半夏白术天麻汤加减治疗急性脑梗死45例
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摘要
目的:观察半夏白术天麻汤加减治疗急性脑梗死的临床疗效。方法:将90例急性脑梗死患者按照随机数字表法分为观察组和对照组,每组各45例。对照组给予依达拉奉注射液+银杏达莫注射液治疗,观察组在对照组的基础上加用半夏白术天麻汤治疗。观察两组患者的临床疗效,比较两组患者治疗前后中医证候积分、神经功能缺损程度评分(NIH-SS)、Barthel指数(BI)评分变化情况;检测两组患者治疗前后全血高切黏度、全血低切黏度、血浆黏度、红细胞压积(hem-atocrit,HCT)、纤维蛋白原(fibrinogen,FIB)水平。结果:对照组有效率为82. 22%,观察组有效率为95. 56%,两组患者临床疗效比较,差异具有统计学意义(P <0. 05)。两组患者治疗后中医证候积分低于本组治疗前,且观察组治疗后低于对照组,差异具有统计学意义(P <0. 05)。两组患者治疗后NIHSS评分低于本组治疗前,BI评分高于本组治疗前,观察组治疗后NIHSS评分低于对照组,BI评分高于对照组,差异均有统计学意义(P <0. 05)。观察组治疗结束后全血高切黏度、全血低切黏度、血浆黏度、HCT、FIB水平低于对照组,差异具有统计学意义(P <0. 05)。结论:半夏白术天麻汤加减治疗急性脑梗死可明显改善患者神经功能和血液流变学指标。
Objective: To observe the clinical curative effect of Modified Pinellia and White Atractylodes and Gastrodia Decoction in combination with Edaravone Injection on acute cerebral infarction. Methods: Ninety patients with acute cerebral infarction were divided into the observation group and the control group according to the random number table method,with 45 cases in each group.The ones in the control group were treated with Edaravone Injection together with Ginkgo Leaf Extract and Dipyridamole Injection,while the ones in the observation group were treated with Pinellia and White Atractylodes and Gastrodia Decoction on the basis of the control group. The clinical efficacies of the two groups were observed. The TCM syndrome scores,neurological deficit scores( NIHSS) and Barthel index( BI) scores before and after the treatment were compared between the two groups. The high blood viscosity,the whole blood low-cut viscosity,plasma viscosity,hematocrit( HCT),fibrinogen( FIB) levels of the two groups before and after treatment were measured. Results: The effective rate of the control group was 82. 22%,and that of the observation group was 95. 56%. The clinical efficacy of the two groups was statistically significant( P < 0. 05). The scores of TCM syndromes in the two groups were lower than those in the group before the treatment,and the observation group was lower than the control group after the treatment. The difference was statistically significant( P < 0. 05). The NIHSS scores of the two groups were lower than those of the group before the treatment,and the BI score was higher than that of the group before the treatment. The NIHSS score of the observation group was lower than that of the control group,and the BI score was higher than that of the control group. The differences were statistically significant( P < 0. 05). The high blood viscosity,whole blood low-cut viscosity,plasma viscosity,HCT and FIB levels of the observation group were lower than those of the control group after treatment,and all the differences were statistically significant( P < 0. 05). Conclusion: Modified Pinellia and White Atractylodes and Gastrodia Decoction in Combination with Edaravone Injection can significantly improve neurological function and blood rheology indicators of patients with acute cerebral infarction.
Objective: To observe the clinical curative effect of Modified Pinellia and White Atractylodes and Gastrodia Decoction in combination with Edaravone Injection on acute cerebral infarction. Methods: Ninety patients with acute cerebral infarction were divided into the observation group and the control group according to the random number table method,with 45 cases in each group.The ones in the control group were treated with Edaravone Injection together with Ginkgo Leaf Extract and Dipyridamole Injection,while the ones in the observation group were treated with Pinellia and White Atractylodes and Gastrodia Decoction on the basis of the control group. The clinical efficacies of the two groups were observed. The TCM syndrome scores,neurological deficit scores( NIHSS) and Barthel index( BI) scores before and after the treatment were compared between the two groups. The high blood viscosity,the whole blood low-cut viscosity,plasma viscosity,hematocrit( HCT),fibrinogen( FIB) levels of the two groups before and after treatment were measured. Results: The effective rate of the control group was 82. 22%,and that of the observation group was 95. 56%. The clinical efficacy of the two groups was statistically significant( P < 0. 05). The scores of TCM syndromes in the two groups were lower than those in the group before the treatment,and the observation group was lower than the control group after the treatment. The difference was statistically significant( P < 0. 05). The NIHSS scores of the two groups were lower than those of the group before the treatment,and the BI score was higher than that of the group before the treatment. The NIHSS score of the observation group was lower than that of the control group,and the BI score was higher than that of the control group. The differences were statistically significant( P < 0. 05). The high blood viscosity,whole blood low-cut viscosity,plasma viscosity,HCT and FIB levels of the observation group were lower than those of the control group after treatment,and all the differences were statistically significant( P < 0. 05). Conclusion: Modified Pinellia and White Atractylodes and Gastrodia Decoction in Combination with Edaravone Injection can significantly improve neurological function and blood rheology indicators of patients with acute cerebral infarction.
引文
[1] SEHEULT J N,CHIBISOV I. A Case of Unexplained Cerebral Si-nus Thrombosis in a 22-Year-Old Obese Caucasian Woman[J]. Lab Med,2016,47(3):233-240.
[2]秦峰,蔡辉.急性缺血性卒中的药物治疗进展[J].疑难病杂志,2015,14(8):870-876.
[3]姜远飞,王小亮,王政霞,等.急性脑梗死的中医药研究进展[J].中医临床研究,2017,9(5):142-144.
[4]中华医学会神经病学分会脑血管病学组急性缺血性脑卒中诊治指南撰写组.中国急性缺血性脑卒中诊治指南2010[J].中国全科医学,2011,14(35):4013-4017.
[5]国家中医药管理局脑病急症协作组.中风病辨证诊断标准(试行)[J].北京中医药大学学报,1994,17(3):64-66.
[6]国家中医药管理局.中医病证诊断疗效标准(2012版)[S].北京:中国医药科技出版社,2012:57.
[7] LEE C F,VENKETASUBRAMANIAN N,WONG K S,et al. Com-parison Between the Original and Shortened Versions of the Nation-al Institutes of Health Stroke Scale in Ischemic Stroke Patients ofIntermediate Severity[J]. Stroke,2016,47(1):236-239.
[8]李奎成,唐丹,刘晓艳,等.国内Barthel指数和改良Barthel指数应用的回顾性研究[J].中国康复医学杂志,2009,24(8):737-740.
[9]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:159-161.
[10]林晖.急性缺血性脑卒中的发病机制及治疗进展[J].内科,2012,7(5):540-542.
[11]江兴,周玉生,盘捷,等.依达拉奉作用机制和临床应用研究进展[J].中南药学,2013,11(8):587-592.
[12]植昌嘉,黄大红,张念希,等.缺血性脑卒中269例中医辨证分型研究[J].中医学报,2012,27(7):876-877.
[13]张贺,梁健芬,梁新安,等.中医药治疗缺血性脑卒中研究进展[J].河南中医,2014,34(6):1069-1071.
[14]陈海峰,胡跃强,甘业贤,等.中医综合疗法治疗急性缺血性中风临床疗效的Meta分析[J].湖南中医杂志,2016,32(8):181-184.
[15]许安祥,陈颖,杨聪慧.半夏白术天麻汤加减辅助治疗急性缺血性脑卒中38例临床疗效观察[J].四川中医,2018,36(2):122-125.
[16]马洁.加味半夏白术天麻汤治疗急性缺血性脑卒中疗效观察[J].山东中医杂志,2017,36(11):938-941.
[17]沈瑞.半夏白术天麻汤治疗急性缺血性脑卒中的疗效分析[J].中西医结合心血管病电子杂志,2018,6(7):132-133.
[2]秦峰,蔡辉.急性缺血性卒中的药物治疗进展[J].疑难病杂志,2015,14(8):870-876.
[3]姜远飞,王小亮,王政霞,等.急性脑梗死的中医药研究进展[J].中医临床研究,2017,9(5):142-144.
[4]中华医学会神经病学分会脑血管病学组急性缺血性脑卒中诊治指南撰写组.中国急性缺血性脑卒中诊治指南2010[J].中国全科医学,2011,14(35):4013-4017.
[5]国家中医药管理局脑病急症协作组.中风病辨证诊断标准(试行)[J].北京中医药大学学报,1994,17(3):64-66.
[6]国家中医药管理局.中医病证诊断疗效标准(2012版)[S].北京:中国医药科技出版社,2012:57.
[7] LEE C F,VENKETASUBRAMANIAN N,WONG K S,et al. Com-parison Between the Original and Shortened Versions of the Nation-al Institutes of Health Stroke Scale in Ischemic Stroke Patients ofIntermediate Severity[J]. Stroke,2016,47(1):236-239.
[8]李奎成,唐丹,刘晓艳,等.国内Barthel指数和改良Barthel指数应用的回顾性研究[J].中国康复医学杂志,2009,24(8):737-740.
[9]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:159-161.
[10]林晖.急性缺血性脑卒中的发病机制及治疗进展[J].内科,2012,7(5):540-542.
[11]江兴,周玉生,盘捷,等.依达拉奉作用机制和临床应用研究进展[J].中南药学,2013,11(8):587-592.
[12]植昌嘉,黄大红,张念希,等.缺血性脑卒中269例中医辨证分型研究[J].中医学报,2012,27(7):876-877.
[13]张贺,梁健芬,梁新安,等.中医药治疗缺血性脑卒中研究进展[J].河南中医,2014,34(6):1069-1071.
[14]陈海峰,胡跃强,甘业贤,等.中医综合疗法治疗急性缺血性中风临床疗效的Meta分析[J].湖南中医杂志,2016,32(8):181-184.
[15]许安祥,陈颖,杨聪慧.半夏白术天麻汤加减辅助治疗急性缺血性脑卒中38例临床疗效观察[J].四川中医,2018,36(2):122-125.
[16]马洁.加味半夏白术天麻汤治疗急性缺血性脑卒中疗效观察[J].山东中医杂志,2017,36(11):938-941.
[17]沈瑞.半夏白术天麻汤治疗急性缺血性脑卒中的疗效分析[J].中西医结合心血管病电子杂志,2018,6(7):132-133.