辨证分型联合西药治疗中风150例临床观察

Syndromes Combined Western Medicine Clinical Observation 150 Cases of Stroke

[目的]观察辨证分型联合西药治疗中风疗效。[方法]使用随机平行对照方法,将150例门诊及住院患者按中医辨证分为四组。风火上扰(A组):镇肝熄风,镇肝熄风汤(怀牛膝12g,代赭石15g,龙骨、牡蛎各12g,白芍、玄参、龟板、天冬、茵陈、川楝子、生麦芽各8g,甘草6g),1剂/d,水煎200m L,早晚口服;30m L醒脑静+500m L生理盐水,1次/d,静滴;风痰瘀阻(B组):祛风、养血、活血、化痰通络,大秦艽汤(秦艽、羌活、独活、防风各12g,当归、白芍、熟地、川芎、白术、茯苓、黄芩、石膏、生地各8g),1剂/d,水煎200m L,早晚口服;6m L疏血通+500m L生理盐水,1次/d,静滴;阿司匹林,300mg/次,1次/d;风痰上扰(C组):化痰通腑,星蒌承气汤:胆南星、全瓜蒌各10g,生大黄、芒硝各6g,1剂/d,水煎100m L,早晚口服;6m L疏血通+500m L生理盐水,1次/d,静滴;阿司匹林,300mg/次,1次/d;气虚血瘀(D组):补气活血,补阳还五汤(生黄芪15g,当归尾、川芎、赤芍、桃仁、红花、地龙各10g),1剂/d,水煎100m L,早晚口服。连续治疗14d为1疗程。观测临床症状、Barthel指数、运动功能评分、不良反应。连续治疗2疗程,判定疗效。[结果]A组痊愈16例,显效8例,有效4例,无效0例,总有效率100.00%。B组痊愈18例,显效7例,有效6例,无效2例,总有效率93.94%。C组痊愈49例,显效10例,有效7例,无效11例,总有效率85.71%。D组痊愈5例,显效3例,有效3例,无效1例,总有效率91.67%。临床疗效A组>B组>D组>C组,临床疗效无明显差异(P>0.05)。运动功能评分四组均有改善(P<0.05,P<0.01),C组>B组>D组>A组,四组间无明显差异(P>0.05)。[结论]辨证分型联合西药治疗中风效果显著,无严重不良反应,值得推广。

[Objective] To observe syndrome type combined western medicine stroke effect.[Methods]Using random parallel control method, 150 cases of outpatient and inpatient according to TCM syndrome type method is simple and randomly divided into four groups. Group A： Zhenganxifeng, Zhenganxifeng soup（Huainiuxi 12 g, Daizheshi15 g, Longgu,Muli 12 g, Baishao,Xuanshen,Guiban,Tiandong,Yinchen,Chuanjiezi,Shengmaiya 8g,Gancao 6g）, 1 / d, decoction 200 m L, sooner or later, oral; 30 m L Xingnaojing ＋ 500 m L saline, 1 times / d, intravenously; group B： chills, blood, blood, phlegm meridians, Daqin macrophylla Tang（Qingjiu,Qianghuo,Duhuo,Fangfeng 12 g,Danggui,Baishao,Shudi,Chuanqiong, Baizhu,Fuling,Huangqi,Shigao,Shengdi 8g）, 1 / d, decoction 200 m L, sooner or later, oral; 6m L sparse blood through ＋ 500 m L saline, 1 times / d, intravenously; aspirin, 300 mg / times, 1 time / d; group C： phlegm Relaxing, Xinglou Dachengqitang： Dannanxing,Quangualou 10 g, Shengdahuang,Mangxiao each 6g, 1/ d, decoction 100 m L, sooner or later, oral; 6m L Shuxuetong ＋ 500 m L saline, 1 times / d, intravenously; aspirin, 300 mg / times, 1 time / d; D group： Buqihuoxue, Buyanghuanwu soup（Shenghuangqi 15 g, Dangguiwei,Chuanqiong,Chishao,Taoren,Honghua,Dilong each 10g）, 1/ d, decoction 100 m L, sooner or later orally. 14 d is a continuous course of treatment. Observation of clinical symptoms, Barthel Index, motor function scores, adverse reactions. Continuous treatment of two courses, determine efficacy. [Results] A group of cured 16 cases, 8 cases were markedly effective in 4 cases, 0 cases, the total efficiency of 100.00%. Group B cured 18 cases, seven cases markedly effective in 6 cases, 2 cases, the total efficiency of 93.94%. Group C cured 49 cases, effective in 10 cases, effective in 7 cases, 11 cases, the total efficiency of 85.71%. D group recovered five cases, three cases markedly effective in 3 cases, 1 case, the total efficiency of 91.67%. Clinical efficacy A group B group D group C group, no significant difference（P 0.05） clinical efficacy. Motor scores were improved in four groups（P〈0.05, P〈0.01）, C group〉Group B〉D Group〉A group,no significant differences among the four groups（P〉0.05）. [Conclusion] Syndrome type combined western medicine stroke effect is significant, it is worth promoting.