活血化瘀汤对脑梗死急性期患者颅内血流动力学及血清神经递质的影响

目的:探讨活血化瘀汤对脑梗死急性期的疗效及颅内血流动力学、血清神经递质的影响。方法:选择86例急性脑梗死患者,随机分为对照组和观察组各43例。对照组给予溶栓治疗,观察组在对照组用药基础上给予活血化瘀汤治疗。比较两组治疗前后脑氧代谢、平均血流量(Qm)、双侧大脑动脉平均血流流速(Vm)、脑血流峰值时间(TTP)、血管阻力指数(RI)、多巴胺(DA)、去甲肾上腺素(NE)、5-羟色胺(5-HT)变化及预后情况。结果:治疗4周后,两组SjvO₂均明显降低,SaO₂及CERO₂明显升高,且观察组更为显著(均P<0.05)。治疗4周后,两组Qm、Vm均升高,TTP、RI、DA、NE、5-HT均降低(均P<0.05); 观察组治疗4周后Qm、Vm均高于对照组,TTP、RI、DA、NE、5-HT均低于对照组(均P<0.05); 观察组预后良好率90.70%高于对照组76.74%(P<0.05)。结论:活血化瘀汤可显著改善脑梗死急性期患者颅内血流动力学,降低血清DA、NE、5-HT等神经递质因子表达。

Effect of Huoxue Huayu decoction on intracranial hemodynamics and serum neurotransmitters in acute cerebral infarction

Objective:To investigate the curative effect of Huoxue Huayu decoction on acute cerebral infarction and the influence of intracranial hemodynamics and serum neurotransmitters.Methods:86 patients with acute cerebral infarction were selected.Randomly divided into control group and observation group,43 cases in each group.The control group was given thrombolytic therapy.The observation group was given Huoxue Huayu decoction on the basis of the control group.Cerebral oxygen metabolism,mean blood flow(Qm),mean blood flow velocity(Vm),peak time of cerebral blood flow(TTP),vascular resistance index(RI),dopamine(DA),norepinephrine(NE),5-hydroxytr yptamine(5-HT)and prognosis were compared between the two groups before and after treatment.Results:After 4 weeks of treatment,SjvO 2 was significantly decreased,SaO 2 and CERO 2 were significantly increased in both groups,and the observation group was more significant(all P<0.05).After 4 weeks of treatment,QM and VM were increased in both groups,while TTP,RI,DA,NE,5-HT were decreased(all P<0.05);after 4 weeks of treatment,Qm and Vm in the observation group were higher than those in the control group,while TTP,RI,DA,NE,5-HT in the observation group were lower than those in the control group(all P<0.05);the good prognosis rate in the observation group was 90.70%higher than that in the control group(76.74%,P<0.05).Conclusion:Huoxue Huayu decoction can significantly improve intracranial hemodynamics and reduce the expression of neurotransmitters such as DA,NE,5-HT in patients with acute cerebral infarction.