通腑通络开窍汤治疗急性脑梗死疗效及对患者髓鞘碱性蛋白、可溶性细胞间黏附分子-1和神经元特异性烯醇化酶的影响

目的:探讨通腑通络开窍汤治疗风痰瘀阻型急性脑梗死(ACI)效果及对可溶性细胞间黏附分子-1(sICAM-1)、髓鞘碱性蛋白(MBP)、神经元特异性烯醇化酶(NSE)的影响。方法:选取60例风痰瘀阻型ACI患者为研究对象,以随机数字表法分为对照组和观察组各30例,对照组采用常规治疗,观察组采用常规治疗联合通腑通络开窍汤,比较两组治疗前后中医临床症状评分、神经功能评分、脑血流情况及血清神经因子变化情况,统计两组不良反应发生情况。结果:两组治疗前中医临床症状评分相近(P>0.05),两组治疗后评分均降低(P<0.05),且观察组低于对照组(P<0.05); 两组治疗前美国国立卫生院卒中量表(NIHSS)评分、改良Rankin量表(mRS)评分差异无统计学意义(P>0.05),两组治疗后NIHSS评分、mRS评分均降低(P<0.05),且观察组均低于对照组(P<0.05); 两组治疗前双侧大脑中动脉(MCA)峰流速、MCA平均流速、血流灌注指数(PI)水平比较,差异无统计学意义(P>0.05),两组治疗后MCA峰流速、MCA平均流速均提高(P<0.05),且观察组均高于对照组(P<0.05),两组治疗后PI水平均降低(P<0.05),且观察组低于对照组(P<0.05); 两组治疗后sICAM-1、MBP、NSE水平均降低(P<0.05),且观察组均低于对照组(P<0.05); 两组不良反应发生率相接近(P>0.05)。结论:对风痰瘀阻型ACI患者实施通腑通络开窍汤治疗可有效减轻其病情及神经功能损伤,改善脑血流及血清神经因子状况,且安全性良好。

Tongfu Tongluo Kaiqiao decoction on acute cerebral infarction and its influence on myelin basic protein,soluble intercellular adhesion molecule-1 and neuron specific enolase

Objective:To explore the effect of Tongfu Tongluo Kaiqiao decoction in treating acute cerebral infarction(ACI)of wind phlegm and blood stasis and its effect on soluble intercellular adhesion molecule-1(sICAM-1),myelin basic protein(MBP),and neuron-specific enolization influence of enzymes(NSE).Methods:A total of 60 patients with wind,phlegm and blood stasis type ACI were selected as the research objects,and they were divided into control group(30 cases,using conventional treatment)and observation group(30 cases,using conventional treatment combined with Tongfu Tongluo Kaiqiao decoction)by random number table.The scores of clinical symptoms,neurological function scores,cerebral blood flow and serum neurological factors of the two groups before and after treatment were compared.The occurrence of adverse reactions in the 2 groups was counted.Results:The scores of TCM clinical symptoms in the two groups before treatment were similar(P>0.05),and the scores of the two groups were reduced after treatment(P<0.05),and observation group was lower than control group(P<0.05).The scores of the National institutes of health stroke scale(NIHSS)and Modified rankin scale(mRS)before treatment in the two groups were similar(P>0.05),and the NIHSS and mRS scores of the two groups were reduced after treatment(P<0.05),and observation group was lower than control group(P<0.05).Before treatment in the two groups,the bilateral middle cerebral artery(MCA)peak flow velocity,MCA average flow rate,and blood perfusion index(PI)levels were similar(P>0.05).After treatment,the MCA peak flow velocity and MCA average flow velocity in the two groups increased(P<0.05),and observation group was higher than control group(P<0.05),PI level decreased after treatment in two groups(P<0.05),and observation group was lower than control group(P<0.05).After treatment,the levels of sICAM-1,MBP and NSE in the two groups decreased(P<0.05),and the levels of observation group were all lower than control group(P<0.05).The incidence of adverse reactions in the two groups was similar(P>0.05).Conclusion:The treatment of Tongfu Tongluo Kaiqiao decoction for ACI patients with wind phlegm and blood stasis resistance can effectively reduce their condition and nerve function damage,improve cerebral blood flow and serum nerve factor status.