涤痰汤联合阿加曲班注射液治疗老年急性脑梗死临床研究
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R743.33

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Clinical Study on Ditan Decoction Combined with Agattriban Injection for Senile Patients with Acute Cerebral Infarction
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    摘要:

    目的:观察在常规疗法基础上加用涤痰汤加减联合阿加曲班注射液治疗老年急性脑梗死患者的效 果。方法:纳入86 例老年风痰阻络型急性脑梗死患者,采用随机数字表法分为对照组、观察组。2 组均给予 脱水降颅压、抗感染、控制血压等常规治疗,并以阿加曲班注射液治疗,观察组加予涤痰汤加减治疗,2 组均 连续治疗14 d。治疗前后评定中医证候评分、美国国立卫生研究院卒中量表(NIHSS) 评分、Barthel 指数评 分,检测炎症因子指标[肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)]、神经功能指标[胰岛素样生 长因子-1(IGF-1)、多胺氧化酶(PAO)、心脏型脂肪酸结合蛋白(H-FABP)]、抵抗素、黑色素瘤缺乏因子 2(AIM2)、凝血功能指标[凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)、纤维蛋 白原(Fib)]及血液流变学指标[血浆黏度(PV)、全血低切黏度(LSV)、全血高切黏度(HSV)、红细胞压 积(HCT)]。比较2 组的临床疗效。结果:治疗后,观察组临床疗效总有效率高于对照组(P<0.05)。2 组语 言謇涩、半身不遂、头痛眩晕、痰多而黏评分均较治疗前下降(P<0.05),观察组4 项中医证候评分均低于对 照组(P<0.05)。2 组NIHSS 评分及TNF-α、IL-1β、PAO、H-FABP、PV、LSV、HSV、HCT、抵抗素、 AIM2 水平均较治疗前下降(P<0.05),PT、TT、APTT 均较治疗前缩短(P<0.05),观察组以上14 项指标 值均低于对照组(P<0.05)。2 组Barthel 指数评分及Fib、IGF-1 水平均较治疗前升高(P<0.05),观察组以 上3 项指标值均高于对照组(P<0.05)。结论:在常规疗法基础上应用涤痰汤加减联合阿加曲班注射液治疗老 年风痰阻络型急性脑梗死患者,可有效改善患者的神经功能、凝血功能和血液黏度,减轻炎症反应,缓解症 状,提升日常生活能力,促进病情恢复。

    Abstract:

    Abstract: Objective: To observe the effect of the additional application of modified Ditan Decoction combined with Agatroban Injection on senile patients with acute cerebral infarction on the basis of conventional therapy. Methods:A total of 86 senile patients with acute cerebral infarction of wind-phlegm blocking the collaterals type were included and divided into the control group and the observation group by random number table method. The two groups were treated with dehydration to reduce cranial pressure, anti- infection, blood pressure control and other conventional treatments, and were treated with Agatroban Injection;the observation group was additionally treated with modified Ditan Decoction. The two groups were treated for 14 days. Before and after treatment, the scores of traditional Chinese medicine (TCM) syndromes, National Institutes of Health Stroke Scale (NIHSS) and Barthel Index were evaluated, and the levels of inflammatory factors,including tumor necrosis factor-α (TNF-α) and interleukin-1β (IL- 1β),nerve function indexes,including insulin-like growth factor-1 (IGF-1),polyamine oxidase (PAO) and cardiac fatty acid binding protein (H-FABP),resistin,absent in melanoma 2 (AIM2),coagulation function indexes,incluing prothrombin time (PT),thrombin time (TT),activated partial thromboplastin time (APTT) and fibrinogen (Fib), and hemorheological indexes, including plasma viscosity (PV), low- shear blood viscosity (LSV),high-shear blood viscosity (HSV) and hematocrit (HCT),were detected in the two groups. The clinical effects in the two groups were also compared. Results: After treatment, the total effective rate in the observation group was higher than that in the control group (P<0.05). The scores of sluggish speech, hemiplegia, headache and vertigo, and profuse and sticky sputum in the two groups were decreased when compared with those before treatment (P<0.05), and the above four TCM syndrome scores in the observation group were lower than those in the control group (P<0.05). The NIHSS scores and the levels of TNF- α, IL- 1β, PAO, H- FABP, PV, LSV, HSV, HCT, resistin and AIM2 in the two groups were decreased when compared with those before treatment (P<0.05),PT,TT and APTT in the two groups were shortened when compared with those before treatment (P < 0.05) , and the above 14 indexes in the observation group were lower than those in the control group (P<0.05). The Barthel Index scores, Fib and IGF- 1 levels in the two groups were increased when compared with those before treatment (P<0.05),and the above three indexes in the observation group were higher than those in the control group (P<0.05). Conclusion: On the basis of conventional therapy, the additional application of modified Ditan Decoction combined with Agatroban Injection for senile patients with acute cerebral infarction of wind- phlegm blocking the collaterals type can effectively improve the nerve function, coagulation function and blood viscosity,reduce inflammation,relieve symptoms,improve the ability of daily life,and promote the recovery of the disease.

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李嘉伟,庞学明,王秋丽.涤痰汤联合阿加曲班注射液治疗老年急性脑梗死临床研究[J].新中医,2023,55(18):15-21

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  • 在线发布日期: 2023-09-22
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