撮风散加味治疗前循环脑梗死急性期风痰阻络证的临床研究

doi:10.11958/20250305

摘要/Abstract

摘要：

目的探讨撮风散加味治疗前循环脑梗死（ACCI）急性期风痰阻络证的临床效果。方法纳入150例ACCI患者并按照随机数字表法分为对照组和治疗组，每组75例。对照组根据脑卒中诊治指南进行规范化干预，治疗组在对照组基础上予撮风散加味治疗，2组连续治疗2周。比较2组治疗效果，治疗前后神经功能损害美国国立卫生研究院卒中量表（NIHSS）评分、日常活动能力Barthel指数（BI）评分、风痰阻络证评分以及血清神经元特异性烯醇化酶（NSE）、S100钙结合蛋白B（S100B）、单核细胞趋化蛋白-1（MCP-1）、血管内皮细胞钙黏蛋白（VE-cadherin）水平。结果治疗组ACCI患者的总有效率高于对照组（93.3% vs. 81.3%，P<0.05）。1周与2周疗程后，2组NIHSS评分和风痰阻络证评分较治疗前下降，BI评分增加，且治疗组改善更加明显（P<0.05）。治疗后，2血清NSE、S100B、MCP-1与VE-cadherin水平均较治疗前下降，且治疗组降低更显著（P<0.05）。结论撮风散加味治疗ACCI急性期风痰阻络证效果显著，可改善神经功能，提高患者日常活动能力。

关键词: 脑梗死, 卒中, 脑血管循环, 撮风散, 神经元特异性烯醇化酶, S100钙结合蛋白B, 单核细胞趋化蛋白-1, 血管内皮细胞钙黏蛋白

Abstract:

Objective To observe the efficacy of Cuofeng San in the treatment of anterior circulation cerebral infarction (ACCI) of patients with syndrome of wind and phlegm blocking collaterals. Methods A total of 150 ACCI patients were collected in this study，and they were divided into the control group and the treatment group using a random number table method, with 75 cases in each group. The control group was given standardized intervention according to the stroke diagnosis and treatment guidelines, while the treatment group was treated with modified Cuofeng San on the basis of the control group. Both groups were treated continuously for 2 weeks. The treatment effects were compared between the two groups before and after treatment, including the National Institutes of Health Neurological Impairment Scale (NIHSS) score, Barthel Index (BI) score of daily activity ability, scores of syndrome of wind and phlegm blocking collaterals, serum levels of neuron specific enolase (NSE), S100 calcium binding protein B (S100B), monocyte chemoattractant protein-1 (MCP-1) and vascular endothelial cell calcium binding protein (VE-cadherin). Results The total effective rate of ACCI patients was higher in the treatment group than that in the control group (93.3% vs. 81.3%, P<0.05). After 1 week and 2 weeks of treatment, the NIHSS score and wind phlegm obstruction syndrome score decreased in both groups compared to those before treatment, while the BI score increased, and the improvement was more significant in the treatment group (P<0.05). After the end of the treatment course, serum levels of NSE, S100B, MCP-1 and VE-cadherin decreased compared to those before treatment, and the decrease was more significant in the treatment group (P<0.05). Conclusion The modified Cuofeng San has a significant effect on the treatment of wind phlegm obstruction syndrome in patients with ACCI acute phase. It can improve neurological function and enhance daily activity ability.

Key words: cerebral infarction, stroke, cerebrovascular circulation, cuofeng san, neuron specific enolase, S100 calcium binding protein B, monocyte chemoattractant protein-1, vascular endothelial cell cadherin

中图分类号:

R743.33

图/表 6

参考文献 21

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组别	n	性别（男/女）	年龄/岁	ACCI发病时间/h
对照组	75	44/31	72.17±7.37	15.17±2.64
治疗组	75	41/34	72.49±7.39	15.33±2.11
t或χ²		0.244	0.266	0.409

组别	n	性别（男/女）	年龄/岁	ACCI发病时间/h
对照组	75	44/31	72.17±7.37	15.17±2.64
治疗组	75	41/34	72.49±7.39	15.33±2.11
t或χ²		0.244	0.266	0.409

组别	治愈	显效	进步	未愈	总有效/%
对照组	3	30	28	14	61（81.3）
治疗组	8	39	23	5	70（93.3）
χ²					4.881^＊

组别	治愈	显效	进步	未愈	总有效/%
对照组	3	30	28	14	61（81.3）
治疗组	8	39	23	5	70（93.3）
χ²					4.881^＊

组别	NIHSS
		治疗前		治疗1周		治疗2周	F
对照组		12.51±2.11		11.11±2.30^a		8.03±0.97^ab	123.684^＊＊
治疗组		12.43±2.08		10.05±2.20^a		6.69±0.90^ab	193.053^＊＊
t		0.234		2.867^＊＊		8.715^＊＊
组别	BI评分
组别	治疗前		治疗1周		治疗2周			F
对照组	52.08±6.73		58.41±7.33^a		68.29±8.14^ab			95.123^＊＊
治疗组	52.05±6.64		62.35±7.66^a		73.43±8.75^ab			146.198^＊＊
t	0.024		3.215^＊＊		3.720^＊＊