“中风阴阳类证辨证及其方证疗效体系”治疗症状性大脑中动脉狭窄的远期疗效

‘Stroke and Syndrome Differentiation and Syndrome Treatment System' to Treat Symptomatic Middle Cerebral Artery Stenosis Term Observation of Curative

目的:探讨"中风阴阳类证辨证及其方证疗效体系"对治疗症状性大脑中动脉狭窄患者预后的影响。方法:对采用"中风阴阳类证辨证及其方证疗效体系"结合内科治疗的46例(观察组)及仅采用内科药物治疗的35例(对照组)症状性大脑中动脉狭窄病例进行回顾分析。记录两组随访期内再中风及死亡的发生情况;采用经颅多普勒超声(TCD)检测患者血流动力学;应用改良兰金评分量表mRS(modified rankin scale,MRS)标准系统评价患者功能。结果:随访时间内观察组再中风发生率为6.52%,低于对照组的22.86%(P<0.05);观察组死亡率4.35%,对照组为14.29%,差异无统计学意义;比较血管收缩期峰值(peak value of systole,Vs),治疗后观察组Vs病/Vs健较治疗前明显下降(P<0.05),对照组与治疗前比较变化不明显,治疗后观察组Vs病/Vs健低于对照组(P<0.05);两组治疗后MRS评分均比治疗前下降(P<0.05),治疗后观察组MRS评分低于对照组(P<0.05)。结论:"中风阴阳类证辨证及其方证疗效体系"联合内科治疗可有效降低症状性大脑中动脉狭窄患者的再中风率,改善脑血流速度和改善神经功能缺损症状。

Objective：To discuss the influence of ischemic stroke traditional Chinese medicine syndrome types differentiated from yin-syndrome and yang-syndrome and its efficacy system on treating symptomatic middle cerebral artery atherosclerosis stenosis on prognosis.Method：Forty-six patients of symptomatic middle cerebral artery atherosclerosis stenosis treated with ischemic stroke traditional Chinese medicine syndrome types differentiated from yin-syndrome and yang-syndrome and its efficacy system with medical treatment （observation group） and thirty-five patients of the same disease with only medical treatment （control group） were retrospectively analyzed.the rates of recurrent stroke and mortality of the two groups in the follow-ups were recorded.The haemodynamics results were evaluated by TCD （transcranial dopper） and mRS （modified rankin scale） were evaluated.Result：In the average periods of follow-ups,the rates of recurrent stroke were 6.52％ in the observation group and 22.86％ in the control group （P ＜ 0.05）; the mortality rates were 4.35％ in the observation group and 14.29％ in the control group,which were statistically insignificant.The ratio of Vs （peak value of systole） before and after treatment was statistically significant （P ＜0.05） in the observation group,while the ratio in the control group was statistically insignificant.After the treatment,the ratio compared with the two groups were statistically significant （P ＜ 0.05）.Conclusion：Ischemic stroke traditional Chinese medicine syndrome types differentiated from yin-syndrome and yang-syndrome and its efficacy system with medical treatment is proved to reduce the rate of recurrent ischemic stroke,change the brain blood speed and improve the neurological defects with regard to the patients suffered from symptomatic middle cerebral artery atherosclerosis stenosis.