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中文摘要: 目的：评价还原汤治疗急性脑梗死的临床疗效及其对患者血清炎症因子IL-6、TNF-α和hs-CRP水平的影响。 方法：将符合标准的100例急性脑梗死患者随机分为治疗组和对照组,每组各50例。两组患者均给予西医常规治疗,治疗组在常规治疗基础上加用还原汤口服,治疗周期为15 d。比较两组患者的临床疗效；治疗前后及发病90 d随访时,采用美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分评价患者的神经功能缺损程度,采用Barthel指数(Barthel index,BI)和改良Rankin量表(modified Rankin scale,mRS)评分评定患者的生活质量；治疗前后检测两组患者的IL-6、TNF-α和hs-CRP水平。 结果：治疗后,治疗组和对照组的临床总有效率分别为83.7%和55.3％,治疗组的疗效优于对照组(P＜0.01)。与治疗前比较,治疗后及随访时,治疗组患者的NIHSS、mRS评分显著降低(P＜0.01),BI评分显著升高(P＜0.01),对照组患者的NIHSS评分亦显著降低(P＜0.01),且随访时,对照组患者的mRS评分显著降低(P＜0.01)、BI评分显著升高(P＜0.01)。与治疗后比较,随访时,两组患者的NIHSS评分均降低(P<0.05),且治疗组患者的BI评分明显升高(P<0.05)、mRS评分显著降低(P<0.05)。与对照组比较,治疗后及随访时,治疗组患者的NIHSS、mRS评分均显著降低(P＜0.01,P＜0.05),BI评分显著升高(P＜0.01,P＜0.05)。治疗后,两组患者的IL-6、TNF-α、hs-CRP水平较治疗前均明显下降(P＜0.01),且治疗组患者的IL-6、TNF-α、hs-CRP水平低于对照组(P＜0.05,P＜0.01)。 结论：还原汤结合西医常规疗法治疗急性脑梗死,能够有效改善患者的临床症状和体征,提高其生活质量及远期疗效,并能降低患者的血清炎症因子水平。
Abstract: Objective:To evaluate the clinical efficacy of Huanyuan Decoction in the treatment of acute cerebral infarction,and observe its effects on serum levels of inflammatory cytokines IL-6,TNF-α and hs-CRP. Methods:100 patients with acute cerebral infarction who met the criteria were randomly divided into the treatment group and control group,50 cases in each group. Both groups were treated with routine western medicine,and the treatment group was orally treated with Huanyuan Decoction based on the routine therapy,with a treatment course of 15 days. The clinical efficacy of both groups was compared. Before and after treatment and during follow-up of 90 days,the degree of nerve function defect in patients was evaluated by National Institute of Heath Stroke Scale(NIHSS) score,the quality of life in patients was evaluated by Barthel index(BI)and modified Rankin scale(mRS) score. The serum levels of IL-6,TNF-α and hs-CRP were detected in both groups before and after treatment. Results:After treatment,the clinical total effective rates were 83.7% in the treatment group and 55.3% in the control group. The efficacy of the treatment group was better than that of the control group(P＜0.01). Compared with treatment before,the NIHSS and mRS scores of the patients in the treatment group were significantly decreased after treatment and during follow-up(P＜0.01),and the BI score was significantly increased(P＜0.01). The NIHSS scores of the patients in the control group were significantly decreased after treatment and during follow-up(P＜0.01),and the mRS score was significantly decreased(P＜0.01)and BI score was significantly increased(P＜0.01)during follow-up.Compared with those after treatment,the NIHSS score was decreased in both groups during follow-up(P<0.05),and the BI score was obviously increased(P<0.05)and mRS score was significantly decreased(P<0.05)in the treatment group during follow-up.Compared with the control group,the NIHSS and mRS scores of the patients in the treatment group were significantly decreased after treatment and during follow-up(P＜0.01,P＜0.05),and the BI score was significantly increased(P＜0.01,P＜0.05).After treatment,the levels of IL-6,TNF-α and hs-CRP were significantly decreased in both groups(P＜0.01),and the levels of IL-6,TNF-α and hs-CRP in the treatment group were lower than those in the control group(P＜0.05,P＜0.01). Conclusion:Huanyuan Decoction combined with routine therapy of western medicine can effectively improve the clinical symptoms and signs of patients in the treatment of acute cerebral infarction,enhance the quality of life and long-term efficacy,and also reduce the serum levels of inflammatory cytokines in patients.
keywords: Huanyuan Decoction acute cerebral infarction therapy of integrated traditional Chinese and western medicine inflammatory cytokines
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