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天麻钩藤饮加减联合依达拉奉治疗缺血性卒中肝阳上亢证患者的效果

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目的:观察天麻钩藤饮加减联合依达拉奉治疗缺血性卒中肝阳上亢证患者的效果.方法:选取 2021 年 3 月至 2023 年 8 月该院收治的 108 例缺血性卒中肝阳上亢证患者进行前瞻性研究,按照随机数字表法将其分为研究组与对照组各 54 例.对照组采用依达拉奉治疗,研究组在对照组基础上联合天麻钩藤饮加减治疗,比较两组临床疗效,治疗前后中医证候积分、肢体运动功能[Fugl-Meyer运动功能评分量表(FMA)]评分、神经功能缺损程度[美国国立卫生研究院卒中量表(NIHSS)]评分、血管内皮功能指标[内皮素-1(ET-1)、一氧化氮(NO)]水平,以及不良反应发生率.结果:研究组治疗总有效率为 94.44%(51/54),高于对照组的 81.48%(44/54),差异有统计学意义(P<0.05);治疗后,两组头晕目眩、半身不遂、面赤耳鸣等中医证候积分均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);两组FMA评分均高于治疗前,且研究组高于对照组,两组NIHSS评分均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);两组ET-1 水平均低于治疗前,且研究组低于对照组,两组NO水平均高于治疗前,且研究组高于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计意义(P>0.05).结论:天麻钩藤饮加减联合依达拉奉治疗缺血性卒中肝阳上亢证患者可提高治疗总有效率和肢体运动功能评分,改善血管内皮功能指标水平,降低中医证候积分和神经功能缺损程度评分,其效果优于单纯依达拉奉治疗.
Effects of modified Tianma Gouteng decoction combined with Edaravone in treatment of ischemic stroke patients with liver-yang hyperactivity syndrome
Objective:To observe effects of modified Tianma Gouteng decoction combined with Edaravone in treatment of ischemic stroke patients with liver-yang hyperactivity syndrome.Methods:A prospective study was conducted on 108 patients with ischemic stroke and liver-yang hyperactivity syndrome admitted to the hospital from March 2021 to August 2023.According to the random number table method,they were divided into study group and control group,54 cases in each group.The control group was treated with Edaravone,while the study group was treated with modified Tianma Gouteng decoction on the basis of that of the control group.The clinical efficacy,the TCM syndrome score,the limb motor function[Fugel-Meyer assessment(FMA)]score,the neurological deficit degree[National Institutes of Health stroke scale(NIHSS)]score,the vascular endothelial function index[endothelin-1(ET-1),nitric oxide(NO)]levels before and after the treatment,and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate of the study group was 94.44%(51/54),which was higher than 81.48%(44/54)of the control group,and the difference was statistically significant(P<0.05).After the treatment,the scores of TCM syndromes such as dizziness,hemiplegia and facial redness and tinnitus in the two groups were lower than those before treatment,those in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).The FMA scores of the two groups were higher than those before treatment,and that in the study group was higher than that in the control group;the NIHSS scores of the two groups were lower than those before treatment,and that in the study group was lower than that in the control group;and the differences were statistically significant(P<0.05).The levels of ET-1 in the two groups were lower than those before treatment,and that in the study group was lower than that in the control group;the levels of NO in the two groups were higher than those before treatment,and that in the study group was higher than that in the control group;and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Modified Tianma Gouteng decoction combined with Edaravone in the treatment of the ischemic stroke patients with liver-yang hyperactivity syndrome can improve the total effective rate of treatment and the limb motor function scores,improve the levels of vascular endothelial function indexes,and reduce TCM syndrome scores and the neurological deficit scores.Moreover,it is superior to simple Edaravone treatment.

Modified Tianma Gouteng decoctionEdaravoneLiver-yang hyperactivity syndromeIschemic strokeVascular endothelial functionTCM syndrome scoreNeurological deficit degree

邢颖、徐亚民、李战平、阎钊

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许昌中医院治未病科,河南 许昌 461000

天麻钩藤饮加减 依达拉奉 肝阳上亢证 缺血性卒中 血管内皮功能 中医证候积分 神经功能缺损程度

2024

中国民康医学
中国社会工作协会

中国民康医学

影响因子:0.649
ISSN:1672-0369
年,卷(期):2024.36(17)