目的 探討扎沖十三味丸聯(lián)合丁苯酞治療急性腦梗死的臨床療效。方法 選取2019年9月-2021年9月漯河市中醫(yī)院治療的80例急性腦梗死患者,按照隨機數(shù)字法將所有患者分為對照組和治療組,每組各40例。對照組患者口服丁苯酞軟膠囊, 0.2 g/次, 3次/d。治療組在對照組的基礎(chǔ)上口服扎沖十三味丸, 5~9粒/次, 1次/d。兩組患者用藥14 d觀察治療效果。對比兩組的療效及癥狀好轉(zhuǎn)時間;比較兩組治療前后全血高切黏度、血漿黏度、血小板黏附率、纖維蛋白原、神經(jīng)功能缺損評分(NIHSS)、日常生活能力評分(Barthel)、白細(xì)胞介素6(IL-6)、同型半胱氨酸(Hcy)、白細(xì)胞介素8(IL-8)、C-反應(yīng)蛋白(CRP)的變化情況。結(jié)果 治療后,治療組患者總有效率是97.50%,顯著高于對照組的77.50%(P<0.05)。治療組患者失語、肢體麻木、頭暈、口角歪斜等癥狀好轉(zhuǎn)時間均明顯短于對照組(P<0.05)。治療后,兩組血漿黏度、血小板黏附率、纖維蛋白原、全血高切黏度均顯著降低(P<0.05);治療后,治療組血液流變學(xué)指標(biāo)改善優(yōu)于對照組(P<0.05)。治療后,兩組NIHSS評分均顯著降低, Barthel評分顯著增高(P<0.05);治療后,治療組NIHSS評分和Barthel評分改善優(yōu)于對照組(P<0.05)。治療后,兩組IL-6、IL-8、Hcy、CRP水平均較治療前顯著降低(P<0.05);治療后,治療組血清因子水平低于對照組(P<0.05)。結(jié)論 扎沖十三味丸聯(lián)合丁苯酞治療急性腦梗死具有較好的臨床療效,可顯著改善急性腦梗死患者的癥狀和日常生活能力,并能有效改善機體血液流變學(xué)指標(biāo),降低機體炎癥反應(yīng),值得臨床借鑒。

Objective To investigate the clinical study of Zhachong Shisanwei Pills combined with butylphthalide in treatment of acute cerebral infarction.Methods A total of 80 patients with acute cerebral infarction treated in Luohe Hospital of Traditional Chinese Medicine from September 2019 to September 2021 were selected and randomly divided into control group and treatment group according to the random number method, with 40 patients in each group. Patients in the control group were po administered with Butylphthalide Soft Capsules, 0.2 g/time, three times daily. Patients in the treatment group were po administered with Zhachong Shisanwei Pills on the basis of the control group, 5 — 9 pills/time, once daily. Two groups were treated for 14 d to observe the therapeutic effect. The curative effect and symptom improvement time of the two groups were compared. The changes of whole blood high shear viscosity, plasma viscosity, platelet adhesion rate, fibrinogen, neurological deficit score (NIHSS), daily living ability score (Barthel), interleukin-6 (IL-6), homocysteine (Hcy), interleukin-8 (IL-8) and C-reactive protein (CRP) were compared between the two groups before and after treatment.Results After treatment, the total effective rate in treatment group was 97.50%, significantly higher than 77.50% in control group (P < 0.05). The improvement time of aphasia, limb numbness, dizziness and mouth angle in treatment group was significantly shorter than that in control group (P < 0.05). After treatment, plasma viscosity, platelet adhesion rate, fibrinogen and whole blood hypershear viscosity were significantly decreased in both groups (P < 0.05). After treatment, the hemorheology index of the treatment group improved better than that of the control group (P < 0.05). After treatment, NIHSS score was significantly decreased and Barthel score was significantly increased in both groups (P < 0.05). After treatment, NIHSS score and Barthel score in the treatment group were better than those in the control group (P < 0.05). After treatment, the levels of IL-6, IL-8, Hcy and CRP in two groups were significantly decreased compared with before treatment (P < 0.05). After treatment, the level of serum factor in treatment group was lower than that in control group (P < 0.05).Conclusion Zhachong Shisanwei Pills combined with butylphthalide has good clinical effect in treatment of acute cerebral infarction, can significantly improve the symptoms and daily living ability of patients with acute cerebral infarction, effectively improve the body's hemorheology index and reduce the body's inflammatory response, which is worthy of clinical reference.

R971

河南省中醫(yī)藥科學(xué)研究專項課題(2015ZY02029)