中华中医药学刊

叶酸、维生素B12联合黄芪生脉饮对急性脑梗死Hcy、CRP、神经功能及凝血功能的影响

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鲍正超 , 董兴红 , 方国华

中华中医药学刊 | 省级项目平台 2026,44(1): 224-228

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中华中医药学刊 |省级项目平台 2026 , 44 (1) : 224 -228

叶酸、维生素B12联合黄芪生脉饮对急性脑梗死Hcy、CRP、神经功能及凝血功能的影响

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鲍正超, 董兴红, 方国华

作者信息

浙江中医药大学附属江南医院，浙江杭州 311201

Effects of Folic Acid And Vitamin B12 Combined with Huangqi Shengmai Decoction（黄芪生脉饮）on Hcy，CRP，Nerve Function and Coagulation Function in Patients with Acute Cerebral Infarction

Zhengchao BAO, Xinghong DONG, Guohua FANG

Affiliations

Jiangnan Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou 311201, Zhejiang, China

出版时间: 2026-01-10 doi: 10.13193/j.issn.1673-7717.2026.01.043

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摘要

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目的

分析叶酸、维生素B12联合黄芪生脉饮对急性脑梗死（ACI）患者同型半胱氨酸（Hcy）、C反应蛋白（CRP）、神经功能、血管内皮功能及凝血功能的影响。

方法

选取医院2018年1月—2022年1月收治的113例ACI患者，按数字随机表法将患者分为两组，其中对照组48例采用常规疗法+叶酸联合维生素B12治疗，观察组65例在对照组基础上联合黄芪生脉饮治疗。统计分析两组治疗前后Hcy、CRP、美国国立卫生研究院卒中量表（NIHSS）评分、日常生活活动能力Barthel指数评分、血管内皮功能指标［一氧化氮（NO）、内皮素-1（ET-1）、血管内皮生长因子（VEGF）］、脑血流灌注水平、血管内皮功能。

结果

两组治疗后血清Hcy及CRP水平均显著下降（P<0.001），观察组治疗后血清Hcy及CRP水平显著低于对照组，相比差异有显著统计学意义（P<0.01）；两组治疗后NIHSS评分显著降低（P<0.001），Barthel指数评分均显著升高（P<0.001），观察组与对照组治疗后NIHSS评分及Barthel指数评分相比差异有显著统计学意义（P<0.01）；两组治疗后NO水平显著升高（P<0.001），ET-1及VEGF水平显著降低（P<0.001），观察组与对照组治疗后NO、ET-1及VEGF水平相比差异有显著统计学意义（P<0.01）。治疗后观察组CRP、白细胞介素-6（IL-6）及肿瘤坏死因子-α（TNF-α）水平均显著低于对照组（P<0.05）。观察组治疗后活化部分凝血活酶时间（aPTT）、凝血酶原时间（PT）、D-二聚体（D-D）水平均高于本组治疗前和同期对照组（P<0.05），FIB低于本组治疗前和同期对照组（P<0.05）。观察组治疗后脑血容量（CBV）和脑血流量（CBF）水平显著高于对照组，差异有统计学意义（P<0.05）。观察组治疗后NO、ET-1及VEGF水平显著优于对照组，差异有统计学意义（P<0.05）。

结论

叶酸、维生素B12联合黄芪生脉饮可有效改善ACI患者神经功能、血管内皮功能、免疫功能和凝血功能，降低脑梗死复发风险，有利于提高患者生活质量，值得临床推广应用。

关键词

急性脑梗死 / 叶酸 / 维生素B12 / 神经功能 / 血管内皮功能

Abstract

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Objective

To analyze the effects of folic acid and vitamin B12 combined with Huangqi Shengmai Decoction（黄芪生脉饮）on homocysteine（Hcy），C-reactive protein（CRP），nerve function and vascular endothelial function in patients with acute cerebral infarction（ACI）.

Methods

A total of 113 ACI patients admitted to the hospital from January 2018 to January 2022 were selected and divided into two groups using a random number table method. The control group（48 cases）were treated with conventional therapy plus folic acid combined with vitamin B12，and the observation group（65 cases）were treated with Huangqi Shengmai Decoction on the basis of the control group. The levels of Hcy and CRP，National Institutes of Health Stroke Scale（NIHSS）score，the activity of daily living Barthel index score，the levels of vascular endothelial function indicators［nitric oxide（NO），endothelin-1（ET-1），vascular endothelial growth factor（VEGF）］，the cerebral blood perfusion level and the vascular endothelium before and after treatment were statistically analyzed in the two groups.

Results

After treatment，the serum levels of Hcy and CRP in the two groups were significantly decreased（P<0.001）. The serum Hcy and CRP levels in the observation group after treatment were significantly lower than those in the control group，and the difference was statistically significant（P<0.01）. After treatment，NIHSS score decreased significantly（P<0.001）and Barthel index score increased significantly（P<0.001）. There was a statistically significant difference between the observation group and the control group in NIHSS score and Barthel index score after treatment（P<0.01）. After treatment，the levels of NO in the two groups were significantly increased（P<0.001）while the levels of ET-1 and VEGF were significantly decreased（P<0.001）. There were statistically significant differences in the levels of NO，ET-1 and VEGF between the observation group and the control group after treatment（P<0.01）. After treatment，the levels of CRP，interleukin-6（IL-6）and tumor necrosis factor-α（TNF-α）in the observation group were significantly lower than those in the control group（P<0.05）. The activated partial thromboplastin time（aPTT），prothrombin time（PT）and D-dimer（D-D）in the observation group after treatment were higher than those before treatment and the control group at the same period（P<0.05），and the FIB was lower than that in the control group before treatment and the control group at the same period（P<0.05）. The values of cerebral blood volume（CBV）and cerebral blood flow（CBF）in the observation group were significantly higher than those in the control group after treatment，and the difference was statistically significant（P<0.05）. After treatment，the levels of NO，ET-1 and VEGF in the observation group were significantly better than those in the control group，and the differences were statistically significant（P<0.05）.

Conclusions

Folic acid and vitamin B12 combined with Huangqi Shengmai Decoction can effectively improve the nerve function，vascular endothelial function，immune function and coagulation function of ACI patients，reduce the risk of cerebral infarction recurrence，and improve the quality of life of patients，which is worthy of clinical application.

Key words

acute cerebral infarction / folic acid / vitamin B12 / neural function / vascular endothelial function

引用本文

鲍正超, 董兴红, 方国华. 叶酸、维生素B12联合黄芪生脉饮对急性脑梗死Hcy、CRP、神经功能及凝血功能的影响. 中华中医药学刊, 2026 , 44 (1) : 224 -228 . DOI: 10.13193/j.issn.1673-7717.2026.01.043

Zhengchao BAO, Xinghong DONG, Guohua FANG. Effects of Folic Acid And Vitamin B12 Combined with Huangqi Shengmai Decoction（黄芪生脉饮）on Hcy，CRP，Nerve Function and Coagulation Function in Patients with Acute Cerebral Infarction[J]. Chinese Archives of Traditional Chinese Medicine, 2026 , 44 (1) : 224 -228 . DOI: 10.13193/j.issn.1673-7717.2026.01.043

参考文献

收起

文献

收起

参考文献引证文献

排序方式：

［1］

李梦雨，李长颖，刘斌，等.远隔缺血后适应对急性脑梗死患者神经功能及血管内皮功能的影响［J］.中华老年心脑血管病杂志，2021，23（7）：727-730.

［2］

MOHAMMAD SEYEDSAADAT S，KALLMES D F，BRINJIKJI W. Remote ischemic conditioning approach for the treatment of ischemic stroke［J］. Neural Regen Res，2020，15（6）：1033-1034.

［3］

王文志，盖思齐.脑血管病的一级预防［J］.中华神经科杂志，2020，53（8）：614-622.

［4］

徐昆明，李水彬，曹裕民，等.阿司匹林联合氯吡格雷对急性脑梗死患者神经功能和hs-CRP、Hcy的影响［J］.海峡药学，2020，32（8）：153-154.

［5］

于磊，丛时兵，李建桥.叶酸联合维生素B12对高同型半胱氨酸脑梗死患者深静脉血栓形成的影响［J］.药物生物技术，2020（4）：352-355.

［6］

俞敏，黄庆梅，覃鹏飞.叶酸、VB₆、VB₁₂对高血压合并急性脑梗死患者血管内皮功能、血清同型半胱氨酸水平及生活质量的影响［J］.心血管康复医学杂志，2019，28（5）：631-634.

［7］

刘德伟，许俊华，张东风，等.叶酸、维生素B12联合多奈哌齐对阿尔茨海默病患者认知功能及精神行为症状的影响［J］.国际精神病学杂志，2020，47（1）：101-103.

［8］

费龙，马浩然.叶酸联合维生素B12对H型高血压患者临床治疗效果及血清N末端B型脑钠肽前体和血栓素A2水平的影响［J］.中国医药，2020，15（7）：1017-1020.

［9］

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.

［10］

CASSINADANE A V，RAMASAMY R. Association of BHMT（rs 3733890）gene polymorphism with biochemical markers of B12 deficiency in T2 DM patients on metformin therapy［J］. Int Res J Adv Sci Hub，2021，3（Special 3S）：176-186.

［11］

OLASO-GONZALEZ G，INZITARI M，BELLELLI G，et al. Impact of supplementation with vitamins B₆，B₁₂，and/or folic acid on the reduction of homocysteine levels in patients with mild cognitive impairment：a systematic review［J］. IUBMB Life，2022，74（1）：74-84.

［12］

IRAWATI A，MUDJANARKO S W，TINDUH D. Effects of treadmill exercises on pancreatic β cell function through the role of vitamin D in patients with type 2 diabetes mellitus［J］. Gaceta Médica De Caracas，2021，129（s2）：13-19.

［13］

陈晶菁，张利林，张玉林，等. VitB12及叶酸对伴高同型半胱氨酸血症的AD患者血清神经递质、细胞因子水平及认知功能的影响［J］.卒中与神经疾病，2020，27（3）：362-364.

［14］

HU C，WU X Y. Effect of vitamin D supplementation on vascular function and inflammation in patients with chronic kidney disease：a controversial issue［J］. Ther Apher Dial，2020，24（3）：265-274.

［15］

LI C X，BU X P，LIU Y R. Effect of folic acid combined with pravastatin on arteriosclerosis in elderly hypertensive patients with lacunar infarction［J］. Medicine（Baltimore），2021，100（28）：26540.

［16］

XUE J，LIU Y，ZHANG S，et al. Changes in the expressions of serum homocysteine，folic acid and vitamin b12 in diabetic neurogenic bladder and the relationship with bladder function［J］. Acta Med Mediter，2020，36（2）：773-777.

［17］

SIENER R，MACHAKA I，ALTEHELD B，et al. Effect of fat-soluble vitamins A，D，E and K on vitamin status and metabolic profile in patients with fat malabsorption with and without urolithiasis［J］. Nutrients，2020，12（10）：3110.

［18］

GASCÓN T M，LOURENÇO B G，PEREIRA E C，et al. Relationship with metalloproteinase 13，E-cadherin，homocysteine and co factors folic acid and vitamin B12 in patients diagnosed with prostate cancer［J］. Curr Enzyme Inhib，2021，17（1）：33-41.

［19］

沈佳燕，卢山，陆研，等.叶酸与维生素B12对急性脑梗死合并高血压患者神经功能、内皮功能及复发率的影响［J］.心脑血管病防治，2021，21（5）：506-508.

［20］

KAYE A D，JEHA G M，PHAM A D，et al. Folic acid supplementation in patients with elevated homocysteine levels［J］. Adv Ther，2020，37（10）：4149-4164.

［21］

HARA D，AKAMATSU M，MIZUKAMI H，et al. A case of subacute combined degeneration of spinal cord diagnosed by vitamin B₁₂ administration lowering methylmalonic acid［J］. Case Rep Neurol，2020，12（1）：27-34.

［22］

张亚珍.黄芪生脉饮联合管通治疗血液透析相关性低血压疗效观察［J］.浙江中医杂志，2013，48（3）：232.

［23］

PAN J H，CAO Z H，FANG C Q，et al. Huangqi Shengmai Yin ameliorates myocardial fibrosis by activating Sirtuin3 and inhibiting TGF-β/smad pathway［J］. Front Pharmacol，2021，12：722530.

［24］

刘燕娟，王飞雪，郝建峰，等.黄芪生脉饮临床应用及基础研究进展［J］.现代中西医结合杂志，2009，18（16）：1961-1963.

［25］

占扎君，郑琼，彭媛，等.黄芪生脉对气虚和阴虚症的治疗作用研究［J］.浙江工业大学学报，2022，50（6）：692-698.

［26］

卢明星，赵茂，王道平，等.基于网络药理学-分子对接探讨黄芪生脉散对糖尿病的作用机制［J］.世界科学技术-中医药现代化，2022，24（9）：3449-3464.

［27］

信悦.黄芪生脉饮质量控制和配伍规律研究［D］.哈尔滨：哈尔滨商业大学，2021.

［28］

马小芬，毛新民，马晓丽，等.黄芪注射液与生脉注射液对气阴两虚证候细胞模型代谢的影响［J］.中华中医药杂志，2022，37（3）：1744-1749.

2026年第44卷第1期

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doi: 10.13193/j.issn.1673-7717.2026.01.043

首发时间：2026-10-14
出版时间：2026-01-10

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浙江中医药大学附属江南医院，浙江杭州 311201

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科 Family	属数 Number of genus	种数 Number of species	占总种数比例 Percentage of total species (%)	属 Genus	种数 Number of species	占总种数比例 Percentage of total species (%)
鹅膏菌科Amanitaceae	2	11	5.26	鹅膏菌属 Amanita	10	4.78
小菇科 Mycenaceae	2	12	5.74	丝盖伞属 Inocybe	5	2.39
多孔菌科 Polyporaceae	8	14	6.70	蜡蘑属 Laccaria	5	2.39
红菇科 Russulaceae	3	23	11.00	小皮伞属 Marasmius	6	2.87
				小菇属 Mycena	11	5.26
				光柄菇属 Pluteus	5	2.39
				红菇属 Russula	17	8.13
				栓菌属 Trametes	5	2.39

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