补阳还五汤治疗瘀血阻络型脑梗死恢复期的随机观察及部分机制研究

目的:观察补阳还五汤治疗瘀血阻络型脑梗死恢复期的临床疗效及部分机制的探讨。方法:将本院2012年1月至2014年5月收治的瘀血阻络型脑梗死恢复期患者100例作为研究对象,随机分为对照组和治疗组,各50例。2组患者均接受神经内科常规治疗和康复训练,治疗组在此基础上加用补阳还五汤,2组均以4周为1个疗程,疗程结束后比较2组患者Brunnstrom六阶段分期标准评分、改良Fugl-Meyer肢体运动评分、改良Barthel指数评分,同时使用ELISA法检测2组外周血HO-1及CO的活性。结果:1)与治疗前相比,2组的Brunnstrom六阶段分期标准评分、改良Fugl-Meyer肢体运动评分、改良Barthel指数评分在治疗后均有提高,差异有统计学意义(P0.05),与对照组比较,治疗组效果更优,差异有统计学意义(P0.05);2)与治疗前比较2组外周血HO-1浓度治疗后明显升高,其中治疗组升高的幅度更明显,差异有统计学意义(P0.05);3)与治疗前比较2组外周血CO活性治疗后明显上调,其中治疗组上调的幅度更明显,差异有统计学意义(P0.05)。结论:补阳还五汤可明显提高瘀血阻络型脑梗死恢复期的肢体功能,其机制可能与通过上调HO-1蛋白表达,增加CO的合成和释放有关。

Observation on the Effect of Buyang Huanwu Decoction in the Treatment of Blood Stasis Obstructing Vessel Type of Cerebral Infarction in Convalescence Stage

To observe the clinical curative effect and mechanism of Buyang Huanwu decoction in treating blood stasis obstructing vessel type of Cerebral Infarction(CI).Methods:A hundred patients with CI in our hospital( January 2012 to May 2014) with blood stasis vessel obstruction type of CI during convalescence were collected then randomly divided into control group and observation group, with 50 cases in each group. Both of the two groups received nerve internal medicine routine treatment and rehabilitation training. Besides, the observation group took Buyang Huanwu decoction. Four weeks as a treatment course. After treatment, Brunnstrom staging standard grade, modified Fugl-Meyer assessment, modified Barthel index score of the two groups were compared and peripheral blood HO-1 and CO were detected by using ELISA method.Results:1) Compared with before treatment, the Brunnstrom staging standard grade, modified Fugl-Meyer assessment, modified Barthel index score after treatment were increased in both of the two groups (P<0.05), while compared with the control group, the observation group had better effect (P<0.05). 2) Compared with before treatment, peripheral blood mononuclear cells HO-1 activity significantly decreased after treatment in the two groups, but the the amplitude of the observation group was more obvious(P<0.05). 3) Compared with before treatment, peripheral blood mononuclear cells CO activity significantly decreased after treatment in the two groups, but the amplitude of the observation group was more obvious(P<0.05).Conclusion:Buyang Huanwu decoction can obviously increase limb function recovery of the blood stasis vessel obstruction type of CI during convalescence, and the mechanism may be related to its reduction of the protein expression of HO-1 as well as the synthesis and release of CO.