李晓宁 顾乃兵

摘要：目的 探讨养血清脑颗粒辅助西药对脑供血不足患者血栓前状态及内皮细胞功能的影响。方法 将200例脑供血不足患者随机分为观察组及对照组各100例。对照组予盐酸倍他司汀氯化钠注射液20 mg，每日1次，静脉滴注；治疗组在对照组基础上予养血清脑颗粒，每次4 g（首量加倍），每日3次，冲服。2组均连续治疗3个月。观察2组治疗前后血浆纤溶酶原激活物抑制剂-1（PAI-l）、组织纤维溶酶原激活物（t-PA）及内皮依赖性舒张功能（EED）、一氧化氮（NO）、内皮素（ET-1）水平，评价临床疗效。结果 观察组总有效率为85%（85/100），对照组为72%（72/100），观察组明显优于对照组（P<0.05）。与本组治疗前比较，2组PAI-l、ET-l水平明显下降，t-PA、EED、NO水平明显升高，差异有统计学意义（P<0.05）；2组治疗后比较，观察组PAI-l、ET-l水平低于对照组，t-PA、EED、NO水平高于对照组，差异有统计学意义（P<0.05）。PAI-l、ET-l水平降低及t-PA、EED、NO水平升高與患者症状改善密切相关（P<0.05）。结论 养血清脑颗粒辅助西药可改善脑供血不足患者血栓前状态及内皮细胞功能，改善慢性脑供血不足，疗效显著。

关键词：养血清脑颗粒；脑血管供血不足；血栓前状态；内皮功能

DOI：10.3969/j.issn.1005-5304.2018.12.005

中图分类号：R277.73 文献标识码：A 文章编号：1005-5304（2018）12-0015-04

Abstract： Objective To investigate the effects of Yangxue Qingnao Granules combined with Western medicine on prethrombotic state and endothelium in patients with cerebral vascular insufficiency. Methods Totally 200 patients with cerebral vascular insufficiency were randomly divided into observation group and control group， with 100 cases in each group. The control group was given betahistine hydrochloride sodium chloride injection 20 mg， once a day， intravenous drip. The observation group was given Yangxue Qingnao Granules on the basis of the control group， 4 g each time （doubling the amount for the first time）， three times a day， take after mixing it with water. The treatment for both groups lasted for three months. Plasma plasminogen activator inhibitor-1 （PAI-1）， tissue plasminogen activator （t-PA） and endothelium-dependent dilation （EED）， nitric oxide （NO） and endothelin （ET-1） were observed before and after treatment， and clinical efficacy was evaluated. Results The total effective rate was 85% （85/100） in the observation group and 72% （72/100） in the control group. The observation group was significantly better than the control group （P<0.05）. Compared with before treatment， the levels of PAI-l and ET-1 decreased significantly， and the levels of t-PA， EED and NO increased significantly， with statistical significance （P<0.05）. After treatment， the levels of PAI-l and ET-1 in the observation group were lower than those in the control group， and the levels of t-PA， EED and NO were higher than those in the control group， with statistical significance （P<0.05）. The levels of PAI-l and ET-1 decreased， and the levels of t-PA， EED and NO increased， which were closely related to the improvement of patients' symptoms （P<0.05）. Conclusion Yangxue Qingnao Granules combined with Western medicine can improve prethrombotic state and endothelial cell function in patients with cerebral vascular insufficiency， improve chronic cerebral blood supply insufficiency， and has remarkable curative effect.

Keywords： Yangxue Qingnao Granules； cerebral vascular insufficiency； prethrombotic state； endothelial function

脑供血不足由大脑血流量下降引起，常见头痛、头晕及记忆力下降。若未及时治疗可能会引起血管性痴呆，严重威胁老年人的身体健康[1-2]。研究发现，脑供血主要与内皮功能及血栓前状态密切相关[3-4]。本研究采用养血清脑颗粒辅助西药治疗脑供血不足，观察患者血栓前状态及内皮细胞功能，现报道如下。

1 资料与方法

1.1 一般资料

选取2015年12月-2017年12月陕西省核工业二一五医院脑供血不足患者200例，均符合《现代实用脑血管病学》[5]诊断标准。采用随机数字表法分为观察组及对照组各100例。观察组男性58例，女性42例；对照组男性53例，对照组47例。2组年龄、病程、体质量指数（BMI）比较差异无统计学意义（P>0.05），具有可比性。见表1。本研究经陕西省核工业二一五医院伦理委员会审核批准（201604-001）。……