观察辨证使用中药注射液治疗急性脑梗死72例临床观察

72 cases of clinical observation on curing acute cerebral infarction (ACI) using traditional Chinese medicine (TCM) injection syndrome differentiation

目的观察辨证使用中药注射液治疗急性脑梗死的疗效性和安全性。方法120例病人随机分为两组,在常规西医治疗基础上治疗组(辨证组)72例依据辨证分为气虚血瘀型35例予以黄芪注射液和血塞通冻干粉应用,风痰瘀阻型21例予以天麻素注射液和川芎嗪注射液应用,热毒瘀阻型16例予以清开灵冻干粉和丹参冻干粉应用;对照组(非辨证组)予以血塞通冻干粉应用。结果辨证使用中药注射液治疗脑梗死结果发现:辨证组疾病总疗效、中医证候疗效及神经功能缺损疗效均明显优于单纯使用活血化瘀中药注射液治疗急性脑梗死的非辨证组(P<0.05);两组中医证候积分变化、神经功能缺损积分治疗后均明显优于治疗前(P<0.05),而辨证组治疗后要明显优于非辨证组(P<0.05)。辨证组在血液流变学指标上较非辨证组明显(P<0.05)。辨证组神经功能缺损评分减少明显优于非辨证组(P<0.01),其血液流变学指标与非辨证组差异有统计学意义(P<0.05)。结论辨证使用中药注射液治疗急性脑梗死是一种安全、有效的方法。

Objective To study the efficacy and safety of treatment for both root cause and symptoms by combining Activating Blood Circulation and Removing Blood Stasis Therapy with traditional Chinese medicine injection. Methods 120 patients with acute cerebral infarction were recruited in the study, and the patients were classified into control group and treatment group randomly. There were three sub- groups in the treatment group： 35 patients were diagnosed as deficiency of vital energy and blood stasis, 21 patients as phlegm and blood stasis, and 16 patients as toxic-heat and blood stasis. Based on the regular treatment with western medicine, the control group were prescribed with Xuesaitong freeze-dried powder; the group with deficiency of vital energy and blood stasis was prescribed with Astragalus mongholicus injection and Xuesaitong freeze-dried powder; the group with phlegm and blood stasis received injection of Gastrodin and injection of Ligustrazine; and the group with toxic-heat blood stasis additionally received Qingkailing freeze-dried powder and salvia miltiorrhiza. Results Activating Blood Circulation and Removing Blood Stasis Therapy （ABCRBS Therapy） as an essential clinical approach should be applied in the whole course of the cerebral infarction treatment. According to the research re- sults, the total effective rates, traditional Chinese medicine syndrome efficacy and nerve function deficit efficacy of treatment groups were better than those of control group （P 〈 0.05） ; the traditional Chinese medicine syndrome score and nerve function deficit score of the treatment group were more effectively improved than those of the control group （P 〈 0.05）. As for improving the hemorheology indexes such as hematocrit, whole blood viscosity aggregation index plasma fibrinogen, plasma viscosity and erythrocyte deformation index, the treatment group was also better than the control group （P 〈 0.05）. Conclusions Treatment with both root cause and symptoms by combining ABCRBS Therapy with TCMI has advantages of safety and efficacy.