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周胜强,刘芳,邓奕辉,李博,曾楚楚,吴智蓉,王琦,王跃强,刘祖贻.芪仙通络方治疗脑梗死恢复及后遗症期肾虚血瘀证的回顾性研究[J].湖南中医药大学学报英文版,2020,40(10):1283-1289.[Click to copy
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| 芪仙通络方治疗脑梗死恢复及后遗症期肾虚血瘀证的回顾性研究 |
| 周胜强,刘芳,邓奕辉,李博,曾楚楚,吴智蓉,王琦,王跃强,刘祖贻 |
| (湖南省中医药研究院附属医院, 湖南 长沙 410006;湖南中医药大学, 湖南 长沙 410208;湖南中医药大学第一附属医院, 湖南 长沙 410007;湖南省中医药研究院, 湖南 长沙 410006) |
| 摘要: |
| 目的 初步评价国医大师刘祖贻效验方芪仙通络方治疗脑梗死恢复及后遗症期（中风-中经络-肾虚血瘀证）的有效性和安全性。方法 以Robert Lovett法、改良Ashworth分级量表、NIHSS评分、BI评分、中医证候积分作为有效性指标，以血常规、肝肾功能、凝血功能以及不良事件作为安全性指标，对2015年1月至2019年6月在湖南省中医药研究院附属医院就诊的脑梗死恢复及后遗症期（中风-中经络-肾虚血瘀证）患者进行回顾性分析，以芪仙通络方为基本方连续干预3~12个月，观察其对患者肌力、肌张力、神经功能缺损程度、日常生活活动能力、中医临床症状以及安全性的影响。结果 共纳入31例患者进行分析，10例治疗3月接受随访，10例治疗6月接受随访，11例续治疗12月接受随访；与治疗前比较，芪仙通络方持续干预3、6、12个月，脑梗死患者上肢肌力分别增加（1.10±0.32）级、（0.90±0.32）级、（0.82±0.40）级（P<0.01），下肢肌力分别增加（1.10±0.32）级、（1.00±0.47）级、（0.82±0.40）级（P<0.01），上肢与下肢肌张力均分别降低（0.50±0.53）级、（0.80±0.63）级、（0.45±0.52）级（P<0.05），NIHSS评分分别减少（9.93±5.07）分、（11.70±3.53）分、（11.09±3.62）分（P<0.01），BI评分分别增加（30.50±11.41）分、（20.00±9.43）分、（24.09±12.6）分（P<0.01），中医证候积分分别减少（17.20±8.35）分、（16.00±3.37）分、（18.82±4.24）分（P<0.01）；芪仙通络方治疗前后所有患者的血常规、肝肾功能、凝血功能未见显著变化，亦无不良事件发生。结论 芪仙通络方治疗脑梗死恢复及后遗症期（中风-中经络-肾虚血瘀证）安全有效，是非常具有临床潜力的促神经修复中药复方制剂，值得深入研发并进一步转化应用。 |
| 关键词: 芪仙通络方 脑梗死 肾虚血虚证 回顾性研究 |
| DOI：10.3969/j.issn.1674-070X.2020.10.022 |
| Received:July 21, 2020 |
| 基金项目:国家中医药管理局“国医大师刘祖贻传承工作室建设项目”（国中医药办人教发〔2015〕24号）；湖南省教育厅重点项目（18A225）；湖南省教育厅优秀青年项目（18B253）；湖南省中医药研究院院级重点课题（201902）；湖南省研究生科研创新项目（CX20190568）；湖南中医药大学中西医结合一流学科开放基金项目（2018ZXYJH26）。 |
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| Retrospective Study on Qixian Tongluo Formula in the Treatment of Cerebral Infarction Recovery and Sequelae of Kidney Deficiency and Blood Stasis Syndrome |
| ZHOU Shengqiang,LIU Fang,DENG Yihui,LI Bo,ZENG Chuchu,WU Zhirong,WANG Qi,WANG Yueqiang,LIU Zuyi |
| (The Affiliated Hospital of Hunan Academy of Chinese Medicine, Changsha, Hunan 410006, China;Hunan University of Chinese Medicine, Changsha, Hunan 410208, China;The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan 410007, China) |
| Abstract: |
| Objective To preliminarily evaluate the efficacy and safety of National TCM Master LIU Zuyi's empirical formula Qixian Tongluo Formula in the treatment of recovery and sequelae of cerebral infarction (apoplexy involving channels and collaterals-kidney deficiency and blood stasis syndrome). Methods Robert Lovett method, modified Ashworth grading scale, NIHSS score, BI score and TCM syndrome score were used as effective indexes, and blood routine, liver and kidney function, blood coagulation function and adverse events were taken as safety indexes. Patients with recovery and sequelae of cerebral infarction (apoplexy involving channels and collaterals-kidney deficiency and blood stasis syndrome) treated in The Affiliated Hospital of Hunan Academy of Chinese Medicine from January 2015 to June 2019 were analyzed retrospectively. The study used Qixian Tongluo Formula as the basic prescription for continuous intervention for 3 to 12 months. The effects of Qixian Tongluo Formula on muscle strength, muscle tension, degree of neurological impairment, activities of daily living, clinical symptoms of traditional Chinese medicine and safety were observed. Results A total of 31 patients were included for analysis. 10 patients were followed up after 3 months' treatment, 10 patients were followed up after 6 months' treatment, and 11 patients were followed up after 12 months' treatment. Compared with those before treatment, after continuous intervention for 3 months, 6 months and 12 months, the upper limb muscle strength of patients with cerebral infarction increased by (1.10±0.32) grade, (0.90±0.32) grade and (0.82±0.40) grade, respectively (P<0.01). The muscle strength of lower limbs increased by (1.10±0.32) grade, (1.00±0.47) grade and (0.82±0.40) grade, respectively (P<0.01). The muscle tension of upper limb and lower limb decreased by (0.50±0.53) grade, (0.80±0.63) grade, (0.45±0.52) grade, respectively (P<0.05). The NIHSS score decreased (9.93±5.07) score, (11.70±3.53) score, (11.09±3.62) score, respectively (P<0.01). The BI index increased (30.50±11.41) score, (20.00±9.43) score, (24.09±12.6) score, respectively (P<0.01). The TCM syndrome score decreased by (17.20±8.35) score, (16.00±3.37) score and (18.82±4.24) score respectively (P<0.01). There was no significant change in blood routine, liver and kidney function and blood coagulation function of all patients before and after treatment with Qixian Tongluo Formula, and no adverse events occurred. Conclusion Qixian Tongluo Formula is safe and effective in the treatment of recovery and sequelae of cerebral infarction (apoplexy involving channels and collaterals-kidney deficiency and blood stasis syndrome). It may be a compound preparation of Chinese materia medica with great clinical potential to promote nerve repair, which is worthy of further research and development and further application. |
| Key words: Qixian Tongluo Formula cerebral infarction kidney deficiency and blood deficiency syndrome retrospective study |
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