盐酸川芎嗪注射液联合补阳还五汤对气虚血瘀证急性脑梗死血液黏度及凝血因子的影响

目的:探讨盐酸川芎嗪注射液联合补阳还五汤治疗急性脑梗死(气虚血瘀证)的疗效及作用机制。方法:110例急性脑梗死患者随机按数字表法分成对照组和观察组各55例。两组均采用常规西医治疗。对照组给予阿司匹林肠溶片,100mg/次,1次/d,和双嘧达莫片,50 mg/次,3次/d,口服。观察组在西医常规治疗的基础上加用盐酸川芎嗪注射液和补阳还五汤,两组疗程均为14 d。采用美国国立卫生研究院卒中量表(NIHSS)进行神经功能缺损评分;检验治疗前后血液流变学指标,D-二聚体(D-D),血小板聚集率(MPAR),血管性血友病因子(v WF),凝血酶原时间(PT),活化部分凝血活酶时间(APTT),凝血酶时间(TT)和纤维蛋白原(FIB)。结果:观察组临床疗效总有效率为90.91%,对照组为76.36%,观察组优于对照组(P0.05);治疗后第14天观察组NIHSS评分低于对照组(P0.05);治疗后观察组D-D,MPAR和v WF水平均低于对照组(P0.05,P0.01);观察组全血黏度(高切、低切)、血浆黏度和红细胞沉降率均低于对照组(P0.05,P0.01);治疗后两组PT,APTT和TT均较治疗前增加(P0.01),观察组增加更为明显(P0.05),治疗后两组FIB均较治疗前下降,观察组下降更为显著(P0.01)。结论:在西医常规治疗的基础上,川芎嗪注射液联合补阳还五汤用于气虚血瘀证急性脑梗死的治疗能改善患者血液流动性,促进患者神经功能的恢复,提高临床疗效。

Influence of Ligustrazine Hydrochloride Injection Combined Buyang Huanwu Tang to Intervention on Blood Viscosity and Coagulation Factor with Acute Cerebral Infarction Patients

Objective: To investigate the influence of ligustrazine hydrochloride injection combined with Buyang Huanwu Tang to blood viscosity and blood coagulation factor on acute cerebral infarction. Method: One hundred and ten patients with acute cerebral infarction were randomly divided into control group(55 cases) and observation group(55 cases) by random number table. Both groups received aspirin enteric-coated tablets, 100 mg/time, 1 time/day, dipyridamole tablets, 50 mg/time, 3 time/day. Based on the treatment of control group, patients in observation group added ligustrazine hydrochloride injection combined with Buyang Huanwu Tang. Courses of treatment in two groups were both 14 days. Scores of neurologic impairment were graded by national institutes of health stroke scale(NIHSS). Before and after treatment, levels of blood rheology target, D-dimer(D-D), maximum platelet aggregation rate(MPAR), von Willebrand factor(vWF), prothrombin time(PT), activated partial thromboplastin time(APTT), thrombin time(TT), fibrinogen(FIB) were detected. Result: Total effective rate in observation group was 90.91% higher than that in control group(76.36%), with significant difference(P<0.05). At the fourteenth day after treatment, NHISS score in the observation group was lower than that in control group(P<0.05). Levels of D-D, MPAR and vWF were lower than those in control group(P<0.05, P<0.01). Levels of whole blood viscosity(high and low shearing), plasmic viscosity and erythrocyte sedimentation rate were also lower than those in control group(P<0.05, P<0.01). Compared with the data before treatment, levels of PT,APTT and TT in both groups increased(P<0.01), and they were more obvious in observation group(P<0.05). And FIB decreased in both groups compared with the data before therapy, it was more obvious in observation group(P<0.01). Conclusion: Based on the conventional western medicine treatment, ligustrazine hydrochloride injection combined with Buyang Huanwu Tang on can improve blood fluidity with acute cerebral infarction patients, enhance the neural function recovery of patients and increase the clinical curative effect.