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目的:观察大补阴丸联合低分子肝素钠治疗脑梗死恢复期阴虚火旺证患者的临床疗效以及对血清白细胞介素-6(IL-6)和基质金属蛋白酶-9(MMP-9)的影响。方法:将98例脑梗死恢复期阴虚火旺证患者随机分为对照组和观察组各49例,2组患者均给予常规基础治疗,对照组给予低分子肝素钠皮下注射,观察组在对照组用药基础上给予大补阴丸治疗,2组疗程均为4周。比较2组中医临床症状评分、神经功能缺损评分、肢体运动功能评分以及血清IL-6、MMP-9水平。结果:总有效率观察组为89.80%,对照组为71.43%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组各项中医症状评分均较治疗前下降(P<0.01);观察组各项评分均低于对照组(P<0.01)。2组CSS评分均较治疗前下降(P<0.01),而上、下肢FMMS评分均较治疗前升高(P<0.01);观察组CSS评分低于对照组(P<0.01),上、下肢FMMS评分均高于对照组(P<0.01)。2组血清IL-6和MMP-9水平均较治疗前下降(P<0.01);观察组血清IL-6和MMP-9水平均低于对照组(P<0.01)。结论:采用大补阴丸联合低分子肝素钠治疗脑梗死恢复期阴虚火旺证患者,可明显改善患者的临床症状和神经功能缺损,提高肢体运动能力。下调血清IL-6和MMP-9水平可能与上述治疗作用相关。
Objective: To observe the clinical efficacy of Dabuyin Pills combined with low-molecular-weight heparin in the treatment of patients with Yin-Huo-Huo-Zheng during the recovery period of cerebral infarction and the effect on the serum levels of interleukin-6 (IL-6) and matrix metalloproteinase-9 influences. Methods: Ninety-nine patients with Yin Deficiency Syndrome during the recovery period of cerebral infarction were randomly divided into control group and observation group (n = 49). The two groups were given routine basic treatment. The control group was injected subcutaneously with low molecular weight heparin sodium. Dabuyin Pill was given on the basis of medication, and the two courses of treatment were 4 weeks. The clinical symptom score, neurological deficit score, limb motor function score and serum IL-6, MMP-9 levels were compared between the two groups. Results: The total effective rate was 89.80% in the observation group and 71.43% in the control group. There was significant difference between the two groups (P <0.05). After treatment, the scores of TCM symptoms in both groups were significantly lower than those before treatment (P <0.01). The score in the observation group was lower than that in the control group (P <0.01). The CSS scores of the two groups were significantly lower than those before treatment (P <0.01), while the FMMS scores of both upper and lower limbs were higher than those before treatment (P <0.01). The CSS scores in the observation group were lower than those in the control group (P <0.01) FMMS scores were higher than the control group (P <0.01). The levels of serum IL-6 and MMP-9 in the two groups were lower than those before treatment (P <0.01). The levels of IL-6 and MMP-9 in the two groups were lower than those in the control group (P <0.01). Conclusion: Dafuyin Pill combined with low molecular weight heparin sodium in patients with recovery of cerebral infarction yin deficiency syndrome can significantly improve the patient’s clinical symptoms and neurological deficits, improve physical activity. Down-regulation of serum IL-6 and MMP-9 levels may be related to the above therapeutic effect.