摘要
目的:观察活血醒脑汤联合法舒地尔对脑动脉瘤介入栓塞术后脑血管痉挛(CVS)患者Lindegaard指数及血管内皮功能的影响。方法:选择80例脑动脉瘤介入栓塞术后CVS患者,随机分成对照组和联合组各40例。对照组应用法舒地尔治疗,联合组在对照组基础上联合活血醒脑汤治疗。治疗2周后,比较2组治疗前后神经功能[中国卒中量表评分(CSS)]、意识状态[Glasgow昏迷评分(GCS)]、经颅多普勒超声检测颅内外血流参数[大脑中动脉平均流速(MCA-Vm)、颈内动脉颅外段平均流速(VICA-Vm)、Lindegaard指数]、血管内皮功能指标[血浆内皮素-1 (ET-1)、一氧化氮(NO)]及不良反应发生率。结果:治疗后,2组CSS评分较治疗前降低(P<0.05),GCS评分较治疗前升高(P<0.05);且联合组CSS评分低于对照组(P<0.05),GCS评分高于对照组(P<0.05)。治疗后,2组MCA-Vm、VICA-Vm、Lindegaard指数水平均较治疗前降低(P<0.05),且联合组上述3项指标水平均低于对照组(P<0.05)。治疗后,2组ET-1水平较治疗前降低(P<0.05),NO水平较治疗前升高(P<0.05);且联合组ET-1水平低于对照组(P<0.05),NO水平高于对照组(P<0.05)。联合组不良反应发生率为15.00%,对照组为10.00%,2组比较,差异无统计学意义(P>0.05)。结论:活血醒脑汤联合法舒地尔治疗脑动脉瘤介入栓塞术后CVS患者,可明显减轻血管内皮损伤,有效调节颅内外血流速度,改善患者神经功能及意识状态。
Objective:To observe the effects of Huoxue Xingnao Decoction combined with Fasudil on Lindegaard indexes and vascular endothelial function in patients with cerebral vasospasm(CVS)after interventional embolization of cerebral aneurysms.Methods:A total of 80 cases of patients with CVS after interventional embolization of cerebral aneurysm were randomly divided into the control group and the combination group,with 40 cases in each group.The control group was treated with Fasudil,and the combination group was additionally treated with Huoxue Xingnao Decoction based on the treatment of the control group.After two weeks of treatment,neurological function[Chinese Stroke Scale(CSS)],state of consciousness[Glasgow Coma Scale(GCS)],transcranial Doppler ultrasound detection parameters[mean flow velocity of middle cerebral artery(MCA-Vm),mean flow velocity of extracranial internal carotid artery(VICA-Vm),and Lindegaard indexes],vascular endothelial function indexes[plasma endothelin-1(ET-1)and nitric oxide(NO)]and the incidence of adverse reactions were compared before and after treatment between the two groups.Results:After treatment,CSS scores in the two groups were decreased when compared with those before treatment(P<0.05),and GCS scores were increased when compared with those before treatment(P<0.05);the CSS score in the combination group was lower than that in the control group(P<0.05),and the GCS score was higher than that in the control group(P<0.05).After treatment,MCA-Vm,VICA-Vm and Lindegaard indexes in the two groups were decreased when compared with those before treatment(P<0.05),and the above three indexes in the combination group were lower than those in the control group(P<0.05).After treatment,the ET-1 levels in the two groups were decreased when compared with those before treatment(P<0.05),and the NO levels were increased when compared with those before treatment(P<0.05);the ET-1 level in the combination group was lower than that the in control group(P<0.05),and the NO level was higher than that in the control group before treatment(P<0.05).The incidence of adverse reactions was 15.00%in the combination group and 10.00%in the control group,there being no significant difference between the two groups(P>0.05).Conclusion:Huoxue Xingnao Decoction combined with Fasudil for patients with CVS patients after interventional embolization of cerebral aneurysm can significantly reduce vascular endothelial injury,effectively regulate intracranial and extracranial blood flow velocity,and improve neurological function and state of consciousness.
作者
王燕锋
吕雅飞
盛义平
WANG Yanfeng;LYU Yafei;SHENG Yiping(Department of Neurosurgery,Lishui People's Hospital,Lishui Zhejiang 323000,China)
出处
《新中医》
CAS
2024年第10期140-144,共5页
New Chinese Medicine
