自拟五虫通络汤联合现代康复治疗急性缺血性脑卒中随机平行对照研究

Random Parallel Control Study on Self-made Wuchong Tongluo Tang joint with Modern Rehabilitation in Treating Acute Ischemic Stroke

[目的]观察自拟五虫通络汤联合现代康复治疗急性缺血性脑卒中疗效。[方法]使用随机平行对照方法,将60例住院及门诊患者按随机数字表法随机分为两组。对照组30例西医常规治疗方法,控制脑水肿、抗血小板聚集、控制血压血糖血脂、预防感染等基础治疗措施。治疗组30例自拟五虫通络汤(黄芪30g,当归12g,川芎15g,丹参30g,赤芍15g,桃仁12g,红花12g,全虫10g,水蛭12g,土元12g,白僵蚕12g,地龙15g,络石藤30g,伸筋草30g,鸡血藤30g,钩藤30g,建曲15g,甘草6g),1剂/d,每剂浓缩为两袋,每袋150mL,2次/d,早晚服用。同时在生命体征稳定后早期加现代康复Bobath疗法。西医治疗同对照组。连续治疗30d为1疗程。观测临床症状、NIHSS评分、不良反应。连续治疗2疗程,判定疗效。[结果]治疗组基本痊愈3例,显著进步15例,进步7例,无变化5例,恶化0例,总有效率83.33%。对照组基本痊愈1例,显著进步11例,进步5例,无变化13例,恶化0例,总有效率56.67%。治疗组疗效优于对照组(P<0.05)。两组NIHSS评分有改善(P<0.05,P<0.01),治疗组优于对照组(P<0.01)。[结论]自拟五虫通络汤联合现代康复治疗急性缺血性脑卒中可以较好的提高患者的生活自理能力,减轻后遗症,且安全,有效,经济,值得进一步研究。

[ Objective ] To investigate the clinical efficacy of Wuchong Tongluo Tang joint with the modern rehabilitation in treating acute ischemic stroke. [ Methods] Using random parallel control method ,60 patients, inpatient and outpatient, were randomly divided into two groups according to random number table method. The control group of 30 patients were treated with routine western medicine（ Basic treatment measures to control cerebral edema, anti -platelet aggregation, control of blood pressure, blood glucose and lipid, prevent of infection）. The treatment group were cured by self - made Wuchong Tongluo Tang （ Huangqi 30g, Danggui 12g, Chuanxiong 15g, Danshen 30g, Dilong 15g, Luoshiteng 30g, Shenjincao 30g, Jixueteng 30g, Gouteng 30g, Jianqu 15g, Gancao 6g） , ldose/day, each dose concentrated into two bags, each bag is 150 mL, 2 times / day, take it in the morning and evening, and When vital signs is stable, add Bobath therapy early. Western medicine treatment of the treatment group is the same with the control group. 1 treatment course is 30 days. Observe clinical sympons, NIHSS score and adverse reactions after two courses of treatment. [ Results ] The overall effective rate in patients of the treatment group： 3cases were basically cured, 15cases remarkably improved, 7 cases improved, 5cases no changed, 0 case deteriorated, and the total effective rate is 83.33%. The overall effective rate in patients of the control group： 1 cases were basically cured, 11 cases remarkably im- proved, 5cases improved, 13cases no changed, 0 case deteriorated, and the total effective rate is 56.67%. The curative effect of the treatment group is better than that of the control group（P 〈0.05 ,P 〈0.01 ）. NIHSS scores were improved in both treatment group and control group （ P 〈 0.01 ）. And it shows that treatment on treatment group is better than the control group in improving patients NIHSS scores. [ Conclusion ] Wuchong Tongluo Tang joint with the modern rehabilitation in treating acute ischemic stroke can safely, effectively improve patients＇ daily living skills, and reduce sequelae. It is worthy of further study.