活血化瘀中药对急性脑梗死静脉溶栓后血清炎症指标及预后的影响

魏衡

文章摘要

活血化瘀中药对急性脑梗死静脉溶栓后血清炎症指标及预后的影响

The effect of traditional Chinese medicine for promoting blood circulation and removing blood stasis on serum inflammatory markers and prognosis after intravenous thrombolysis in acute cerebral infarction

DOI：

中文关键词: 活血化瘀急性脑梗死静脉溶栓炎症指标预后

英文关键词: Promoting blood circulation and removing blood stasis Acute cerebral infarction Intravenous thrombolysis Inflammatory markers Prognosis

基金项目:湖北省中西医结合医院青年项目(No.H2023Q001)；鄂州市科技计划项目(No.EZ01-007-20230082)

作者	单位	邮编
魏衡^*	湖北省中西医结合医院	430000

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中文摘要:

目的：探讨活血化瘀中药对急性脑梗死（ACI）患者静脉溶栓（IVT）后血清炎症指标及预后的影响。方法：采用回顾性研究方法，纳入230例中医辨证为风痰阻络证的ACI患者，按1：1随机分为中药组与对照组各115例。两组均接受IVT和常规西医治疗，中药组在此基础上加用活血化瘀中药。分别在治疗前、治疗2周后检测血清超敏C-反应蛋白（hsCRP）、血清淀粉样蛋白A（SAA）和肿瘤坏死因子-α（TNF-α）水平；在治疗前和治疗90天后评估美国国立卫生研究院脑卒中量表（NIHSS）和改良Rankin量表（mRS）评分。结果：治疗前，两组患者的炎症指标（hsCRP、SAA、TNF-α）和神经功能评分（NIHSS、mRS）均无显著差异（P>0.05）。治疗2周后，中药组hsCRP（6.46±0.80 vs 6.80±1.36，P<0.05）和SAA（9.75±4.04 vs 11.11±4.68，P<0.05）水平显著低于对照组；TNF-α水平（1189.50±330.03 vs 1206.82±371.41）虽低于对照组，但差异无统计学意义（P>0.05）。治疗90天后，中药组NIHSS评分（3.95±1.42 vs 4.37±1.58，P<0.05）显著低于对照组；mRS评分（2.09±0.67 vs 2.12±0.67）虽低于对照组，但差异无统计学意义（P>0.05）。两组均未发生严重药物不良反应。结论：活血化瘀中药辅助IVT治疗可有效改善ACI患者的神经功能，降低血清炎症指标水平，有助于改善患者预后。

英文摘要:

Objective: To investigate the effect of traditional Chinese medicine for promoting blood circulation and removing blood stasis on serum inflammatory markers and prognosis in patients with acute cerebral infarction (ACI) after intravenous thrombolysis (IVT). Method: A retrospective study was conducted on 230 patients with ACI diagnosed with wind phlegm obstructing collaterals syndrome in traditional Chinese medicine. They were randomly divided into a traditional Chinese medicine group and a control group, with 115 cases in each group. Both groups received IVT and conventional Western medicine treatment, and the traditional Chinese medicine group received the addition of blood activating and stasis removing herbs on this basis. Two weeks later, compare the differences in various inflammatory markers between the two groups before and after treatment. After 3 months, compare the differences in neurological function and daily living ability between the two groups before and after treatment. Result: Before treatment, there was no statistically significant difference in inflammatory markers, serum high-sensitivity C-reactive protein (hsCRP), serum amyloid A (SAA), and tumor necrosis factor- α(TNF-α) levels between the two groups of patients (all P>0.05). After 2 weeks of treatment, the levels of hsCRP (6.46±0.80 vs 6.80±1.36) and SAA (9.75 ± 4.04 vs 11.11±4.68) in the traditional Chinese medicine group were significantly lower than those in the control group, and the differences were statistically significant (P<0.05). The level of TNF-α (1189.50±330.03 vs 1206.82±371.41) was lower than that in the control group, but the difference was not statistically significant (P>0.05). Before treatment, there was no statistically significant difference in the National Institutes of Health Stroke Scale (NIHSS) and Modified mRS score (mRS) between the two groups of patients (both P>0.05). After 90 days of treatment, the NIHSS score of the traditional Chinese medicine group (3.95 ± 1.42 vs 4.37 ± 1.58) was lower than that of the control group, and the difference was statistically significant (P<0.05). The mRS score (2.09 ± 0.67 vs 2.12 ± 0.67) was lower than that of the control group, but the difference was not statistically significant (P>0.05). Neither group experienced serious adverse drug reactions. Conclusion: Chinese herbal medicine for promoting blood circulation and removing blood stasis assisted IVT can effectively improve the neurological function of ACI patients, reduce serum inflammatory markers levels, and improve prognosis.

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