从血清降钙素原及同型半胱氨酸水平研究补阳还五汤治疗急性脑梗死的作用机制

The mechanism of Bu-Yang-Huan-Wu decoction in treating acute cerebral infarction by evaluating the levels of serum procalcitonin and homocysteine

摘要:

目的 从血清降钙素原（procalcitonin，PCT）及同型半胱氨酸（homocysteine，Hcy）变化探讨补阳还五汤（芪龙祛瘀合剂）治疗急性脑梗死患者的疗效机制。方法 选取2018年6月至2020年12月急性脑梗死患者219例，筛选气虚血瘀型患者128例随机分为对照组（n=64，西医常规治疗）和治疗组（n=64，西医常规治疗+补阳还五汤）进行临床观察治疗，维持治疗4周。临床上评价2组患者在入院时、入院第10天及入院第4周时的美国国立卫生研究院卒中量表（National Institutes of Health Stroke Scale，NIHSS）评分以及中风专用生活质量量表（stroke-specific quality of life scale，SS-QOL）评分变化；并检测3个时间节点患者血清PCT及Hcy水平，统计临床不良反应与实验室不良反应监测。结果 与治疗前相比，治疗4周时2组患者的NIHSS评分均低于治疗前水平，并且治疗组比对照组更低（P<0.01）；与治疗前相比，治疗4周时2组患者的SS-QOL评分均高于治疗前，并且治疗组比对照组更高（P<0.01）；治疗4周时2组患者Hcy与PCT与同组治疗前比较有统计学差异；并且治疗组患者治疗4周时Hcy与PCT均低于对照组，有统计学差异。结论 补阳还五汤治疗急性脑梗死患者安全有效，可能通过降低血清中PCT及Hcy水平的作用机制，改善神经功能缺损症状。

Abstract:

Objective To explore the therapeutic mechanism of Bu-Yang-Huan-Wu decoction（Qi-Long-Qu-Yu mixture） in the treatment of acute cerebral infarction from the changes of serum procalcitonin（PCT）and homocysteine（Hcy）.Methods A total of 219 patients with acute cerebral infarction were selected from June 2018 to December 2020. And 128 patients with qi deficiency and blood stasis type in traditional Chinese medicine were randomly divided into control group（n=64，conventional treatment of Western medicine）and treatment group（n=64，conventional treatment of Western medicine plus Bu-Yang-Huan-Wu decoction）for clinical treatment and observation，with 4 weeks of the treatment observation. The changes of National Institutes of Health Stroke Scale（NIHSS）score and stroke-specific quality of life scale（SS-QOL） score at admission，10th day and 4th week were evaluated clinically. Serum PCT and Hcy levels were detected at the three time points，and clinical adverse reactions and laboratory adverse reactions were counted.Results Compared with before treatment，NIHSS scores of 2 groups at 4th week were significantly lower after treatment，and the NIHSS scores of treatment group were lower than that of control group，and the treatment group had lower scores than the control group（P<0.01）. Compared with before treatment，the SS-QOL scores of 2 groups at 4th week were higher than before treatment，and those of the treatment group were higher than those of the control group（P<0.01）. At 4th week，there were significant differences in Hcy and PCT of the two groups compared with before the treatment. In addition，Hcy and PCT in the treatment group were lower than those in the control group at 4th week，with statistical differences.Conclusion Bu-Yang-Huan-Wu decoction is safe and effective in the treatment of patients with acute cerebral infarction，and may improve the symptoms of neurological impairment by reducing the levels of PCT and Hcy in serum.