-Meyer and MBI in the two groups were higher than those before treatment(P<0.05),and the observation group was higher than the control group(P<0.05).3)With the increase of Vm(P<0.05)before treatment,PI and RI were significantly lower than those before treatment(P<0.05),and the observation group was better than the control group(P<0.05).4)CNDS was positively correlated with Vm and negatively correlated with PI and RI.Conclusion:Huangqiguizhiwuwu Decoction in adjuvant therapy can effectively convalescence cerebral infarction neurological function,motor function and ability of daily life,and improve the evaluation of blood flow Vm in cerebral hemodynamics,reduce the resistance index and pulsatility index.