2025 年第 12 期 第 20 卷

逐瘀活血汤联合丁苯酞治疗老年脑梗死恢复期的临床研究

Clinical study of Zhuyu Huoxue decoction combined with butylphthalide in the treatment of elderly patients with cerebral infarction in recovery period

作者：王丽萍1魏雅丽2常顺2高艺1

英文作者：Wang Liping1 Wei Yali2 Chang Shun2 Gao Yi1

单位：1复旦大学附属华东医院老年科，上海200040；2上海市静安区曹家渡街道社区卫生服务中心，上海200040

英文单位：1Department of Geriatrics Huadong Hospital affiliated to Fudan University Shanghai 200040 China; 2Caojiadu Community Health Service Center Jing′an district Shanghai Shanghai 200040 China

关键词：脑梗死恢复期；丁苯酞；逐瘀活血汤；证候积分；血液流变性；神经功能

英文关键词：Therecoveryperiodofcerebralinfarction;Butylphthalide;ZhuyuHuoxuedecoction;Syndromescore;Hemorheology;Nervefunction

• 摘要：

• 目的 探讨逐瘀活血汤联合丁苯酞治疗老年脑梗死恢复期的效果。方法 选取2023年3月至2025年2月复旦大学附属华东医院收治的120例老年脑梗死恢复期患者为研究对象，按随机数字表法分成观察组和对照组，各60例。对照组在常规治疗基础上联合丁苯酞治疗；观察组在对照组基础上加用逐瘀活血汤加减治疗，2组均治疗1个月。比较2组临床疗效、中医证候积分、血液流变学指标、脑损伤标志物、日常生活自理能力、生活质量及治疗期间不良反应发生情况。结果 治疗1个月时，观察组临床疗效优于对照组（P＜0.05）。观察组中医主症、次症以及总证候积分均低于对照组（P＜0.05）。治疗后，2组血浆黏度、血细胞比容水平均较治疗前降低，且观察组低于对照组（均P＜0.05）；治疗后，2组血清神经元特异性烯醇化酶水平低于治疗前，脑源性神经营养因子水平高于治疗前，且观察组两指标改善均优于对照组（均P＜0.05）。治疗后，2组改良Barthel指数评分、脑卒中专用生存质量量表评分高于治疗前，且观察组均高于对照组［（79±8）分比（71±10）分、（163±22）分比（150±20）分］（均P＜0.05）。2组不良反应总发生率比较差异无统计学意义（P＞0.05）。结论 逐瘀活血汤联合丁苯酞软胶囊治疗老年脑梗死恢复期，可提高临床疗效，进一步改善患者临床症状，更有效改善血液流变性和神经功能，提高患者日常生活自理能力以及生活质量，且安全性较好。

• Objective To investigate the effect of Zhuyu Huoxue decoction combined with butylphthalide in the treatment of elderly patients with cerebral infarction in the recovery period. Methods A total of 120 elderly patients with cerebral infarction in recovery period admitted to Huadong Hospital Affiliated to Fudan University from March 2023 to February 2025 were selected as the research objects. According to the random number table method, they were divided into the observation group and the control group, with 60 cases in each group. The control group was treated with butylphthalide on the basis of conventional treatment. The observation group was treated with Zhuyu Huoxue decoction on the basis of the control group. Both groups were treated for 1 month. The clinical efficacy, traditional Chinese medicine syndrome scores, hemorheology indexes, brain injury markers, self-care ability of daily life, quality of life, and adverse reactions during treatment were compared between the two groups. Results After 1 month of treatment, the clinical efficacy of the observation group was better than that of the control group (P＜0.05). The scores of traditional Chinese medicine main symptom score, secondary symptoms and total syndrome in the observation group were lower than those in the control group (all P＜0.05). After treatment, the plasma viscosity and hematocrit of the two groups were lower than those before treatment, and those of the observation group was lower than those of the control group (all P＜0.05). After treatment, the levels of serum neuron-specific enolase in the two groups were lower than those before treatment, and the levels of brain-derived neurotrophic factor were higher than those before treatment, and the improvement of the two indexes in the observation group was better than that in the control group (all P＜0.05). After treatment, the modified Barthel index scores and stroke specific quality of life scale scores of the two groups were higher than those before treatment, and those of the observation group were higher than those of the control group ［(79±8) vs (71±10), (163±22) vs (150±20)］(all P＜0.05). There was no significant difference in the total incidence of adverse reactions between the two groups (P＞0.05). Conclusion Zhuyu Huoxue decoction combined with butylphthalide soft capsule in the treatment of elderly patients with cerebral infarction in the recovery period can improve the clinical efficacy, further improve the clinical symptoms of patients, more effectively improve hemorheology and nerve function, improve the self-care ability of daily life and quality of life of patients, and has good safety.