醒神益气汤联合丁苯酞治疗对脑梗死急性期患者S100β、CRP及神经功能的影响(1)
〔摘要〕 目的 探讨醒神益气汤联合丁苯酞治疗对脑梗死急性期患者S100β、C反应蛋白(CRP)及神经功能的影响。方法 选择本院2016年1月至2017年6月收治的82例急性脑梗死患者，分为对照组和实验组，每组41例。对照组予以丁苯酞治疗，实验组在对照组基础上加以醒神益气汤治疗。观察比较两组患者的临床疗效、S100β、CRP、美国国立卫生研究院卒中量表(NIHSS)及不良反应发生情况。结果 实验组总有效率高于对照组，差异有统计学意义(P<0.05)；治疗后，两组S100β、CRP、NIHSS均较治疗前下降，且实验组低于对照组，差异有统计学意义(P<0.05)；两组均有皮疹、胃肠道不适、恶心发生，组间不良反应发生率比较差异无统计学意义(P>0.05)。结论 醒神益气汤联合丁苯酞对脑梗死急性期患者的临床疗效优于单纯丁苯酞治疗，可恢复血脑屏障功能，抑制S100β及CRP表达，改善神经功能。
〔关键词〕 脑梗死；急性期；醒神益气汤；丁苯酞；S100β；C反应蛋白；神经功能
〔中图分类号〕R743.3；R28 〔文献标志码〕B 〔文章编号〕doi：10.3969/j.issn.1674-070X.2018.08.018
〔Abstract〕 Objective To investigate the impact of Xingshen Yiqi Decoction combined with butylphthalide on S100β， C-reactive protein (CRP)， and neurological function in patients with acute cerebral infarction. Methods A total of 82 patients with acute cerebral infarction who were admitted to our hospital from January 2016 to June 2017 were enrolled and equally divided into control group and experimental group. Both groups were treated with butylphthalide， while the experimental group received Xingshen Yiqi Decoction in addition. Then clinical outcomes， S100β， CRP， National Institutes of Health Stroke Scale (NIHSS) score， and adverse reactions were compared between the two groups. Results The experimental group had a significantly higher overall response rate than the control group (P<0.05). After treatment， the levels of S100β and CRP， and NIHSS score reduced significantly in both groups； the experimental group had significantly lower levels of S100β and CRP， and NIHSS score than the control group (P<0.05). Rashes， gastrointestinal discomfort， and nausea were observed in both groups. However， there were no significant differences in the incidence rates of adverse reactions between the two groups (P>0.05). Conclusion The clinical efficacy of Xingshen Yiqi Decoction combined with butylphthalide is superior to that of butylphthalide alone in the treatment of acute cerebral infarction. The combination therapy can restore the function of the blood-brain barrier， inhibit the expression of S100β and CRP， and improve neurological function.
〔Keywords〕 cerebral infarction； acute stage； Xingshen Yiqi Decoction； butylphthalide； S100β； C-reactive protein； neurological function
腦梗死为常见心脑血管疾病，是因脑组织局部血液循环骤然障碍，产生缺血、缺氧的软化性坏死所致，存在较高的发病率及病死率，可出现失语、头晕等神经症状[1]。国外研究发现[2]，脑梗死后患者神经损伤修复的机制较为复杂，和间接损伤有着密切的联系，S100β、C反应蛋白(c-reactive protein，CRP)能够诱导局部组织的炎症反应，参与神经病变，通过测定其浓度改变可评估疾病转归。丁苯酚为脑梗死急性期的常用药物，其对脑血流灌注有显著改善作用，促进神经功能的修复，但单用疗效并不理想[3]。近年来中医药于心脑血管疾病中的效果已得到临床证实[4]，醒神益气汤可开窍醒神、益气升清。临床鲜有关于二者联合应用的报道，本研究旨在探讨醒神益气汤联合丁苯酞治疗脑梗死急性期患者对S100β、CRP及神经功能的影响，现将结果报道如下。, 百拇医药(朱岩 刘涛 辛颖 穆晓东)
〔关键词〕 脑梗死；急性期；醒神益气汤；丁苯酞；S100β；C反应蛋白；神经功能
〔中图分类号〕R743.3；R28 〔文献标志码〕B 〔文章编号〕doi：10.3969/j.issn.1674-070X.2018.08.018
〔Abstract〕 Objective To investigate the impact of Xingshen Yiqi Decoction combined with butylphthalide on S100β， C-reactive protein (CRP)， and neurological function in patients with acute cerebral infarction. Methods A total of 82 patients with acute cerebral infarction who were admitted to our hospital from January 2016 to June 2017 were enrolled and equally divided into control group and experimental group. Both groups were treated with butylphthalide， while the experimental group received Xingshen Yiqi Decoction in addition. Then clinical outcomes， S100β， CRP， National Institutes of Health Stroke Scale (NIHSS) score， and adverse reactions were compared between the two groups. Results The experimental group had a significantly higher overall response rate than the control group (P<0.05). After treatment， the levels of S100β and CRP， and NIHSS score reduced significantly in both groups； the experimental group had significantly lower levels of S100β and CRP， and NIHSS score than the control group (P<0.05). Rashes， gastrointestinal discomfort， and nausea were observed in both groups. However， there were no significant differences in the incidence rates of adverse reactions between the two groups (P>0.05). Conclusion The clinical efficacy of Xingshen Yiqi Decoction combined with butylphthalide is superior to that of butylphthalide alone in the treatment of acute cerebral infarction. The combination therapy can restore the function of the blood-brain barrier， inhibit the expression of S100β and CRP， and improve neurological function.
〔Keywords〕 cerebral infarction； acute stage； Xingshen Yiqi Decoction； butylphthalide； S100β； C-reactive protein； neurological function
腦梗死为常见心脑血管疾病，是因脑组织局部血液循环骤然障碍，产生缺血、缺氧的软化性坏死所致，存在较高的发病率及病死率，可出现失语、头晕等神经症状[1]。国外研究发现[2]，脑梗死后患者神经损伤修复的机制较为复杂，和间接损伤有着密切的联系，S100β、C反应蛋白(c-reactive protein，CRP)能够诱导局部组织的炎症反应，参与神经病变，通过测定其浓度改变可评估疾病转归。丁苯酚为脑梗死急性期的常用药物，其对脑血流灌注有显著改善作用，促进神经功能的修复，但单用疗效并不理想[3]。近年来中医药于心脑血管疾病中的效果已得到临床证实[4]，醒神益气汤可开窍醒神、益气升清。临床鲜有关于二者联合应用的报道，本研究旨在探讨醒神益气汤联合丁苯酞治疗脑梗死急性期患者对S100β、CRP及神经功能的影响，现将结果报道如下。, 百拇医药(朱岩 刘涛 辛颖 穆晓东)