天麻钩藤饮联合醒脑开窍针刺法对急性脑梗死患者血管内皮功能、脑血管储备功能及CD62P、CD63表达的影响

摘要 目的：探讨天麻钩藤饮联合醒脑开窍针刺法辅助治疗对急性脑梗死患者血管内皮功能、脑血管储备功能及血小板表面-颗粒膜糖蛋白（CD62P）、溶酶体膜糖蛋白（CD63）表达的影响。方法：选择2017年1月至2019年12月收治的急性脑梗死患者80例，依照随机数字表法分为对照组（40例，予以常规治疗）和观察组（40例，常规治疗的基础上给予天麻钩藤饮联合醒脑开窍针刺法辅助治疗），比较两组临床有效率及治疗前后的美国国立卫生研究院卒中量表（NIHSS）评分、长谷川智能量表（HDS）评分、Barthel指数、血管内皮功能指标（包括一氧化氮（NO）、内皮素-1（ET-1））、脑血管储备功能指标脑血管储备功能（CVR）、脉动指数（PI）]及血小板CD62P、CD63水平。结果：观察组的临床总有效率为92.50%（37/40），对照组的临床总有效率为70.00%（28/40），2组比较差异有统计学意义（P<0.05）。观察组NIHSS评分明显低于对照组，HDS评分和Barthel指数均明显高于对照组（P<0.05）。观察组治疗后血清NO、CVR水平水平明显高于对照组，血清ET-1、PI及血小板CD62P、CD63表达水平均明显低于对照组（P<0.05）。结论：在常规治疗的基础上，天麻钩藤饮联合醒脑开窍针刺法辅助治疗急性脑梗死的临床疗效显著，能够明显改善血管内皮功能、脑血管储备功能、神经功能，提高生活质量，改善血小板CD62P、CD63表达。

Effects of Tianma Gouteng Decoction Combined with Xingnao Kaiqiao Needling on Vascular Endothelial Function, Cerebrovascular Reserve Function and Expression of CD62P and CD63 in Patients with Acute Cerebral Infarction

ABSTRACT Objective: To explore the effect of tianma gouteng decoction combined with xingnao kaiqiao needling as auxiliary on vascular endothelial function, cerebrovascular reserve function and alpha-granular membrane protein (CD62P), lysosome intact membrane protein (CD63) of patients with acute cerebral infarction. Methods: 80 cases of patients with acute cerebral infarction in our hospital from 2017 January to December 2019 were selected. According to the random indicator method, they were divided into the control group (n=40, treated with conventional treatment) and the observation group (n=40, treated with tianma gouteng decoction combined with xingnao kaiqiao needling as auxiliary on the basis of conventional treatment). The clinical efficient, United States national institutes of health stroke scale (NIHSS) score, hasegawa intelligence scale (HDS) score, Barthel index, endothelial function indexes including nitric oxide (NO), endothelin 1 (ET-1)], cerebrovascular reserve function indexes cerebrovascular reserve (CVR), pulse index (PI)] and the levels of platelet CD62P and CD63 of two groups before and after treatment were compared. Results: Total effective rate of observation group was 92.50% (37/40), which was significantly higher than the control group 70.00% (28/40)], and the difference was statistically significant (P<0.05). NIHSS score of the observation group after treatment was significantly lower than that in the control group, while HDS score and Barthel index were significantly higher than that in the control group (P<0.05). The levels of serum NO and CVR after treatment in the observation group were significantly higher than those in the control group, and the expression levels of serum ET-1, PI and platelet CD62P and CD63 were significantly lower than those in the control group(P<0.05). Conclusion: On the basis of conventional treatment, tianma gouteng decoction combined with xingnao kaiqiao needling as auxiliary has a significant clinical effect in the treatment of acute cerebral infarction, which can significantly improve vascular endothelial function, cerebrovascular reserve function and nerve function, improve the quality of life, and improve the expression of platelet CD62P and CD63.