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目的探讨通窍化栓汤治疗急性脑梗死(风痰瘀阻型)的临床疗效及对血清内皮素(ET)及一氧化氮(NO)水平的影响。方法选择我院神经内科治疗的64例急性脑梗死(风痰瘀阻型)病人,随机分为对照组和研究组。对照组31例病人给予长春西汀注射液20mL,每日1次静脉输注,阿司匹林100mg每日1次口服。研究组33例病人在对照组治疗基础上予通窍化栓汤100mL,每日3次口服。疗程为15d。比较治疗前后病人血清ET、NO、Barthel指数评分、美国国立卫生研究院卒中量表(NIHSS)评分变化及治疗后临床疗效。结果治疗后两组病人血清ET水平明显降低,差异有统计学意义(P<0.01);与对照组比较,研究组病人治疗后血清ET水平较低,差异有统计学意义(P<0.01)。治疗后两组病人血清NO水平均明显升高,差异有统计学意义(P<0.01);与对照组比较,研究组病人治疗后血清NO水平较高,差异有统计学意义(P<0.01)。治疗后两组病人Barthel指数均明显提高(P<0.05),NIHSS评分均降低(P<0.05);与对照组比较,研究组病人治疗后Barthel指数评分较高,差异有统计学意义(P<0.05);NIH SS评分较低,差异有统计学意义(P<0.05)。治疗后与对照组比较,研究组病人治疗总有效率较高,差异有统计学意义(P<0.05)。结论通窍化栓汤对急性脑梗死(风痰瘀阻型)病人有较好的疗效,能较快促使机体ET和NO水平恢复到正常范围。
Objective To investigate the clinical efficacy of Tongqiao Huashi decoction in the treatment of acute cerebral infarction (Wind-phlegm and stasis obstruction type) and its effect on the level of serum endothelin (ET) and nitric oxide (NO). Methods Sixty-four patients with acute cerebral infarction (phlegm-stasis type) treated by neurology in our hospital were randomly divided into control group and study group. Control group, 31 patients given Vinpocetine injection 20mL, daily intravenous infusion, aspirin 100mg daily oral. 33 patients in the study group were given Tongqiao Huacheng Decoction 100mL on the basis of the control group and were orally administered 3 times a day. Treatment for 15d. The changes of serum ET, NO, Barthel index before and after treatment, NIHSS score and the clinical effect after treatment were compared. Results After treatment, the level of serum ET in the two groups of patients was significantly lower (P <0.01). Compared with the control group, the level of ET in the study group was lower after treatment, with a statistically significant difference (P <0.01). After treatment, serum NO levels in both groups were significantly increased, the difference was statistically significant (P <0.01); Compared with the control group, serum NO levels in the study group were significantly higher after treatment (P <0.01) . After treatment, the Barthel index of both groups were significantly increased (P <0.05), and the NIHSS scores were decreased (P <0.05). Compared with the control group, the Barthel index of the study group was higher after treatment, the difference was statistically significant (P < 0.05); NIH SS score was lower, the difference was statistically significant (P <0.05). After treatment, compared with the control group, the total effective rate of treatment in study group was higher, the difference was statistically significant (P <0.05). Conclusion Tongqiao Huashi Decoction has better curative effect on patients with acute cerebral infarction (phlegm-stasis type) and promptly return the levels of ET and NO to the normal range.