天麻钩藤颗粒联合丁苯酞对风火痰阻型脑卒中恢复期患者神经功能及脑血管储备功能的影响
Influence of butylphthalide combined with Tianma Gouteng Granula on neurological function and cerebrovascular reserve function in patients with wind-fire-phlegm obstructive stroke in convalescent period
韩卫南 1乔春友 1许宁宁 1祁博宇 1石露露1
作者信息
- 1. 张家口市第一医院药学部 河北 张家口 075000
- 折叠
摘要
目的 探究天麻钩藤颗粒联合丁苯酞对风火痰阻型脑卒中恢复期患者血清血管内皮生长因子(VEGF)、脑源性神经营养因子(BDNF)水平及脑血管储备功能的影响.方法 前瞻性选取2021年1月至2023年12月张家口市第一医院收治的122例风火痰阻型脑卒中恢复期患者为研究对象,按照随机数字表法将其分为对照组(n=61)和观察组(n=61).两组均给予常规治疗,对照组给予丁苯酞治疗,观察组在对照组的基础上加用天麻钩藤颗粒治疗.比较两组患者疗效,比较两组治疗前和治疗28 d后的美国国立卫生研究院卒中量表(NIHSS)评分、日常生活活动能力(Bar-thel 指数)、中医证候积分评分、血清 VEGF和BDNF水平、脑血管储备功能指标[脑血管储备功能(CVR)、脉动指数(PI)];观察并记录两组研究过程中不良反应发生情况.结果 观察组整体疗效优于对照组,且观察组总有效率为93.44％,显著高于对照组(77.05％),差异有统计学意义(P＜0.05).观察组治疗28 d后的NIHSS评分、中医证候积分分别为(4.93±1.30)、(10.17±2.27)分,均低于对照组[(6.88±1.79)、(13.96±2.46)分],Barthel 指数评分为(71.61±12.29)分,高于对照组[(60.96±11.28)分],差异均有统计学意义(P＜0.05).观察组治疗28 d后的血清VEGF、BDNF 水平分别为(241.61±51.79)、(9.12±1.36)μg/L,均高于对照组[(211.45±47.94)、(7.62±1.28)µg/L],差异均有统计学意义(P＜0.05).观察组治疗28 d后的CVR为(29.94±5.48)％,高于对照组[(25.61±5.37)％],PI为0.61±0.19,低于对照组(0.72±0.22),差异均有统计学意义(P＜0.05).两组患者在整个研究中均未发生明显不良反应.结论 丁苯酞联合天麻钩藤颗粒可显著降低风火痰阻型脑卒中恢复期患者的中医证候积分,改善神经功能和脑血管储备功能,且对提高患者日常生活能力也具有显著的作用.
Abstract
Objective To explore the influences of butylphthalide combined with Tianma Gouteng Granula on serum vascular endothelial growth factor(VEGF),brain-derived neurotrophic factor(BDNF)levels and cerebrovascular reserve function in patients with wind-fire-phlegm obstructive stroke in convalescent period.Methods One hundred and twenty-two patients with wind-fire-phlegm obstructive stroke in convalescent period admitted to Zhangjiakou First Hospital from January 2021 to December 2023 were prospectively selected as the study subjects.They were divided into the control group(n=61)and the observation group(n=61)according to the random number table method.Both groups were given routine treatment,in addition,the control group was applied butylphthalide,and the observation group was given Tianma Gout-eng Granules on the basis of the control group.The efficacy of the two groups was compared;the national institutes of health stroke scale(NIHSS)score,activities of daily living(Barthel index),traditional Chinese medicine syndrome scores,serum VEGF,BDNF levels,and cerebrovascular reserve function indicators[cerebrovascular reserve function(CVR),pulsatility index(PI)]before and 28 days after treatment were compared between the two groups.The occurrence of adverse reactions in the two groups was observed and recorded.Results The overall therapeutic effect of the observation group was better than that of the control group,and the total effective rate of the observation group was 93.44％,which was sig-nificantly higher than that of the control group(77.05％),the difference was statistically significant(P＜0.05).After 28 days of treatment,the NIHSS score and traditional Chinese medicine syndrome score of the observation group were(4.93±1.30)and(10.17±2.27)points,respec-tively,which were lower than those of the control group[(6.88±1.79)and(13.96±2.46)points],the Barthel index score was(71.61±12.29)points,which was higher than those of the control group[(60.96±11.28)points],and the differences were statistically significant(P＜0.05).After 28 days of treatment,the serum levels of VEGF and BDNF in the observation group were(241.61±51.79)and(9.12±1.36)pg/L,re-spectively,which were higher than those in the control group[(211.45±47.94)and(7.62±1.28)μg/L],and the differences were statisti-cally significant(P＜0.05).After 28 days of treatment,the CVR of the observation group was(29.94±5.48)％,which was higher than that of the control group[25.61±5.37)％],and the PI was 0.61±0.19,which was lower than that of the control group(0.72±0.22),and the differences were statistically significant(P＜0.05).Both groups of patients did not experience significant adverse reactions throughout the entire study.Conclusion Butylphthalide combined with Tianma Gouteng Granula can obviously reduce traditional Chinese medicine syndrome scores of patients with wind-fire-phlegm obstructive stroke in convalescent period,improve the neurological function and cerebrovascular reserve function,and also have a significant effect on improving patients'daily life ability.
关键词
血管内皮生长因子类/脑源性神经营养因子/日常生活活动/丁苯酞/天麻钩藤颗粒/风火痰阻型/脑卒中神经功能Key words
Vascular endothelial growth factors/Brain-derived neurotrophic factor/Activities of daily living/Butylphthalide/Tianma Gouteng Granula/Wind-fire-phlegm obstructive stroke/Neurological function引用本文复制引用
基金项目
河北省中医药管理局科研计划(2019539)
出版年
2024
NETL
NSTL
万方数据