【摘要】 目的:探讨补阳还五汤联合依达拉奉治疗缺血性脑卒中疗效及对血液流变学的影响。方法:选取2012年3月—2015年2月医院收治的85例缺血性脑卒中患者为研究对象,将患者随机分为对照组(42例)和观察组(43例),两组患者均给予常规治疗+静脉滴注依达拉奉注射液30 mg/次,2次/d,观察组加服加味补阳还五汤,每天1剂(400 m L)分早晚2次服用,两组均连续治疗2周;治疗前后采用神经功能评分量表(NIHSS)与日常生活能力评定量表(ADL)进行评分,比较两组临床疗效及血液流变学指标及血清血管内皮生长因子(VEGF)、基质金属蛋白酶-9(MMP-9)水平变化。结果:治疗后观察组临床疗效总有效率95.35%显著高于对照组80.95%(χ2=4.242,P<0.05);两组全血高切黏度、全血低切黏度、血浆黏度、纤维蛋白原水平治疗后均比治疗前显著降低(P<0.05),治疗后观察组与对照组比较,差异具有统计学意义(P<0.05);治疗后两组患者NIHSS评分、MMP-9水平比治疗前显著降低(P<0.05),ADL、VEGF水平比治疗前显著升高(P<0.05),治疗后观察组NIHSS与ADL评分、VEGF与MMP-9水平与对照组比较,具有统计学差异(P<0.05)。结论:补阳还五汤联合依达拉奉治疗缺血性脑卒中可显著改善患者血液流变学指标,促进神经功能恢复,与降低血清MMP-9水平,升高VEGF水平有关。更多还原

【Abstract】 Objective: This aim is to explore the efficacy of Buyang Huanwu Decoction combined with edaravone in treatment of ischemic stroke and its effect on blood rheology. Methods: A total of 85 patients with ischemic stroke from March 2012 to February 2015 in the hospital were selected. The patients were randomly divided into control group( 42cases) and observation group( 43 cases). Patients were given routine therapy plus intravenous edaravone injection 30 mg / times,twice a day and patients in observation group were given Buyang Huanwu Decoction,400 m L / d,twice a day,two weeks of continuous treatment in both groups. Neurological rating scale( NIHSS) rating scale and activities of daily living( ADL) score were recorded before and after treatment. The clinical efficacy and hemorheology,serum vascular endothelial growth factor( VEGF),matrix metalloproteinase- 9( MMP- 9) levels were compared. Results: After treatment,the clinical total effective rate in observation group was 95. 35%,which was significantly higher than that in control group80. 95%( χ2= 4. 242,P < 0. 05). The high shear whole blood viscosity,low shear whole blood viscosity,plasma viscosity and fibrinogen level in two groups significantly decreased than those before treatment( P < 0. 05). The difference between observation group and the control group was statistically significant( P < 0. 05). NIHSS score and MMP- 9 levels were significantly lower than those before treatment( P < 0. 05). ADL and VEGF levels were significantly higher than those before treatment( P < 0. 05). NIHSS and ADL scores as well as VEGF and MMP- 9 levels in two groups had statistically significant difference( P < 0. 05). Conclusion: The results show that Buyang Huanwu Decoction combined with edaravone in treatment of ischemic stroke patients can significantly improve blood rheology and promote neurological recovery,with decreasing serum MMP- 9 levels and increasing VEGF levels.更多还原