作者：窦维华1 ，陈燕 2 ，吴鹏 1 ，杨飘 1 ，卢惠卿 1 ，董少龙 1

单位：

1.530023 广西壮族自治区南宁市，广西中医药大学第一附属医院脑病科　2.530001 广西壮族自治区南宁市，广西中医药大学

Units：

1.Department of Encephalopathy，the First Affiliated Hospital of Guangxi University of Chinese Medicine，Nanning 530023，China2.Guangxi University of Chinese Medicine，Nanning 530001，China

关键词：

脑梗死；气虚血瘀；梗塞通 2 号方；补阳还五汤；炎性因子；疗效比较研究

Keywords：

Cerebral infarction；Qi-deficiency blood stasis；Gengsaitong decoction 2；Buyang Huanwu decoction；Inflammatory factors；Comparative effectiveness research

CLC：

DOI：

10.12114/j.issn.1008-5971.2021.00.002

Funds：

广西医疗卫生适宜技术研究与开发课题（S201410-02）

摘要：

背景　脑梗死发病率、致残率、致死率及复发率均较高，通常伴有不同程度的肢体活动障碍。在中医学理论中，脑梗死属“中风”范畴，以气虚血瘀证多见，因此其治疗原则以补气活血、疏经通络为主。目的　比较梗塞通 2 号方与补阳还五汤治疗气虚血瘀型脑梗死的临床疗效。方法　选取 2018 年 6 月—2019 年 6 月广西中医药大学第一附属医院收治的气虚血瘀型脑梗死患者 120 例，按照随机数字表法分为对照组和观察组，各 60 例。两组患者入院后均给予常规治疗，其中对照组患者采用补阳还五汤治疗，观察组患者采用梗塞通 2 号方治疗，两组患者均进行两周的治疗。比较两组患者的临床疗效及治疗前后美国国立卫生研究院卒中量表（NIHSS）评分、日常生活能力量表（ADL）评分及炎性因子水平，并观察两组患者治疗期间不良反应发生情况。结果　与对照组相比，观察组患者临床疗效更优（P ＜ 0.05）。观察组患者治疗后 NIHSS 评分及 C 反应蛋白（CRP）、白介素 6（IL-6）、肿瘤坏死因子 α（TNF-α）水平较对照组降低，ADL 评分较对照组升高（P ＜ 0.05）。两组患者治疗期间不良反应发生率比较，差异无统计学意义（P ＞ 0.05）。结论　梗塞通 2 号方治疗气虚血瘀型脑梗死的临床疗效优于补阳还五汤，其可更有效地改善患者的神经功能，减轻炎性反应，提高日常生活能力，且安全性高。

Abstract：

Background　Cerebral infarction has higher rate of attack，disability，mortality and recurrence，often accompany by varying degrees of physical activity disorders.In traditional Chinese medicine，cerebral infarction belongs to stroke category，and Qi-deficiency blood stasis type is more common，therefore，its treatment principle is to invigorate Qi，promote blood circulation，dredge channels and dredge collaterals.Objective　To compare the clinical effect of Gengsaitong decoction 2 and Buyang Huanwu decoction in the treatment of cerebral infarction with Qi-deficiency blood stasis type.Methods　A total of 120 cases of patients with cerebral infarction with Qi-deficiency blood stasis type were selected in the First Affiliated Hospital of Guangxi University of Chinese Medicine from June 2018 to June 2019，and they were divided into control group and observation group，60 cases in each group.Patients were given basic treatment，patients in control group were given Buyang Huanwu decoction，patients in observation group were given Gengsaitong decoction 2，both groups were treated for 2 weeks.The clinical effect，NIHSS score，ADL score，levels of inflammatory factors before and after treatment were compared between the two groups，and the incidence of adverse reactions of the two groups were observed.Results　Compared with control group，observation group had better clinical effect（P ＜ 0.05）.Compared with control group，observation group had lower NIHSS score and levels of CRP，IL-6，TNF-α，and higher ADL score after treatment（P ＜ 0.05）.There was no significant difference in incidence of adverse reactions between the two group（P ＞ 0.05）.Conclusion　Compared with Buyang Huanwu decoction，Gengsaitong decoction 2 has better clinical effect in the treatment of cerebral infarction with Qi-deficiency blood stasis type，which can more effectively improve the neurological function of patients，improve the life ability，reduce inflammatory reaction，promote the ability of daily living，and with high safety.

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