潜阳活血通络方对急性脑梗死患者纤溶系统的影响

目的： 探讨潜阳活血通络方治疗急性脑梗死的临床疗效及对纤溶系统的影响。 方法： 将76例患者采用随机按入院前后分为对照组和观察组各38例。两组均参照“中国急性缺血性脑卒中诊治指南 2010”给予西医常规治疗，包括控制血压、血糖、体温，抗凝、抑制血小板等措施。观察组在对照组治疗的基础上加用潜阳活血通络方，1剂/d，两组疗程均为14 d。采用临床神经功能缺损评分（CSS评分）评价神经损害程度，采用Fugl-Meyer运动功能评价量表（FMI）评估肢体运动功能，采用改良Ashworth痉挛评定量表评价肢体痉挛程度，采用发色底物法检血浆组织纤溶酶原激活物（t-PA）和组织纤溶酶原抑制物（PAI）含量，采用免疫比浊法检测纤维蛋白原（FIB），采用酶联免疫吸附法免疫测定D-二聚体（D-D）和血管假性血友病因子（vWF），以上指标治疗前后各进行1次评价。 结果： 治疗后两组CSS评分和改良Ashworth评分均较治疗前下降，观察组低于对照组（P<0.01）；两组治疗后FMI评分较治疗前上升，观察组高于对照组（P<0.01）；治疗后两组t-PA均治疗前上升，观察组高于对照组（P<0.01）；观察组PAI水平降低，并低于对照组（P<0.01）；两组治疗后血浆FIB，D-D和vWF水平均较治疗前下降（P<0.01），观察组FIB，D-D和vWF水平均低于对照组（P<0.01）；观察组总有效率92.11%，对照组73.68%，观察组优于对照组（P<0.05）。 结论： 潜阳活血通络方能通过调节纤溶系统功能，有效溶解血栓，抑制血栓形成，从而改善病变部位的供血，促进了神经功能的恢复。

Influence of Qianyang Huoxue Tongluo Decoction in Treating Fibrinolytic System of Acute Cerebral Infarction Patients

Objective: The purpose is to discuss the clinical effects of Qianyang Huoxue Tongluo decoction in treating of acute cerebral infarction patients and influence of fibrinolytic system. Method: Seventy-six patients were randomly divided into control group (38 cases) and observation group (38 cases)by random number table.Both groups received conventional western medicine treatment according to guideline of 2010 Chinese acute ischemic cerebral infarction,including controlling blood pressure,blood glucose,body temperature,anticoagulation and restraining blood platelet.Patients in control group taken aspirin enteric-coated tablets.Taken orally.For patients in observation group added Qianyang Huoxue Tongluo decoction based on the treatment of control group,1 does/day.Treatment courses of two groups continued 14 days.Use clinical neurological function deficit scores (CSS scores) to evaluate the degree of nerve damage.Adopt Fugl-Meyer campaign function test (FMI) to assess movement function.Use improved Ashworth spasm rating chart to estimate the degree of limb spasm.Employ developing substrate method to examine the content of tissue plasminogen activator(t-PA) and plasminogenemia activator inhibitor(PAI).Adopt immune turbidimetric method to detectfibrinogen(FIB).Use enzyme-linked immunosorbent method to test D-dimer(D-D) and von willebrand factor (vWF).The indexes above each take one evaluation before and after treatment. Result: CSS scores and improve Ashworth scores of both groups declined after treatment.The data of observation group was lower than the control group(P<0.01).After treatment,FMI scores of both group increased.Besides the data of observation group was superior to the control group(P<0.01).Both groups' levels of t-PA and PAI reduce which in the observation group was lower than in the control group(P<0.01).After treatment,the level of plasma FIB,D-D and vWF was falling(P<0.01).For observation group the level of plasma FIB,D-D and vWF was inferior to which in control group(P<0.01).The total effective rate in the observation group was 92.11% superior to 73.68% in the control group(P<0.05). Conclusion: Qianyang Huoxue Tongluo decoction can effectively dissolve thrombus and inhibit thrombosis by means of adjusting the fibrinolytic system function.Through this it was able to improve the blood supply of the lesion site and promote the recovery of neurological function.