大黄通腑汤治疗痰热腑实证急性脑梗死神经系统损害80例临床观察

Clinical Observation on Dahuang Tongfu Decoction for Lesion of Nervous S ystem in 80 Acute Cerebral Infarction Patients with Phlegm-Heat and Bowel-Repl etion Syndrome

目的观察大黄通腑汤对痰热腑实证急性脑梗死患者神经功能缺损、日常生活能力的改善作用、血清高敏C-反应蛋白(hs-CRP)水平的影响以及神经系统损害的治疗效果。方法将160例脑梗死患者随机分为研究组和对照组各80例。两组均给予常规药物治疗和康复治疗,研究组加用大黄通腑汤治疗10天。观察两组在发病后24h和急性期3、7、15天时的血清hs-CRP水平、治疗15天急性期结束时神经功能缺损评分和日常生活能力(Batherl指数)的变化。在45天黄金康复期结束时随诊再次评定Batherl指数。结果研究组患者在发病后45天时的Batherl指数优于15天时(P<0.05),研究组45天和15天时日常生活能力均优于对照组(P<0.05)。研究组发病3天时神志障碍发生率明显少于对照组,差异有统计学意义(P<0.05),7天和10天时比较差异无统计学意义(P>0.05)。研究组自身各时间段血清hs-CRP水平比较差异有统计学意义(P<0.05)。研究组在治疗3、7、15天各个时间段的血清hs-CRP水平均较对照组低,差异有统计学意义(P<0.05)。病程15天急性期结束时,两组患者脑梗死整体疗效总有效率比较差异有统计学意义(P<0.01),研究组优于对照组。结论大黄通腑汤能明显提高痰热腑实证急性脑梗死患者神经功能缺损的康复程度,改善其日常生活能力,并具有调整脑梗死后机体炎症反应,降低升高的CRP水平。

Objective To observe the effect of Dahuang Tongfu D ec oction [Decoction of Dahuang（Radix et Rhizoma Rhei） to Free the Bowels] o n the neural function defect,activity of daily living and level of high-sensitivity C-reactive prot ein（hs-CRP） for acute cerebral infarction（ACI） patients with phlegm-heat and bowel-repletion syndrome.Methods Totally 160 ACI patients were randomized into research group and control group,with 80 in each.Both groups received the routine medication and rehabilitation.Dahuang Tongfu Decoction was added in the researc h group for 10 days.The serum level of hs-CRP was observed in both groups 24 h ours after onset and on the 3rd,7th and 15th day of acute stage.After treating for 15 days,the change of neural function defect score and Batherl index was ob s erved at the end of acute stage.After treating for 45 days,Batherl index was e valuated again with follow-up at the end of best recovery stage. Results The Bat hel index on the 45th day of onset was superior to that on the 15th day in the r esearch group（P0.05）.The Bathel index on the 45th day and 15th day of o nset in the research group was superior to that in the control group（P0.05）. Compa ring with the control group,the occurrence rate of conscious disturbance in the research group was significantly decreased on the 3rd day of onset（P0.0 5）,b ut the difference was not statistically significant on the 7th and 10th day（P 0.05）.Comparing in group,the difference of hs-CRP level in the research grou p was statistically significant at different time（P0.05）.On the 3rd,7th and 1 5th day of the treatment course,the hs-CRP level in the research group was sig n ificantly lower than that in the control group（P0.05）.After treating fo r 15 days,the total effective rate of the research group was superior to that o f th e control group at the end of acute stage（P0.01）.Conclu sion Dahuang Tongfu Decoction could recover neural function defect obvi ously,reduce the invalidity rate and CRP level,improve activity of daily livin g and regulate inflammatory react ion for ACI patients with phlegm-heat and bowel-repletion syndrome.