【摘要】 目的探讨滋水清肝饮合通督调神针刺法治疗后循环短暂性脑缺血发作疗效及对血液流变学指标、血管内皮功能的影响。方法将2015年3月—2018年6月江苏省苏北人民医院收治的124例后循环短暂性脑缺血发作患者随机分为对照组和观察组,每组62例。对照组给予抗血小板、降血压、降血糖等常规西医治疗,观察组在此基础上加用滋水清肝饮合通督调神针刺治疗,疗程均为2周。观察2组治疗前后基底动脉和椎动脉血流速度、血液流变学指标(血浆黏度、全血高切黏度、全血低切黏度、血细胞比容)、血管内皮功能指标(血友病因子、内皮素-1、一氧化氮)及阴虚阳亢症候积分变化情况,记录2组临床疗效。结果 2组治疗后基底动脉、椎动脉血流速度及一氧化氮水平显著升高(P均<0.05),血液流变学指标水平、血友病因子水平、内皮素-1水平及阴虚阳亢症候积分均显著降低(P均<0.05),且观察组各指标改善情况均优于对照组(P均<0.05);观察组治疗总有效率为90.3%(56/62),显著高于对照组的71.0%(44/62)(P<0.05)。结论滋水清肝饮合通督调神针刺治疗后循环短暂性脑缺血发作可有效控制病情进展,降低血液黏稠度,进而改善后循环缺血状态,可能与有效改善血液流变学指标和血管内皮功能密切相关。更多还原

【Abstract】 Objective It is to investigate the effect of Zishui Qinggan Decoction combined with Tongdu Tiaoshen acupuncture on post-circulatory transient ischemic attack and its influence on hemorheological indexes and vascular endothelial function. Methods A total of 124 patients with posterior circulation transient ischemic attack treated in Subei People’s Hospital from March 2015 to June 2018 were randomly divided into control group and observation group, with 62 cases in each group. The control group was given conventional western medicine for antiplatelet, lowering blood pressure and blood sugar, and the observation group was treated with Zishui Qinggan Decoction and Tongdu Tiaoshen acupuncture based on the control group. The course of treatment was 2 weeks. The changes of the blood flow velocity of the basilar artery and vertebral artery, hemorheology indexes(plasma viscosity, whole blood high shear viscosity, whole blood low shear viscosity, hematocrit),vascular endothelial function indexes(hemophilia factor, endothelin-1, nitric oxide) and the scores of syndrome of Yin deficiency and Yang hyperactivity before and after treatment were observed in the two groups, and the clinical efficacy of the 2 groups was recorded. Results The blood flow velocity of the basilar artery and vertebral artery and the level of nitric oxide were increased significantly after treatment in the two groups(P<0.05), the levels of hemorheological indexes, the level of hemophilia factor, the levels of endothelin-1 and the scores of syndrome of Yin deficiency and Yang hyperactivity were significantly reduced(P<0.05), and the improvements of the observation group were better than those of the control group(P<0.05); the total effective rate of treatment in the observation group was 90.32%(56/62), which was significantly higher than 70.97%(44/62) of the control group(P<0.05). Conclusion Zishui Qinggan Decoction combined with Tongdu Tiaoshen acupuncture can effectively control the progression of the disease, reduce blood viscosity, and improve the ischemic status of the posterior circulation in the treatment of post-circulatory transient ischemic attack, its mechanism may be closely related to the effective regulation of blood rheology indexes and vascular endothelial function.更多还原