【摘要】 目的 探讨自拟活血通络方治疗急性脑梗死溶栓后气虚血瘀证的增效作用。方法 选取南昌市第一医院2022年1月—2023年1月接受阿替普酶静脉溶栓治疗后气虚血瘀型急性脑梗死患者70例，随机分两组，各35例。对照组静脉溶栓后予对症治疗，观察组在此基础上予以活血通络方干预。治疗1个月后比较两组中医证候积分、脑部血流灌注量、血管内皮及神经功能。结果 治疗前，两组各项指标比较，差异无统计学意义（P>0.05）。治疗后，两组中医证候积分、内皮素-1(ET-1)水平均下降，病灶边缘区局部脑血流量（rCBF）、一氧化氮（NO）水平均上升，且观察组指标改善情况较对照组更明显（P<0.05）。两组治疗前后平均通过时间（MTT）比较，差异无统计学意义（P>0.05）。治疗后，观察组达峰时间（TPP）短于对照组，美国国立卫生研究院卒中量表（NIHSS）评分低于对照组（P<0.05）。结论 自拟活血通络方可有效提升急性脑梗死溶栓后气虚血瘀证患者的神经功能，改善其脑血流灌注及血管内皮功能。更多还原

【Abstract】 Objective To explore the synergistic effect of self-made Huoxue Tongluo prescription on patients with qi deficiency and blood stasis syndrome after thrombolysis in acute cerebral infarction. Methods Seventy patients with acute cerebral infarction of qi deficiency and blood stasis type who received intravenous thrombolysis with alteplase in Nanchang First Hospital from January 2022 to January 2023 were selected and randomly divided into two groups, with 35 cases in each group. The control group was given symptomatic treatment after intravenous thrombolysis, while the observation group was additionally given Huoxue Tongluo prescription for intervention on this basis. After 1 month of treatment, the traditional Chinese medicine(TCM) syndrome scores, cerebral blood perfusion, vascular endothelium and neurological function were compared between the two groups. Results Before treatment, there were no statistically significant differences in all indicators between the two groups(P>0.05). After treatment, the TCM syndrome scores and endothelin-1(ET-1) levels in both groups decreased, while the regional cerebral blood flow(rCBF) in the marginal zone of the lesion and nitric oxide(NO) levels increased. Moreover, the improvement of indicators in the observation group was more significant than that in the control group(P<0.05). There was no statistically significant difference in the mean transit time(MTT) between the two groups before and after treatment(P>0.05). After treatment, the time to peak(TPP) in the observation group was shorter than that in the control group, and the national institutes of health stroke scale(NIHSS) score was lower than that in the control group(P<0.05). Conclusion The self-made Huoxue Tongluo prescription can effectively improve the neurological function of patients with qi deficiency and blood stasis syndrome after thrombolysis in acute cerebral infarction, and enhance their cerebral blood perfusion and vascular endothelial function.更多还原