摘要
目的:探讨恒清Ⅲ号方对缺血性脑卒中(IS)病人的作用及其机制。方法:选取上海交通大学医学院附属第六人民医院的IS病人210例,随机分为对照组与观察组。对照组给予基础治疗,观察组在基础治疗上加用恒清Ⅲ号方治疗。两组疗程均为8周。比较两组临床疗效,治疗前后两组美国国立卫生研究院卒中量表(NIHSS)评分、日常生活活动能力(ADL)评分、Bathel指数(BI)量表评分、简易运动功能评价量表(FMA)、中国卒中量表(CCS)评分、生活质量综合评定问卷-74(GQOL-74)评分及中医证候积分,检测治疗前后两组血液流变学指标、血清视黄醇结合蛋白4(RBP4)、血清淀粉样蛋白(SAA)、神经元特异性稀醇化酶(NSE)、基质金属蛋白酶9(MMP-9)、Apelin-13、成纤维细胞生长因子23(FGF23)、Klotho、D-二聚体(D-D)及C反应蛋白(CRP)水平变化。结果:观察组总有效率高于对照组,差异有统计学意义(83.50%与65.69%,P<0.01)。与治疗前比较,对照组和观察组治疗后NIHSS评分、CCS评分、中医证候总积分均下降(P<0.05),ADL评分、BI评分、FMA评分、GQOL-74评分均升高(P<0.05)。与对照组治疗后比较,观察组NIHSS评分、CCS评分、中医证候总积分均下降(P<0.05),ADL评分、BI评分、FMA评分、GQOL-74评分均升高(P<0.05)。与治疗前比较,观察组治疗后血小板黏附率、红细胞比容、血浆黏度、全血低切黏度及全血高切黏度均降低(P<0.05),血清RBP4、SAA、NSE及MMP-9水平均降低(P<0.05),血清Apelin-13、FGF23、Klotho、D-D及CRP水平均降低(P<0.05)。与对照组治疗后比较,观察组血小板黏附率、红细胞比容、血浆黏度、全血低切黏度及全血高切黏度均降低(P<0.05),血清RBP4、SAA、NSE、MMP-9、Apelin-13、FGF23、Klotho、D-D及CRP水平均降低(P<0.05)。结论:恒清Ⅲ号方能改善IS病人的临床症状,其作用机制可能与降低IS病人血黏度,血清RBP4、SAA、NSE、MMP-9、Apelin-13、FGF23、Klotho、D-D及CRP水平有关。
Objective:To investigate the effect of HengqingⅢPrescription in the treatment of ischemic stroke(IS)and its mechanism.Methods:Two hundred and ten IS patients were randomly divided into the control group and the observation group.The patients in the control group were treated with conventional treatment for 8 weeks,and the patients in the observation group was treated with HengqingⅢPrescription on the basis of conventional treatment for 8 weeks.The clinical efficacy were compared between two groups.The National Institutes of Health Stroke Scale(NIHSS)scores,Ability of Daily Living(ADL)scores,Bathel Index(BI)scale scores,Fugl-Meyer Assessment(FMA)Scale,Chinese Stroke Scale(CCS)scores,General Quality of Life Questionnaire-74(GQOL-74),scores and Chinese Medicine Evidence Score were compared between the two groups.Blood rheology,serum retinol-binding protein 4(RBP4),serum amyloid(SAA),neuron-specific sparing enzyme(NSE),matrix metalloproteinase 9(MMP-9),Apelin-13,fibroblast growth factor 23(FGF23),Klotho,D-dimer(D-D),and C-reactive protein(CRP)levels were compared between two groups.Results:The total effective rate of the observation group was higher than that of the control group,and the difference was statistically significant(83.50%vs 65.69%,P<0.01).Compared with data before treatment,the NIHSS score,CCS score,and total Chinese Medicine Evidence Score were decreased(P<0.05),and the ADL score,BI score,FMA score,and GQOL-74 score were increased(P<0.05)in the two groups after treatment.Compared with the control group after treatment,the NIHSS score,CCS score,and total Chinese Medicine Evidence Score were decreased in the observation group(P<0.05),and the ADL score,BI score,FMA score,and GQOL-74 score were increased in the observation group(P<0.05).Compared with data before treatment,platelet adhesion rate,erythrocyte specific volume,plasma viscosity,whole blood low-cut viscosity and whole blood high-cut viscosity,serum RBP4,SAA,NSE and MMP-9 and serum Apelin-13,FGF23,Klotho,D-D and CRP were decreased in the observation group(P<0.05).Compared with the control group after treatment,platelet adhesion rate,erythrocyte specific volume,plasma viscosity,whole blood low-cut viscosity and whole blood high-cut viscosity,serum RBP4,SAA,NSE and MMP-9,and serum Apelin-13,FGF23,Klotho,D-D and CRP were decreased in the observation group(P<0.05).Conclusion:HengqingⅢPrescription could significantly improve the clinical symptoms of IS patients,and its mechanism might be related to decreasing blood viscosity and levels of serum RBP4,SAA、NSE,MMP-9,Apelin-13,FGF23,Klotho,D-dimer,and CRP in IS patients.
作者
邓楚珺
孟胜喜
陈慧泽
王兵
李文涛
潘卫东
张云云
DENG Chujun;MENG Shengxi;CHEN Huize;WANG Bing;LI Wentao;PAN Weidong;ZHANG Yunyun(Shanghai Sixth People′s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200233,China)
出处
《中西医结合心脑血管病杂志》
2023年第8期1382-1386,共5页
Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease
基金
上海市第六人民医院医疗服务能级提升工程临床医疗技术骨干队伍培育项目(No.20220213)
上海市第六人民医院院级课题项目(No.ynxg202218)
上海市进一步加快中医药传承创新发展3年行动计划(2021年—2023年)项目[No.ZY(2021—2023)-0205-04]
华东片区及市级中医专科专病联盟建设项目[No.ZY(2021—2023)-0302]。
关键词
缺血性脑卒中
恒清Ⅲ号方
血黏度
神经功能
血液流变学
ischemic stroke
HengqingⅢPrescription
blood viscosity
neurological function
hemorheology
