中医辨证治疗脑梗死的45例临床观察

Clinical Observation of 45 Cases of Cerebral Infarction Treated with Syndrome differentiation in Chinese medicine

目的观察中西医结合治疗脑梗死的临床疗效及治疗前后血液流变学指标变化。方法将87例脑梗死患者随机分为两组。对照组42例采用西医常规治疗方法,治疗组45例在对照组治疗基础上加服中药并用中医辨证治疗,疗程均为4周。观察两组临床疗效以及治疗前后血液流变学指标变化。结果两组疗效比较中,治疗组总有效率86.67%,对照组总有效率57.14%,两组比较,差异有统计学意义(P<0.01),治疗组疗效优于对照组。治疗组治疗后全血低切黏度、全血高切黏度及血液黏度与本组治疗前及对照组治疗后比较,差异均有统计学意义(P<0.05或P<0.01);两组治疗前后血小板聚集率比较差异均有统计学意义(P<0.05或P<0.01),但两组治疗后比较,差异无统计学意义(P>0.05)。结论在常规治疗基础上加用中医辨证治疗对于急性脑梗死恢复期的疗效更为显具,明显优于西医常规治疗。

Objective To observe the clinical efficacy of integrated Chinese and western medicine on cerebral infarction and the changes in hemorheological indicators before and after treatment.Methods 87 cases of cerebral infarction were randomly divided into two groups.In control group（42 cases）,the conventional western medicine was adopted.In treatment group（45 cases）,on the basis of the treatment as control group,Chinese herbal medicine was combined according to syndrome differentiation of Chinese medicine.The duration of treatment was 4 weeks.The clinical efficacy and the changes in hemorheological indicators before and after treatment were observed in two groups.Results In efficacy comparison of two group,the total effective rate was 86.67% in treatment group and was 57.14% in control group,indicating significant statistical difference in comparison（P0.01）.The efficacy in treatment group was superior to control group.The whole blood viscosity of low shear rate,whole blood viscosity of high shear rate and blood viscosity after treatment were different significantly as compared with those before treatment in treatment group as well as those after treatment in control group in statistics（P0.05 or P0.01）.The platelet aggregation before treatment was different significantly in statistics between two groups（P0.05 or P0.01）,but after treatment,there was no significant statistical difference between two groups（P0.05）.Conclusion On the basis of conventional treatment,the treatment according to syndrome differentiation in Chinese medicine achieves better efficacy on acute cerebral infarction in recovery stage,which is superior apparently to conventional treatment with western medicine.