【摘要】 目的 探讨银杏叶提取物(Ginkgo biloba extract,GBE)联合风池穴聚焦超声治疗急性脑梗死(Acute ischemic stroke,AIS)患者的临床疗效及其对神经功能恢复的影响。方法 选取2021年11月-2023年7月在番禺区中医院接受治疗的86例AIS患者作为研究对象;采用随机数字表法将患者分为对照组和治疗组,每组各43例;对照组接受GBE治疗,治疗组则在对照组基础上联合风池穴聚焦超声治疗;治疗前后对2组患者进行超敏C反应蛋白(High-sensitivity C-reactive protein,Hs-CRP)、脂蛋白磷脂酶A2、同型半胱氨酸水平及血栓弹力图检测,包括凝血因子功能(Reaction time,R)、纤维蛋白原聚合时间(Fibrinogen polymerization time,K)、纤维蛋白原聚合速度(Fibrinogen polymerization speed,Angle)和血小板功能(Platelet function,MA),并进行美国国立卫生院神经功能缺损评分(National institutes of health neurological deficit score,NIHSS)、简易精神状态检查(Mini-mental state examination,MMSE)、日常生活活动能力评分(Activities of daily living (ADL) score,Barthel指数)及改良Rankin量表(Modified Rankin scale,mRS)评分。结果 治疗后2组NIHSS评分均显著改善(P均<-0.01),但组间均无明显差异(P=0.134);治疗组治疗后mRS评分(P<0.001)、Barthel指数(P=0.007)和MMSE评分(P=0.017)的改善均显著优于对照组;2组治疗后HsCRP水平均有所升高,但对照组升高更明显(P=0.002);治疗组治疗后的血栓弹力图、R,K值显著高于对照组,而Angle值和MA值显著低于对照组(P均<-0.01)。结论 GBE联合风池穴聚焦超声治疗AIS患者,可能有助于改善患者的高凝状态、认知功能及日常生活能力,降低残障程度,其疗效优于单纯GBE治疗。更多还原

【Abstract】 Objective To explore the clinical efficacy of ginkgo biloba extract(GBE) combined with Fengchi acupoint focused ultrasound in the treatment of patients with acute ischemic stroke(AIS) and its influence on the recovery of neurological function.Methods A total of 86 patients with AIS who received treatment at Panyu District Hospital of Traditional Chinese Medicine from November 2021 to July 2023 were selected as the research subjects.The patients were divided into the control group and the treatment group by the method of random number table,with 43 cases in each group.The control group received GBE treatment,while the treatment group received focused ultrasound therapy at Fengchi acupoint in addition to the treatment received by the control group.Before and after the treatment,the two groups of patients underwent detection of high-sensitivity C-reactive protein(Hs-CRP),lipoprotein phospholipase A2(Lp-PLA2),homocysteine(HCY),and thromboelastography,including reaction time,fibrinogen polymerization time(K),fibrinogen polymerization speed(Angle),and platelet function(MA).Patients were also assessed with the national institutes of health neurological deficit Score(NIHSS),mini-mental state examination(MMSE),activities of daily living(ADL) score(Barthel Index),and modified Rankin scale(mRS).Results After treatment,both groups showed significant improvement in NIHSS scores compared to baseline(both P<0.01),but there was no significant difference between the groups(P=0.134).Compared with the control group,the treatment group demonstrated significant improvements in mRS score(P<0.001),Barthel index(P=0.007),and MMSE score(P=0.017).In terms of inflammatory markers,both groups showed an increase in Hs CRP after treatment,with the control group showing a more significant increase(P=0.002).Regarding coagulation function,the treatment group showed significantly higher R and K values,and lower Angle and MA values than the control group(all P<0.01),indicating better improvement in hypercoagulability.Conclusion The combination of GBE and focused ultrasound therapy at the Fengchi acupoint for AIS patients may help improve hypercoagulability,cognitive function,and activities of daily living,while reducing the degree of disability.Its therapeutic effect appears superior to GBE treatment alone.更多还原