辨病与辨证相结合治疗急性缺血性中风

Clinical research on treatment for ischemic stroke by traditional Chinese medicine syndrome differentiation combined with differential diagnosis in western medicine

目的:探讨辨病与辨证相结合治疗急性缺血性中风的临床疗效。方法:对诊断明确的138例急性缺血性中风患者随机分为治疗组和常规对照组。两组基础用药相同,同时治疗组患者依据中医理论进行辨证分型,分为气虚、痰湿、痰火和阴虚4个亚组,根据证型加用相关中药汤剂治疗,观察其临床表现、舌象和美国国立卫生研究院卒中量表(N IHSS评分)的变化,并与常规治疗对照组比较。结果:经治疗后各组相关指标及N IHSS评分均明显好转,但治疗组更具优势(各治疗亚组P均<0.01,对照组P<0.05)。结论:采用辨病与辨证相结合的综合手段诊治急性缺血性中风优于单纯的西药治疗效果。

Objective： To investigate the clinical therapeutic effects on ischemic stroke by syndrome differentiation in traditional Chinese medicine （TCM） combined with differential diagnosis in western medicine. Methods ： One hundred and thirty - eight cases suffered from ischemic stroke were randomly divided into treatment group and control group, and according to TCM theory the treatment group was subdivided into Qi - deficiency （气虚）, phlegm -dampness （痰湿）, phlegm - fire （痰火） and Yin - deficiency （阴虚 ） subgroups. Different TCM decoction was administrated respectively to the four subgroups. The clinical symptoms and signs, tongue picture of TCM diagnosis as well as the changes of national institutes of health stoke score （NIHSS） were observed and compared with those of the control group before and after treatment. Results ： NIHSS scores were improved in all the groups （P〈0.01 for treatment group and P〈0.05 for control group）. The effects of treatment groups were significantly superior to that of the control group （P〈0. 05）. Conclusion： The method of TCM syndrome differentiation combined with diagnosis of western medicine is a better method than simple western medicine in diagnosing and treating isehemie stroke.