中医临床路径治疗风痰阻络型急性脑梗死随机平行对照研究

Clinical Pathway of Traditional Chinese Medicine Treatment of Wind Phlegm Obstruction Type Complex Random Parallel Control Study of Acute Cerebral Infarction

[目的]观察中医临床路径治疗风痰阻络型急性脑梗死疗效。[方法]使用随机平行对照方法，将60例住院患者按就诊顺序号抽签方法简单随机分为两组。对照组30例脱水、维持水和电解质平衡、抗血小板聚集、脑保护、防治并发症。治疗组30例按《风痰阻络型急性脑梗死临床路径》治疗，真方白丸子（法半夏、胆南星、白附子、天麻各10g，全蝎5g，当归、白芍各lOg，鸡血藤20g，牛膝、桑叶、菊花各10g），浓煎400mL，1剂／d，早晚分服；药物敷贴选用远红外穴位敷贴（合谷、曲池、足三里、丰隆等），针灸（肩髑、曲池、外关、合谷、足三里、阴陵泉、丰隆、太冲等）；基础治疗同对照组。连续治疗10～14d为1疗程。观测临床症状、神经功能缺损程度评分、不良反应。治疗1疗程，判定疗效。[结果]治疗组痊愈3例，显效1例，有效24例，无效2例，总有效率93．33％。对照组痊愈O例，显效O例，有效19例，无效11例，总有效率63．33％。治疗组疗效优于对照组（P〈0．05）。神经功能缺损程度评分、症状总分治疗组治疗组优于对照组（P〈0．05）。[结论]中医临床路径治疗风痰阻络型急性脑梗死，疗效满意，无严重不良反应，值得推广。

[Objective] To observe the traditional Chinese medicine clinical pathway＇s treatment curative effect of wind phlegm acute cerebral infarction. [Methods] Using random parallel comparison methods, taking 60 cases of inpatients divided into two groups, in a clinic serial number and in a simple random draw . Comparison group of 30 eases of dehydration, maintaining water and electrolyte balance, antiplatelet aggregation, brain protection, prevention and treatment of complications.Treatment group of 30 cases,treat according to the wind phlegm acute cerebral infarction clinical pathway, with prescription of white balls （pinellia, bravery south star, giant typhonium rhizome, rhizoma gastrodiae per 10 g, scorpion 5 g, angelica, radix paeoniae alba per 10g, suberect spatholobus stem 20 g, twotooth achyranthes root, mulberry leaf, chrysanthemum 10 g）, thick Fried 400 ml, 1 dose / d, take in the morning and evening ;Drug patches of far-infrared acupoint sticking （union valley, QU chi, foot three mile, hong leong, etc.）, acupuncture （shoulder Yu, QU chi, closed, or union valley, foot three mile, Yin ling spring, hong leong, Taichong, etc.）; Foundation treatment is the same as the comparison group. Continuous treatment of 10-14 d to one course.Observation of clinical symptoms, the degree of nerve function defect score and adverse reactions, and then judge curative effect for course treatment.[Result] Treatment group, 3 cases recovered, 1 case had marked effect, 24 cases had effect ,2 cases had no effect , total effective rate was 93.33%. The comparison group no one recovered, no one had marked effect, 19 cases had effect, 11 cases had no effect, total effective rate was 63.33%. The treatment group＇s curative effect is better than that of comparison group （P〈0.05）. Degree of nerve function defect score, the symptoms score in treatment group is better than that of comparison group （P〈0.05）. [Conclusion]The traditional Chinese medicine clinical pathway treatment wind phlegm acute cerebral infarction, curative effect is satisfied and there is no serious adverse reactions and be worthy of promotion.