1.上海中医药大学附属市中医医院脑病科(上海 200071)
2.上海市静安区北站医院神经内科(上海 200071)
3.上海市静安区中医医院脑病科(上海 200072)
4.上海市嘉定区中医医院脑病科(上海 201800)
5.上海市奉贤区中医医院脑病科(上海 201499)
6.上海市普陀区中医医院脑病科(上海 200062)
7.上海市静安区闸北中心医院中医科(上海 200070)
张华廷,男,硕士,住院医师,主要从事中医药治疗脑血管疾病的临床研究
李文涛,主任医师,教授,博士生导师;E-mail: lwt1132@163.com
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张华廷,赵彪绩,胡佳利等.神经复原方预防轻型缺血性卒中复发的多中心随机双盲对照研究[J].上海中医药大学学报,2022,36(05):17-21.
ZHANG Huating,ZHAO Biaoji,HU Jiali,et al.A multi⁃center, randomized, double⁃blind, controlled study on Shenjing Fuyuan Formula in prevention of minor ischemic stroke recurrence[J].Academic Journal of Shanghai University of Traditional Chinese Medicine,2022,36(05):17-21.
张华廷,赵彪绩,胡佳利等.神经复原方预防轻型缺血性卒中复发的多中心随机双盲对照研究[J].上海中医药大学学报,2022,36(05):17-21. DOI: 10.16306/j.1008-861x.2022.05.004.
ZHANG Huating,ZHAO Biaoji,HU Jiali,et al.A multi⁃center, randomized, double⁃blind, controlled study on Shenjing Fuyuan Formula in prevention of minor ischemic stroke recurrence[J].Academic Journal of Shanghai University of Traditional Chinese Medicine,2022,36(05):17-21. DOI: 10.16306/j.1008-861x.2022.05.004.
目的,2,观察神经复原方预防轻型缺血性卒中(IS)复发的临床疗效。,方法,2,采用多中心、随机、双盲、安慰剂对照的研究方法,纳入气阴不足、痰瘀阻滞型轻型IS患者180例,随机分为治疗组和对照组,每组各90例。两组患者均给予西医常规治疗,在此基础上,治疗组患者给予神经复原方颗粒剂口服,对照组患者给予神经复原方颗粒安慰剂口服,两组治疗周期均为270 d。治疗90、180、270 d后,记录IS、短暂脑缺血发作(TIA)及其他缺血性疾病(包括心肌梗死、急性冠脉综合征等)的发生情况,统计并比较两组患者的IS复发率、TIA发生率等。,结果,2,研究过程中,治疗组10例患者、对照组10例患者剔除或脱落,最终纳入统计分析者治疗组80例、对照组80例。①治疗90、180、270 d后,治疗组患者的IS复发率分别为3.75%、3.75%、5.00%,对照组患者的IS复发率分别为2.50%、13.75%、16.25%,治疗180、270 d后治疗组患者的IS复发率明显低于对照组(,P,<,0.05);②治疗90、180、270 d后,治疗组患者的TIA发生率分别为5.00%、6.25%、6.25%,对照组患者的TIA发生率分别为6.25%、16.25%、17.50%,治疗180、270 d后治疗组患者的TIA发生率明显低于对照组(,P,<,0.05);③治疗过程中,对照组2例患者发生新发急性心肌缺血,治疗组无其他缺血性疾病发生;④治疗90、180、270 d后,治疗组患者的总体缺血性事件发生率分别为8.75%、10.00%、11.25%,对照组患者的总体缺血性事件发生率分别为10.00%、28.75%、31.25%,治疗180、270 d后治疗组患者的总体缺血性事件发生率明显低于对照组(,P,<,0.05)。,结论,2,神经复原方能够有效预防轻型IS复发及TIA发生,降低总体缺血性事件的发生率,且随着治疗时间延长,治疗效果更明显。
Objective: To observe the clinical effect of Shenjing Fuyuan Formula in preventing the recurrence of minor ischemic stroke (IS).,Methods,2,A multi-center, randomized, double-blind, controlled study was applied. A total of 180 patients of minor IS with Qi-yin deficiency and phlegm-stasis stagnation type were included, and randomly divided into the treatment group and control group, 90 cases in each group. The patients in the two groups were treated with conventional western medicine. Based on above, the patients in the treatment group were orally treated with Shenjing Fuyuan Formula granules, and the patients in the control group were orally treated with Shenjing Fuyuan Formula granule placebo, with a course of 270 d. After 90, 180 and 270 d of treatment, the occurrences of IS, transient ischemic attack (TIA) and other ischemic events (including myocardial infarction, acute coronary syndrome and so on) were recorded, and the recurrence rate of IS, the incidence of TIA and so on were calculated and compared in the two groups.,Results,2,In the course of study, 10 patients in the treatment group and 10 patients in the control group were eliminated and shed off, finally 80 patients in the treatment group and 80 patients in the control group were included in the statistical analysis. ①After 90, 180 and 270 d of treatment, the recurrence rates of IS in the treatment group were 3.75%, 3.75% and 5.00% respectively, and the recurrence rates of IS in the control group were 2.50%, 13.75% and 16.25% respectively. After 180 and 270 d of treatment, the recurrence rates of IS in the treatment group were significantly lower than those in the control group (,P,<,0.05). ②After 90, 180 and 270 d of treatment, the incidences of TIA in the treatment group were 5.00%, 6.25% and 6.25% respectively, and the incidences of TIA in the control group were 6.25%, 16.25% and 17.50% respectively. After 180 and 270 d of treatment, the incidences of TIA in the treatment group were significantly lower than those in the control group (,P,<,0.05). ③In the course of treatment, new-onset acute myocardial ischemia occurred in 2 patients in the control group and no other ischemic diseases occurred in the treatment group. ④After 90, 180 and 270 d of treatment, the incidences of total ischemic events in the treatment group were 8.75%, 10.00% and 11.25% respectively, and the incidences of total ischemic events in the control group were 10.00%, 28.75% and 31.25% respectively. After 180 and 270 d of treatment, the incidences of total ischemic events in the treatment group were significantly lower than those in the control group (,P,<,0.05).,Conclusion,2,Shenjing Fuyuan Formula can effectively prevent the recurrence of minor IS and the occurrence of TIA, reduce the incidence of total ischemic events, and the effect becomes more obvious with the prolongation of the treatment time.
缺血性卒中神经复原方二级预防
ischemic strokeShenjing Fuyuan Formulasecondary prevention
KRISHNAMURTHI R V, IKEDA T, FEIGIN V L. Global, Regional and Country-Specific Burden of Ischaemic Stroke, Intracerebral Haemorrhage and Subarachnoid Haemorrhage: A Systematic Analysis of the Global Burden of Disease Study 2017[J]. Neuroepidemiology, 2020, 54(2): 171-179.
GAM A, GAR B, FUSTER C V. The Global Burden of Cardiovascular Diseases and Risk Factors[J]. J Am Coll Cardiol, 2019, 74(20): 2529-2532.
COULL A J, LOVETT J K, ROTHWELL P M, et al. Population based study of early risk of stroke after transient ischaemic attack or minor stroke: implications for public education and organisation of services[J]. BMJ, 2004, 328(7435): 326.
《中国脑卒中防治报告2020》编写组,王陇德. 《中国脑卒中防治报告2020》概要[J]. 中国脑血管病杂志, 2022, 19(2): 136-144.
JU Y, ZHAO X Q , WANG C X , et al. Neurological deterioration in the acute phase of minor ischemic stroke is an independent predictor of poor outcomes at 1 year: results from the China National Stroke Registry (CNSR)[J]. Chin Med J (Engl), 2013, 126(18): 3411-3416.
陆小青,王炜为. 神经复原方联合阿司匹林预防缺血性脑卒中复发的临床研究[J]. 中西医结合心脑血管病杂志, 2014, 12(10): 1173-1175.
中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组. 中国急性缺血性脑卒中诊治指南2018[J]. 中华神经科杂志, 2018, 51(9): 666-682.
王伊龙,赵性泉,刘新峰,等. 高危非致残性缺血性脑血管事件诊疗指南[J]. 中国卒中杂志, 2016, 11(6): 481-491.
郑筱萸. 中药新药临床研究指导原则(试行)[M]. 北京: 中国医药科技出版社, 2002.
吴勉华,王新月. 中医内科学[M]. 9版. 北京: 中国中医药出版社, 2018.
LIN J, ZHENG H, CUCCHIARA B L, et al. Association of Lp-PLA2-A and early recurrence of vascular events after TIA and minor stroke[J]. Neurology, 2015, 85(18): 1585-1591.
AKOUDAD S, SEDAGHAT S, HOFMAN A, et al. Kidney function and cerebral small vessel disease in the general population[J]. Int J Stroke, 2015, 10(4): 603-608.
BOEHME A K, MCCLURE L A, ZHANG Y, et al. Inflammatory Markers and Outcomes After Lacunar Stroke: Levels of Inflammatory Markers in Treatment of Stroke Study[J]. Stroke, 2016, 47(3): 659-667.
周杰,张阳,郭毅佳, 等. 基于TOAST和ASCO分型的轻型卒中病因学分型研究[J]. 四川大学学报(医学版), 2017, 48(3): 493-496.
张微微. 脑小血管病的新进展[J]. 中华脑血管病杂志(电子版), 2008, 2(4): 272-277.
CRAGGS L J, YAMAMOTO Y, DERAMECOURT V, et al. Microvascular pathology and morphometrics of sporadic and hereditary small vessel diseases of the brain[J]. Brain Pathol, 2014, 24(5):495-509.
SPS3 STUDY GROUP, BENAVENTE O R, COFFEY C S, et al. Blood-pressure targets in patients with recent lacunar stroke: the SPS3 randomised trial[J]. Lancet, 2013, 382(9891): 507-515.
GOLDSTEIN L B, AMARENCO P, SZAREK M, et al. Hemorrhagic stroke in the Stroke Prevention by Aggressive Reduction in Cholesterol Levels study[J]. Neurology, 2008, 70(24 Pt 2): 2364-2370.
王拥军. 非致残性缺血性脑血管事件的诊断和治疗[J]. 临床药物治疗杂志, 2019, 17(1): 41-46.
陈慧亭,崔应麟. 益气活血通络法在缺血性中风二级预防中的应用[J]. 中国民族民间医药, 2018, 27(11): 4-5.
党翠娇,蔡定芳,俞晓飞. 缺血性脑卒中内科二级预防现状[J]. 中西医结合心脑血管病杂志, 2017, 15(21): 2706-2709.
张永刚,魏春霞. 补阳还五汤联合二级预防在降低缺血性脑卒中复发率中的效果观察[J]. 青海医药杂志, 2016, 46(4): 66-67.
刘毅,赵虹. 缺血性中风从毒论治[J]. 湖北中医杂志, 2001, 23(1): 15-16.
祁建国,张燕,张彪,等. 缺血性中风不同时期中医证候演变规律分析[J]. 河南中医, 2016, 36(1): 69-72.
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