补阳还五汤对气虚血瘀型脑梗死患者脑血管储备功能的影响

目的:采用经颅多普勒(TCD)结合屏气试验评价补阳还五汤对气虚血瘀型脑梗死患者脑血管储备功能的影响,并观察两组临床疗效和神经功能缺损评分。方法:将150例气虚血瘀型脑梗死患者随机分为2组,治疗组78例;对照组72例。两组均给予西医规范治疗,口服阿司匹林肠溶片,100 mg/次,1次/d,或口服硫酸氢氯吡格雷片,75 mg/次,1次/d;根据病情给予脱水降颅压,脑细胞保护药物,他汀类降脂治疗,调控血压、血糖及康复治疗。对照组在西医规范治疗基础上加三七通舒胶囊,0.2 g/次,3次/d。治疗组在西医规范治疗的基础上加用补阳还五汤,180 m L/次,2次/d。通过TCD结合屏气试验测定治疗前后脑血管储备功能(CVR),屏气指数(BMI)和平均血流速度(V_m)上升率。并观察两组临床疗效和神经功能缺损(NIHSS)评分。结果:治疗组总有效率达到91%,对照组总有效率76.4%,治疗组优于对照组(P0.05)。与治疗前比较,治疗后7,14 d治疗组NIHSS评分明显降低(P0.05),治疗组低于对照组(P0.05)。与治疗前比较,治疗后14 d治疗组CVR,BMI,Vm上升率均明显提高(P0.05);治疗后14 d,治疗组CVR高于对照组(P0.05)。结论:在西医常规治疗的基础上,补阳还五汤能改善气虚血瘀型脑梗死患者的脑血管储备功能,改善神经功能缺损,提高临床疗效。

Effect of Buyang Huanwu Tang on Cerebral Vascular Reserve Function in Patients with Qi Deficiency and Blood Stasis Type Cerebral Infarction

Objective: To explore the effect of Buyang Huanwu Tang on cerebral vascular reserve function in patients with Qi deficiency and blood stasis type cerebral infarction by using transcranial Doppler (TCD) combined with breath holding test, and to observe the clinical efficacy and neurological deficit scores in two groups. Method: The 150 patients with Qi deficiency and blood stasis type cerebral infarction were randomly divided into 2 groups:the treatment group of 78 cases and the control group of 72 cases. Patients in both groups received standardized western medicine treatment:aspirin enteric-coated tablets, 100 mg/times, 1 time/day; or Clopidogrel Bisulfate tablets, 75 mg/times, 1 time/day; medicines for reducing intracranial pressure, brain protective drugs, statin lipid-lowering therapy or rehabilitation therapy was given to regulate blood pressure and blood sugar according to actual conditions. Based on the western medicine treatment, patients in control group added Sanqi Tongshu capsules, 0.2 g/times, 3 times/day, but the patients in treatment group added Buyang Huanwu Tang on the basis of western medicine treatment, 180 mL/time, 2 times/day. Before and after treatment, TCD combined with breath holding test was used to determine the cerebral vascular reserve (CVR), breath holding index (BMI) and mean velocity (V_m) rate; in addition, the clinical efficacy and NIHSS scores were observed in both groups. Result: The total effective rate was 91% in treatment group, better than 76.4% in control group (P<0.05). Day 7 and day 14 after treatment, the NIHSS scores in treatment group were significantly reduced (P<0.05), and they were lower than those in control group (P<0.05). On day 14 after treatment, the levels of CVR, BMI and V_m were increased in treatment group (P<0.05), and the level of CVR in treatment group was higher than that in conrol group (P<0.05). Conclusion: On the basis of routine treatment of Western medicine, Buyang Huanwu Tang can improve the cerebral vascular reserve function in patients with Qi deficiency and blood stasis type cerebral infarction, so as to improve neurological function and improve clinical efficacy.