星蒌承气汤联合常规西医治疗对急性脑梗死合并卒中相关性肺炎痰热腑实证患者的临床疗效及对炎症因子与脑肠肽的影响

Clinical Efficacy of Xinglou Chengqi Decoction Combined with Conventional Western Medicine Therapy in Patients with Acute Ischemic Stroke Complicated with Stroke-Associated Pneumonia of Phlegm-Heat Fu-Excess Syndrome, and Its Effects on Inflammatory Factors and Brain-Gut Peptides

摘要

目的 探讨星蒌承气汤联合常规西医治疗对急性脑梗死（acute ischemic stroke，AIS）合并卒中相关性肺炎（stroke-associated pneumonia，SAP）痰热腑实证患者的临床疗效及对炎症因子与脑肠肽的影响。方法 以随机数字表法将2024年1月至2025年5月在常州市中医医院诊治的150例AIS合并SAP痰热腑实证患者分为对照组（接受常规西医治疗）和观察组（接受星蒌承气汤联合常规西医治疗），各75例，均持续治疗10 d。比较2组治疗10 d后的临床疗效、临床症状缓解时间，治疗前和治疗3、10 d后的炎症因子水平、脑肠肽水平、临床评分，以及治疗期间的不良反应发生情况。结果 与对照组相比，观察组的总有效率显著提升，临床症状缓解时间明显缩短（P< 0.05）；治疗3、10 d后，观察组的炎症因子水平及临床评分显著降低，脑肠肽水平明显升高（ P< 0.05）。2组的不良反应发生率差异无统计学意义（ P> 0.05）。结论 星蒌承气汤联合常规西医治疗可显著提升AIS合并SAP痰热腑实证患者临床疗效，缩短症状缓解时间，改善炎症因子与脑肠肽水平，且不良反应少，临床应用安全可靠。

Abstract

Objective To investigate the clinical efficacy of Xinglou Chengqi Decoction combined with conventional Western medicine therapy in patients with acute ischemic stroke (AIS) complicated with stroke-associated pneumonia (SAP) of phlegm-heat fu-excess syndrome, and its effects on inflammatory factors and brain-gut peptides. Methods A total of 150 patients with AIS complicated with SAP of phlegm-heat fu-excess syndrome admitted and treated at Changzhou Traditional Chinese Medicine Hospital from January 2024 to May 2025 were divided into a control group (conventional Western medicine therapy) and an observation group (conventional Western medicine therapy plus Xinglou Chengqi Decoction) by random number table, with 75 cases in each group, and all patients were treated continuously for 10 days. The two groups were compared in terms of clinical efficacy on day 10 of treatment, time to clinical symptom resolution, levels of inflammatory factors, brain-gut peptides and clinical scores before treatment and on days 3 and 10 after treatment; as well as incidence of adverse reactions during treatment.Results Compared with the control group, the observation group demonstrated a significantly higher total effective rate and shorter time to clinical symptom resolution (P< 0.05). On days 3 and 10 after treatment, the observation group showed significant reductions in the levels of inflammatory factors and clinical scores, along with notable increases in brain-gut peptides levels ( P< 0.05). There was no statistically significant difference in the incidence of adverse reaction between the two groups ( P> 0.05). Conclusion Xinglou Chengqi Decoction combined with conventional Western medicine therapy can improve the clinical efficacy in patients with AIS complicated with SAP of phlegm-heat fu-excess syndrome, regulate the levels of inflammatory factors and brain-gut peptides, and shorten time to clinical symptom resolution. This combined regimen has few adverse reactions and is safe and reliable for clinical application.

关键词

星蒌承气汤 / 急性脑梗死 / 卒中相关性肺炎 / 痰热腑实证

Key words

Xinglou Chengqi Decoction / acute ischemic stroke / stroke-associated pneumonia / phlegm-heat fu-excess syndrome

参考文献

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基金资助

2022年度常州市卫健委科技项目(QN202236)