温阳通脉颗粒治疗脾肾阳虚型缺血性中风疗效观察

Therapeutic effects of Wenyang Tongmai granule for treatment of patients with yang deficiency of spleen and kidney and ischemic stroke

中国中西医结合急救杂志 Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care 2011 Vol.18 No.6 P.333-336 -------------------------------------------------------------------------------- 温阳通脉颗粒治疗脾肾阳虚型缺血性中风疗效观察 目的 观察常规方案联合温阳通脉颗粒口服治疗脾肾阳虚型缺血性中风患者的临床疗效.方法 选择60例符合中医辨证为脾肾阳虚型的缺血性中风患者,按随机数字表法分为观察组和对照组,每组30例.两组均给予西医常规治疗,观察组同时加服温阳通脉颗粒,疗程均为4周.观察两组治疗后中医证候积分、临床疗效、神经功能缺损程度[中国卒中量表评分（CSS）]、日常生活能力状态[巴塞尔指数（BD]以及凝血指标的变化情况.结果 观察组中医证候改善的愈显率和总有效率均明显高于对照组（愈显率：82.8％比44.4％,总有效率：96.6％比74.1％,P＜ 0.01和P＜0.05）;治疗2周后中医证候总积分（分）均较对照组明显改善（36.87±7.95比42.87±9.59,P＜0.05）,临床疗效愈显率较对照组明显升高（62.1％比40.7％,P＜0.05）.观察组在减少CSS、增加BI、延长凝血酶原时间（PT）及活化部分凝血活酶时间（APTT）方面与对照组比较差异均有统计学意义（P＜0.05或P＜0.01）.结论 温阳通脉颗粒治疗缺血性中风疗效显著,在改善临床症状的同时,能够减轻神经功能缺损程度,提高日常生活能力,并对凝血指标有积极影响.

Objective To evaluate the clinical effects of Wenyang Tongmai granule （WYTMG） in treatment of patients with ischemic stroke on the basis of syndrome differentiation of traditional Chinese medicine （TCM）. Methods Sixty cases with yang deficiency of spleen and kidney and ischemic stroke were divided randomly into two groups： control and treatment groups （each n = 30）. Both groups were treated with conventional western medicine, and in the treatment group, additionally oral WYTMG was given. Both groups were treated for d weeks. The changes of score of TCM syndrome, clinical therapeutic effect, the score of neurologic impairment degree （ Chinese stroke scale （CSS） ）, the state of daily life ability [ Barthel index （BI）] and the blood coagulation indexes were observed before and after treatment in the two groups. Results The recovery and apparent effect rate and the total effective rate of TCM syndrome in the treatment group were obviously higher than those in the control group （ 82.8% vs. 44.4%, 96.6% vs. 74.1%, P 〈 0.01 and P 〈 0.05 ）. Two weeks after treatment, the total score of TCM syndrome in the treatment group was significantly improved compared to that in the control group （ 36.87 ± 7.95 vs. 42.87 ± 9.59, P 〈 0.05）, the clinical curative and significant effective rate was markedly higher than that in the control group （62.1% vs. 40.7%, P 〈 0.05）. In the treatment group, the score of neurologic functional impairment degree was decreased, the state of daily life ability was improved, and the differences in the aspects of prolongation of prothrombin time （ PT ） and activated part of thromboplastin time （ APTF ） between the two groups had statistical significance （P 〈 0.05 or P 〈 0.01 ）. Conclusion The therapeutic effect of WYTMG combined with conventional therapy in treating patients with yang deficiency of spleen and kidney and ischemic stroke is evident. The treatment can improve clinical symptoms and palliate neurologic functional impairment and elevate ability of daily life. It also has positive effect on the indexes of blood coagulation. The above data indicate that WYTMG is an effective drug for recovery phase of ischemic stroke.