通络活血汤联合尿激酶静脉溶栓治疗急性脑梗死临床观察
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R743.3

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浙江省自然科学基金资助项目(LY15H 110053)


Clinical Observation on Tongluo Huoxue Tang Com bined with Venous Urokinase Thrombolysis for Acute Cerebral Infarction
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    摘要:

    目的:观察通络活血汤联合尿激酶静脉溶栓治疗急性脑梗死患者的疗效及对外周血单核细胞Toll样受体4(TLR4)、白细胞介素-1β(IL-1β)水平的影响。方法:将106例急性脑梗死患者随机分为2组各53例,对照组应用尿激酶静脉溶栓治疗,研究组应用通络活血汤联合尿激酶静脉溶栓治疗,2组均持续治疗4周。比较2组治疗后的临床疗效,记录2组治疗前后的美国国立卫生研究院卒中量表(NIHSS)评分和Barthel指数评分,检测2组治疗前后的血液流变学指标以及外周血单核细胞TLR4、IL-1β水平。结果:治疗后,研究组总有效率90.57%,高于对照组的69.81%,差异有统计学意义( P <0.05)。2组NIHSS评分均较治疗前降低( P <0.01),Barthel指数评分均较治疗前升高( P <0.01);研究组NIHSS评分低于对照组( P <0.01),Barthel指数评分高于对照组( P <0.01)。2组全血低切黏度、全血高切黏度、血小板聚集率和红细胞压积水平均较治疗前降低( P <0.01),研究组各项指标值均低于对照组( P <0.01)。2组外周血单核细胞TLR4、IL-1β水平均较治疗前降低( P <0.01),研究组2项指标值均低于对照组( P <0.01)。结论:通络活血汤联合尿激酶静脉溶栓治疗急性脑梗死疗效显著,能有效改善患者的神经功能,提高日常生活能力,改善血液流变学,减轻炎症反应。

    Abstract:

    Objective: To observe the curative effect of Tongluo Huoxue tang combined with venous urokinase throm bolysis for acute cerebral infarction and its effect on levels of toll-like receptor-4(TLR4)and interleukin-1β (IL-1β )in peripheral blood mononuclear cells.Methods:Divided 106 cases of patients with acute cerebral infarction into two groups randomly,53 cases in each group.The controlgroup was treated with venous urokinase throm bolysis,while the study group was treated with Tongluo Huoxue tang com bined with venous urokinase throm bolysis.The two groups continuously received treatment for four weeks.Compared the clinicaleffect after treatment in the two groups,recorded scores of National Institute of Health stroke scale(NIHSS)and the Barthel index in the two groups before and after treatment,and detected levels of hemorheological indexes and levels of TLR4 and IL-1β in peripheral blood mononuclear cells in the two groups before and after treatment.Results:After treatment,the total effective rate was 90.57% in the study group,higher than than of 69.81%in the control group,the difference being significant( P <0.05).The scores of NIHSS in the two groups were decreased when compared with those before treatment( P <0.01),and the Barthel index scores were increased( P <0.01).The score of NIHSS in the study group was lower than that in the control group( P <0.01),and the Barthel index score was higher( P <0.01).Levels of the whole low blood viscosity,whole high blood viscosity,platelet aggregation rate and hem atocrit in the two groups were decreased when compared with those before treatment( P <0.01).Each index above in the study group was lower than that in the control group( P <0.01).Levels of TLR4 and IL-1β in peripheral blood mononuclear cells of the two groups were decreased when compared with those before treatment( P <0.01),and the above two indexes in the study group were lower than those in the control group( P <0.01).Conclusion:The therapy of Tongluo Huoxue tang com bined with venous urokinase throm bolysis has a significant curative effect in treating acute cerebral infarction,which caneffectively alleviate the neurological deficits of patients,enhance the activity of daily living, improve hemorheology and reduce inflamm atory response.

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邱蓓蓉,魏会会.通络活血汤联合尿激酶静脉溶栓治疗急性脑梗死临床观察[J].新中医,2018,50(9):45-48

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  • 在线发布日期: 2018-09-04
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