消栓通络颗粒对缺血性中风风痰瘀阻证的早期干预
发布时间：2019-07-26 21:31
【摘要】：目的:探讨消栓通络颗粒早期干预对缺血性中风(风痰瘀阻证)患者康复的疗效,及对炎症因子和神经因子的影响。方法:将160例患者按SAS软件生成的随机按数字表法分为对照组和观察组。两组均参照指南给予综合内科处理和康复措施。对照组给予针刺和推拿的中医康复措施,观察组在对照组基础加用消栓通络颗粒,12 g/次,3次/d,温开水冲服。两组疗程均为4周。分别于治疗前、治疗后7,14,28 d进行美国国立卫生院神经功能缺损(NIHSS)评分评价;采用功能独立性评定量表(FIM)评定日常生活活动能力,采用四肢简化Fugl-Meyer功能量表(FMA)评价肢体的功能活动,致残/病死情况采用Rankin修订量表(mRS)评价;检测治疗前后可溶性黏附分子-1(SICAM-1),高敏C反应蛋白(hs-CRP),白细胞介素-6(IL-6),肿瘤坏死因子-α(TNF-α),S100-β蛋白(S100-β),血管生成素(ANG-1)和内皮素-1(ET-1)水平。并进行安全性评价。结果:观察组疾病疗效总有效率为89.47%,优于对照组的77.03%(χ~2=4.182,P0.05);经重复测量的方差分析,治疗后两组患者NIHSS评分均呈下降趋势(F_(对照)=7.026,F_(观察)=7.683,P0.05),治疗后14 d和28 d观察组NIHSS评分均低于对照组(P0.05,P0.01);治疗后观察组FIM和Fugl-Meyer(上、下肢)评分及总分均高于对照组(P0.01);治疗后观察组PRO量表症状、心理维度评分及总分均低于对照组(P0.01);经秩和检验,观察组致残/病死情况轻于对照组(P0.05);治疗后观察组血清SICAM-1,hs-CRP,IL-6和TNF-α水平均低于对照组(P0.01);治疗后观察组血清S100-β,ANG-1和ET-1水平低于对照组(P0.01)。结论:在综合治疗方案中,消栓通络颗粒能减轻致残程度和提高患者和临床疗效,并能抑制SICAM-1,hs-CRP,IL-6和TNF-α炎症因子表达,调节S100-β,ANG-1和ET-1因子,起到减轻炎症反应,保护神经细胞,促进神经功能康复的作用。
[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-伪 (TNF- 伪), 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- 伪 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- 伪 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.
【作者单位】： 河北省中医院党校分院;
【基金】：河北省中医药管理局科研计划项目(2012031)
【分类号】：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-伪 (TNF- 伪), 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- 伪 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- 伪 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.
【作者单位】： 河北省中医院党校分院;
【基金】：河北省中医药管理局科研计划项目(2012031)
【分类号】：R277.7
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