化浊行血汤治疗痰瘀阻络型脑梗死恢复期的临床研究

摘要/Abstract

摘要： 目的探讨与分析化浊行血汤治疗痰瘀阻络型脑梗死恢复期的临床效果。方法选择2020年8月—2023年2月天津市河东区中医医院收治的98例痰瘀阻络型脑梗死恢复期患者作为研究对象,根据1:1随机数表法把98例患者分为中医组49例与对照组49例。对照组给予常规西医治疗,中医组在对照组治疗的基础上给予化浊行血汤治疗。两组均治疗观察2个月,比较两组治疗前后神经功能缺损评分、精神状态与认知功能评分、大脑中动脉血流速度变化、生活质量评分。结果治疗2个月后两组患者神经功能缺损评分均较治疗前下调,与对照组比较,中医组下调的程度更大,差异具有统计学意义（P<0.05）;治疗2个月后两组患者精神状态与认知功能评分较治疗前升高,与对照组比较,中医组升高的程度更大,差异具有统计学意义（P<0.05）;两组患者治疗的脑中动脉舒张期末血流速度和收缩期峰血流速度较治疗前升高,与对照组比较,中医组升高的程度更大,差异具有统计学意义（P<0.05）;治疗2个月后中医组的生活质量得分与对照组比较有较大程度的升高,差异具有统计学意义（P<0.05）。结论化浊行血汤治疗痰瘀阻络型脑梗死恢复期能改善患者的神经缺损状况,提高患者的精神状态与认知功能评分,改善患者的大脑中动脉血流速度,从而提高患者的生活质量。

关键词: 化浊行血汤, 痰瘀阻络型, 脑梗死, 神经缺损, 精神状态, 认知功能, 血流速度

Abstract: Objective To explore and analysis the clinical effect of Huazhuo Xingxue Tang on the recovery stage of cerebral infarction of phlegm stasis obstruction type. Methods A total of 98 patients with phlegm stasis obstruction type cerebral infarction during the recovery period diagnosed and treated at Hedong District Traditional Chinese Medicine Hospital in Tianjin from August 2020 to February 2023 were selected as the research subjects. Accorded to a 1:1 random number table method, the 98 patients were divided into the traditional Chinese medicine group of 49 cases and the control group of 49 cases. The control group were treated with conventional Western medicine, while the traditional Chinese medicine group were treated with Huazhuo Xingxue Tang on the basis of the control group. Both groups were treated and observed for 2 months, and the scores of nerve function deficit, mental state and cognitive function, changes in middle cerebral artery blood flow velocity and quality of life were compared between the two groups before and after treatment. Results After 2 months of treatment, the neurological deficit scores of both groups of patients decreased compared to before treatment, and the degree of downregulation in the traditional Chinese medicine group was greater. Compared with the control group, the difference was statistically significant (P<0.05); After 2 months of treatment, the mental state and cognitive function scores of the two groups of patients increased compared to before treatment, and the degree of increase was greater in the traditional Chinese medicine group. Compared with the control group, the difference was statistically significant (P<0.05); The end diastolic blood flow velocity and peak systolic blood flow velocity of the middle cerebral artery in the two groups of patients treated increased compared to before treatment, and the degree of increase in the traditional Chinese medicine group was greater. Compared with the control group, the difference was statistically significant (P<0.05); The quality of life scores of the traditional Chinese medicine group after two months of treatment showed a significant increase compared to the control group, and the difference was statistically significant (P<0.05). Conclusion Huazhuo Xingxue Tang can improve patients' neurological deficits, improve their mental state and cognitive function scores, improve the blood flow velocity of the middle cerebral artery, and thus improve their quality of life in the recovery period of phlegm stasis obstruction type cerebral infarction.

Key words: Huazhuo Xingxue Tang, phlegm stasis obstructing collaterals type, cerebral infarction, neurological defects, mental state, cognitive function, blood flow velocity

中图分类号:

R287

宁宏. 化浊行血汤治疗痰瘀阻络型脑梗死恢复期的临床研究[J]. 中华养生保健, 2024, 42(21): 19-23.

NING Hong. Clinical Study on the Treatment of Phlegm Stasis Blocking Collateral Type Cerebral Infarction in the Recovery Period with Huazhuo Xingxue Decoction[J]. ZHONGHUA YANGSHENG BAOJIAN, 2024, 42(21): 19-23.

参考文献

[1] 曾鑫冰,唐三,谢若曦,等.化痰通络汤对脑缺血/再灌注损伤大鼠肠道菌群的影响[J].湖南中医药大学学报,2023,43(6):982-991.
[2] 龚思琪,邵涵,汤安琪,等.脑梗死后神经细胞替代治疗的前沿进展[J].中华神经医学杂志,2023,22(1):72-76.
[3] 陈和禾,许美飞,余静,等.益气通络汤加减治疗脑梗死恢复期临床研究[J].新中医,2023,55(7):85-89.
[4] 庄志江,张丽红,兰瑞.清热熄风活血汤调控JNK/p38 MAPK信号通路改善脑梗死大鼠脑组织损伤的干预机制[J].中国老年学杂志,2023,43(3):607-611.
[5] 刘蕊,马力,江礼焰,等.化痰通络汤对风痰阻络型脑梗死病人神经功能及血清淀粉样蛋白A、糖化血清蛋白的影响[J].安徽医药,2023,27(2):396-400.
[6] 任扬,赵义纯.醒脑开窍针刺联合化瘀祛痰汤对急性脑梗死痰瘀互结证患者血小板相关参数、认知功能及神经功能的影响[J].吉林中医药,2023,43(7):845-848.
[7] 吴婷婷,王兴臣,焉凯,等.化浊行血汤联合常规治疗对脑梗死恢复期患者的临床疗效[J].中成药,2023,45(4):1393-1396.
[8] 国家中医药管理局.中华人民共和国中医药行业标准——《中医病证诊断疗效标准》:ZY/T001.1-94[S].北京:中国中医药出版社,2017.
[9] 王桂红,王拥军.急性脑梗死的欧洲治疗指南[J].国外医学(脑血管疾病分册),2001,9(2):101-103.
[10] 李鑫,于丽红,王兴臣,等.基于网络药理学研究化浊行血汤产生缺血耐受的作用机制及实验验证[J].世界中医药,2023,18(7):964-972.
[11] 张承亮,徐晏雯,郑康,等.益气解毒通络汤联合尤瑞克林治疗急性脑梗死临床疗效观察[J].中华中医药学刊,2023,41(3):223-226.
[12] 杨海霞,郝泓旭,仇凯强,等.温针灸联合通痹活络汤治疗脑梗死恢复期疗效及对患者肢体与吞咽功能的影响[J].陕西中医,2023,44(5):648-651.
[13] 付雪琴,兰瑞,张勇,等.小续命汤对急性脑缺血再灌注大鼠突触可塑性的影响[J].中国中药杂志,2023,48(14):3882-3889.
[14] 任庆萍,赵嘉诚,林海,等.柴胡加龙骨牡蛎汤联合艾司西酞普兰治疗急性脑梗死伴焦虑抑郁障碍患者的疗效及对血清单胺类神经递质水平的影响[J].海南医学,2023,34(10):1397-1401.
[15] 陆柯茹,张斌.芪蛭消栓汤联合静脉溶栓治疗急性脑梗死的疗效及对血清VILIP-1、PTX3和Cav-1水平的影响[J].检验医学与临床,2023,20(5):634-638.
[16] 单玉栋,赵艳萌,靳晓飞,等.补阳还五汤通过PI3 K/AKT通路调控自噬抗大鼠脑缺血/再灌注损伤的作用[J].中国药理学通报,2023,39(2):386-391.
[17] 赵敏菡,储心乔,曹晓慧,等.基于JNK信号通路调控细胞自噬探讨化浊解毒活血通络方对脑缺血再灌注损伤的保护作用[J].中国实验方剂学杂志,2023,29(7):115-125.
[18] 张金波,张雷,陈艳霞,等.中药清燥润肺化浊行血汤对PM2.5致肺损伤小鼠的干预作用[J].中华危重病急救医学,2017,29(5):465-468.
[19] 吴婷婷,王兴臣,焉凯,等.化浊行血汤联合常规治疗对脑梗死恢复期患者的临床疗效[J].中成药,2023,45(4):1393-1396.
[20] 王明明,张盼盼.化瘀清络脑安汤结合脑栓通胶囊对急性期脑梗死患者肢体痉挛状态的影响[J].河南中医,2023,43(4):576-580.
[21] 李鑫. 化浊行血汤联合头针治疗缺血性脑卒中急性期(血浊瘀阻证)的临床及网络药理学研究[D].济南:山东中医药大学,2022.