半夏白术天麻汤加减对急性脑梗死的疗效及其对VEGF,Ang-2和NSE水平的影响

摘要

Objective:To observe the efficacy of Banxia Baizhu Tianma decoction combined with western medicine in the treatment of acute cerebral infarction (ACI) and the effect on the levels of vascular endothelial growth factor (VEGF),angiopoietin (Ang)-2 and neuron-specific enolase (NES).Methods:120 patients with ACI were randomly divided into an observation group and a control group,and each group had 60 cases.The control group was given conventional treatment,and the observation group received Banxia Baizhu Tianma decoction on the basis of the therapy in the control group.Efficacy after treatment,the levels of neurological deficits (NFDS score),quality of daily living (Barthel Index),blood rheology,VEGF,Ang-2 and NSE before and after treatment were observed in two groups.Results:The total effective rate in the observation group was 91.67％,which was significantly higher than 76.67％ in the control group,and the difference was statistically significant (x2 =4.002,P ＜ 0.05).Before treatment,the levels of NFDS score,Barthel index,blood viscosity at high and low shear,plasma viscosity,fibrinogen,VEGF,Ang-2 and NSE didn't have a statistically significant difference (P ＞ 0.05),but after treatment the levels of NFDS score,blood viscosity at high and low shear,plasma viscosity,fibrinogen and NSE were significantly decreased in two groups compared with those before treatment (P ＜0.01),and the levels of Barthel index,VEGF and Ang-2 were significantly improved in two groups compared with those before treatment (P ＜0.01).The decreasing or increasing levels in the observation group were more obvious compared with those in the control group (P ＜ 0.01).Conclusion:The efficacy of Banxia Baizhu Tianma decoction combined with western medicine in the treatment of acute cerebral infarction (ACI) is obvious,and its mechanism may be to promote the body's neovascularization,and improve microcirculation,so as to improve the neurological impairment and quality of life.%目的:观察半夏白术天麻汤加减联合西医治疗急性脑梗死(ACI)的疗效及其对血管内皮生长因子(VEGF),血管生成素(Ang)-2和神经元特异性烯醇化酶(NES)水平的影响.方法:选择符合纳入标准的ACI患者120例,随机将患者分为观察组和对照组,每组60例.对照组予以常规治疗,观察组在对照组的基础上予以半夏白术天麻汤加减治疗.观察两组患者治疗后的临床疗效,治疗前后神经功能缺损程度(NFDS评分),日常生活质量(Barthel指数),血液流变学,VEGF,Ang-2和NSE水平的变化.结果:观察组的总有效率为91.67％明显高于对照组的76.67％,差异有统计学意义(x2=4.002,P＜0.05).两组患者治疗前NFDS评分,Barthel指数,全血黏度高切、低切,血浆黏度,纤维蛋白原,VEGF,Ang-2和NSE水平差异无统计学意义(P＞0.05),治疗后两组患者的NFDS评分,全血黏度高切、低切,血浆黏度,纤维蛋白原和NSE水平较治疗前明显降低(P＜0.01),两纽的Barthel指数,VEGF和Ang-2水平较治疗前明显提高(P＜0.01),而观察组的降低或者提高水平更为明显(P＜0.01).结论:半夏白术天麻汤加减联合西医治疗急性脑梗死的疗效显著,能促进机体新生血管形成,改善微循环,从而改善神经功能缺损和生活质量.