补阳还五汤对H型高血压合并急性脑梗死患者同型半胱氨酸、血液流变学及神经功能的影响

【目的】探讨补阳还五汤对H型高血压合并急性脑梗死患者同型半胱氨酸、血液流变学及神经功能的影响。【方法】将60例H型高血压合并急性脑梗死患者随机分为观察组和对照组,每组各30例。对照组给予常规西医治疗方案治疗(包括降压治疗和急性脑梗死的常规治疗等),观察组在对照组的基础上给予加用补阳还五汤治疗,疗程为3周。于治疗前及治疗1、2、3周后,观察2组患者的血压、血浆同型半胱氨酸(Hcy)水平、血液流变学指标(全血低切黏度、血浆黏度、全血高切黏度、纤维蛋白),以及美国国立卫生研究院卒中量表(NIHSS)评分和Barthel指数的变化情况,并观察2组患者的不良反应发生情况。【结果】(1)治疗1、2、3周后,2组患者的舒张压、收缩压及血浆Hcy水平均较治疗前明显降低(P<0.05);且治疗1、2、3周后,观察组的血浆Hcy水平均明显低于对照组(P<0.05),而2组的舒张压、收缩压比较,差异均无统计学意义(P>0.05)。(2)治疗1、2、3周后,2组患者的全血低切黏度、全血高切黏度、血浆黏度、纤维蛋白水平均较治疗前明显降低(P<0.05);且治疗1、2、3周后,观察组的全血低切黏度、全血高切黏度、血浆黏度、纤维蛋白水平均明显低于对照组(P<0.05)。(3)治疗1、2、3周后,2组患者的NIHSS评分均较治疗前明显降低,Barthel指数均较治疗前明显增高(P<0.05);且治疗1、2、3周后,观察组的NIHSS评分均明显低于对照组,Barthel指数均明显高于对照组(P<0.05)。(4)观察组与对照组的不良反应发生率分别为16.67%、13.33%,组间比较,差异无统计学意义(P>0.05)。【结论】补阳还五汤能够有效降低H型高血压合并急性脑梗死患者血浆Hcy水平,改善患者的神经功能及血液流变学指标,提高患者的日常生活能力,但对血压的影响不明显。

Effect of Buyang Huanwu Decoction on Homocysteine,Hemorheology and Neurologic Function in Patients with H-type Hypertension Complicated with Acute Cerebral Infarction

Objective To observe the effect of Buyang Huanwu Decoction on homocysteine,hemorheology(Hcy)and neurologic function in patients with H-type hypertension complicated with acute cerebral infarction.Methods Sixty H-type hypertension patients complicated with acute cerebral infarction were randomly divided into observation group and control group,30 patients in each group.The control group was given conventional western medicine treatment including medicine for lowering blood pressure and conventional therapy for acute cerebral infarction,and the observation group was treated with oral use of Buyang Huanwu Decoction on the basis of treatment for the control group.The treatment for the two groups lasted 3 weeks.Before treatment and after treatment for one week,2 weeks and 3 weeks,we monitored the blood pressure,plasma Hcy level,and hemorheological indexes including whole blood low shear viscosity,whole blood high shear viscosity,plasma viscosity,fibrin as well as the scores of National Institute of Health Stroke Scale(NIHSS)and Barthel Index in the two groups.Meanwhile,the incidence of the adverse reaction in the two groups was also observed.Results(1)After treatment for one week,2 weeks and 3 weeks,the diastolic blood pressure,systolic blood pressure and plasma Hcy level in the two groups were obviously decreased(P<0.05 compared with those before treatment),and the plasma Hcy level in the observation group was much lower than that in the control group(P<0.05).However,the differences of the diastolic blood pressure and systolic blood pressure between the two groups after treatment were insignificant(P>0.05).(2)After treatment for one week,2 weeks and 3 weeks,whole blood low shear viscosity,whole blood high shear viscosity,plasma viscosity,and fibrin level in the two groups were obviously decreased(P<0.05 compared with those before treatment),and the levels of the above indexes in the observation group were lower than those in the control group(P<0.05).(3)After treatment for one week,2 weeks and 3 weeks,NIHSS scores were much decreased and Barthel Index was obviously increased in the two groups(P<0.05 compared with those before treatment),and NIHSS scores were lower and Barthel Index was higher in the observation group than those in the control group(P<0.05).(4)The incidence of adverse reaction in the observation group was 16.67%and that in the control group was 13.33%after treatment,but there was no statistically significant difference between the two groups(P>0.05).Conclusion Buyang Huanwu Decoction is effective on reducing the plasma Hcy level of H-type hypertension patients complicated with acute cerebral infarction,and can improve the hemorheology,neurological function and abilities of daily life of the patients,but has no obvious effect on blood pressure.