消栓通絡顆粒對缺血性中風風痰瘀阻證的早期干預
發(fā)布時間：2019-07-26 21:31
【摘要】：目的:探討消栓通絡顆粒早期干預對缺血性中風(風痰瘀阻證)患者康復的療效,及對炎癥因子和神經(jīng)因子的影響。方法:將160例患者按SAS軟件生成的隨機按數(shù)字表法分為對照組和觀察組。兩組均參照指南給予綜合內(nèi)科處理和康復措施。對照組給予針刺和推拿的中醫(yī)康復措施,觀察組在對照組基礎加用消栓通絡顆粒,12 g/次,3次/d,溫開水沖服。兩組療程均為4周。分別于治療前、治療后7,14,28 d進行美國國立衛(wèi)生院神經(jīng)功能缺損(NIHSS)評分評價;采用功能獨立性評定量表(FIM)評定日常生活活動能力,采用四肢簡化Fugl-Meyer功能量表(FMA)評價肢體的功能活動,致殘/病死情況采用Rankin修訂量表(mRS)評價;檢測治療前后可溶性黏附分子-1(SICAM-1),高敏C反應蛋白(hs-CRP),白細胞介素-6(IL-6),腫瘤壞死因子-α(TNF-α),S100-β蛋白(S100-β),血管生成素(ANG-1)和內(nèi)皮素-1(ET-1)水平。并進行安全性評價。結果:觀察組疾病療效總有效率為89.47%,優(yōu)于對照組的77.03%(χ~2=4.182,P0.05);經(jīng)重復測量的方差分析,治療后兩組患者NIHSS評分均呈下降趨勢(F_(對照)=7.026,F_(觀察)=7.683,P0.05),治療后14 d和28 d觀察組NIHSS評分均低于對照組(P0.05,P0.01);治療后觀察組FIM和Fugl-Meyer(上、下肢)評分及總分均高于對照組(P0.01);治療后觀察組PRO量表癥狀、心理維度評分及總分均低于對照組(P0.01);經(jīng)秩和檢驗,觀察組致殘/病死情況輕于對照組(P0.05);治療后觀察組血清SICAM-1,hs-CRP,IL-6和TNF-α水平均低于對照組(P0.01);治療后觀察組血清S100-β,ANG-1和ET-1水平低于對照組(P0.01)。結論:在綜合治療方案中,消栓通絡顆粒能減輕致殘程度和提高患者和臨床療效,并能抑制SICAM-1,hs-CRP,IL-6和TNF-α炎癥因子表達,調(diào)節(jié)S100-β,ANG-1和ET-1因子,起到減輕炎癥反應,保護神經(jīng)細胞,促進神經(jīng)功能康復的作用。
[Abstract]:Objective: to investigate the effect of early intervention of Xiaoshuan Tongluo granule on rehabilitation of patients with ischemic apoplexy (wind-phlegm stasis syndrome) and its effect on inflammatory factors and neural factors. Methods: 160 patients were randomly divided into control group and observation group according to the method of digital table generated by SAS software. Both groups were given comprehensive medical treatment and rehabilitation measures according to the guidelines. The control group was given traditional Chinese medicine rehabilitation measures of acupuncture and massage, while the observation group was treated with Xiaoshuan Tongluo granule, 12 g / time, 3 times / d, warm boiled water and flushing in the control group. The course of treatment in both groups was 4 weeks. The (NIHSS) score of neurological deficit was evaluated at 7, 14 and 28 days after treatment, the activity of daily living was evaluated by functional independence scale (FIM), the functional activity of limbs was evaluated by limb simplified Fugl-Meyer function scale (FMA), and the disability / death rate was evaluated by Rankin revised scale (mRS) before treatment, 14 days after treatment, 28 days after treatment, (FIM) was used to evaluate the ability of daily living, (FMA) was used to evaluate the functional activity of limbs, and the disability / death rate was evaluated by Rankin revised scale (mRS). The levels of soluble adhesion molecule-1 (SICAM-1), high sensitivity C-reactive protein (hs-CRP), IL-6 (IL-6), tumor necrosis factor-偽 (TNF- 偽), S100-尾 protein (S100-尾), angiogenin (ANG-1) and endothelin-1 (ET-1) were measured before and after treatment. The security evaluation was carried out. Results: the total effective rate of the observation group was 89.47%, which was better than that of the control group (77.03%). After repeated analysis of variance, the NIHSS score of the two groups showed a downward trend (F_ (control) = 7.026, F_ (observation) = 7.683, P 0.05), and the NIHSS score of the observation group was lower than that of the control group on the 14th and 28th day after treatment (P0.05, P0.01). After treatment, the scores and total scores of FIM and Fugl-Meyer (upper and lower limbs) in the observation group were higher than those in the control group (P 0.01). After treatment, the symptoms, psychological dimension score and total score of the observation group were lower than those in the control group (P 0.01). After rank sum test, the disability / death rate in the observation group was lighter than that in the control group (P 0.05). After treatment, the levels of serum SICAM-1,hs-CRP,IL-6 and TNF- 偽 in the observation group were lower than those in the control group (P 0.01). After treatment, the levels of serum S 100-尾, ANG-1 and ET-1 in the observation group were lower than those in the control group (P 0.01). Conclusion: Xiaoshuan Tongluo granule can reduce the degree of disability and improve the clinical efficacy, inhibit the expression of SICAM-1,hs-CRP,IL-6 and TNF- 偽 inflammatory factors, regulate S100-尾, ANG-1 and ET-1 factors, play an important role in reducing inflammatory reaction, protecting nerve cells and promoting the rehabilitation of nerve function.
【作者單位】： 河北省中醫(yī)院黨校分院;
【基金】：河北省中醫(yī)藥管理局科研計劃項目(2012031)
【分類號】：R277.7
[Abstract]:Objective: to investigate the effect of early intervention of Xiaoshuan Tongluo granule on rehabilitation of patients with ischemic apoplexy (wind-phlegm stasis syndrome) and its effect on inflammatory factors and neural factors. Methods: 160 patients were randomly divided into control group and observation group according to the method of digital table generated by SAS software. Both groups were given comprehensive medical treatment and rehabilitation measures according to the guidelines. The control group was given traditional Chinese medicine rehabilitation measures of acupuncture and massage, while the observation group was treated with Xiaoshuan Tongluo granule, 12 g / time, 3 times / d, warm boiled water and flushing in the control group. The course of treatment in both groups was 4 weeks. The (NIHSS) score of neurological deficit was evaluated at 7, 14 and 28 days after treatment, the activity of daily living was evaluated by functional independence scale (FIM), the functional activity of limbs was evaluated by limb simplified Fugl-Meyer function scale (FMA), and the disability / death rate was evaluated by Rankin revised scale (mRS) before treatment, 14 days after treatment, 28 days after treatment, (FIM) was used to evaluate the ability of daily living, (FMA) was used to evaluate the functional activity of limbs, and the disability / death rate was evaluated by Rankin revised scale (mRS). The levels of soluble adhesion molecule-1 (SICAM-1), high sensitivity C-reactive protein (hs-CRP), IL-6 (IL-6), tumor necrosis factor-偽 (TNF- 偽), S100-尾 protein (S100-尾), angiogenin (ANG-1) and endothelin-1 (ET-1) were measured before and after treatment. The security evaluation was carried out. Results: the total effective rate of the observation group was 89.47%, which was better than that of the control group (77.03%). After repeated analysis of variance, the NIHSS score of the two groups showed a downward trend (F_ (control) = 7.026, F_ (observation) = 7.683, P 0.05), and the NIHSS score of the observation group was lower than that of the control group on the 14th and 28th day after treatment (P0.05, P0.01). After treatment, the scores and total scores of FIM and Fugl-Meyer (upper and lower limbs) in the observation group were higher than those in the control group (P 0.01). After treatment, the symptoms, psychological dimension score and total score of the observation group were lower than those in the control group (P 0.01). After rank sum test, the disability / death rate in the observation group was lighter than that in the control group (P 0.05). After treatment, the levels of serum SICAM-1,hs-CRP,IL-6 and TNF- 偽 in the observation group were lower than those in the control group (P 0.01). After treatment, the levels of serum S 100-尾, ANG-1 and ET-1 in the observation group were lower than those in the control group (P 0.01). Conclusion: Xiaoshuan Tongluo granule can reduce the degree of disability and improve the clinical efficacy, inhibit the expression of SICAM-1,hs-CRP,IL-6 and TNF- 偽 inflammatory factors, regulate S100-尾, ANG-1 and ET-1 factors, play an important role in reducing inflammatory reaction, protecting nerve cells and promoting the rehabilitation of nerve function.
【作者單位】： 河北省中醫(yī)院黨校分院;
【基金】：河北省中醫(yī)藥管理局科研計劃項目(2012031)
【分類號】：R277.7
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