清热凉血通瘀汤加减辅助治疗缺血性脑卒中急性期临床疗效

Qingre Liangxue Tongyu Decoction in Adjuvant Treatment of Acute Ischemic Stroke

目的:探讨清热凉血通瘀汤加减辅助治疗缺血性脑卒中急性期临床疗效,同时观察其对患者血流动力学的影响,从而为临床患者规范、合理治疗提供参考,更好地改善其预后。方法:按照随机数字表法将2013年2月—2015年2月152例缺血性脑卒中急性期患者分组为对照组(常规西医治疗)与治疗组(于对照组治疗基础上加中药清热凉血通瘀汤治疗),各76例。比较两组患者治疗前、后血液流变学变化及临床症状积分变化,统计两组临床疗效及不良反应。结果:治疗后,治疗组全血黏度高切、全血黏度低切、血浆比黏度、甘油三酯、血沉及红细胞聚集指数较治疗前显著改善,对照组除血沉及细胞聚集指数外,其他各项指标较治疗前显著改善,P<0.05;然治疗组各项血流动力学指标较对照组改善显著,P<0.05。治疗后两组患者各项临床症状积分较治疗前显著下降,P<0.05,除语言外,治疗组其他各项临床症状积分较对照组改善显著,P<0.05。治疗组治疗总有效率96.1%明显高于对照组69.7%,P<0.05;治疗期间未见明显不良反应。结论:应用清热凉血通瘀汤辅助治疗缺血性脑卒中急性期可显著改善患者临床症状及血流动力学,提高临床疗效,且具有一定安全性。

Objective： To discuss the clinical efficacy of Qingre Liangxue Tongyu Decoction in the adjuvant treatment of acute ischemic stroke and observe its effects on hemodynamics so as to standardize the clinical patients and reasonable treatment to provide a reference and to better improve their prognosis. Methods： During February 2013- February 2015,by the random number table,a tatal of 152 patients with acute ischemic stroke cases were grouped into control group（ routine therapy） and treatment group（ on the basis of the control group adding Qingre Liangxue Tongyu Decoction）,each 76 cases. We compared two groups’ hemorheology and clinical symptom score changes of patients before and after treatment and observed the clinical efficacy and adverse reactions. Results： After the treatment,high shear whole blood viscosity,whole blood viscosity at low shear,plasma viscosity,triglyc-erides,erythrocyte sedimentation rate and erythrocyte aggregation index were significantly improved compared with those before treatment and those of the control group except ESR and cell aggregation index. Other indicators significantly improved compared with those before treatment,P 〈 0. 05. However,all hemodynamic parameters in treatment group compared with those of the control group improved significantly,P 〈 0. 05. After treatment,the patients’ clinical symptom scores significantly decreased,P 〈 0. 05.Except language,other clinical symptom scores improved significantly compared with those of the control group,P 〈 0. 05. The total efficiency of the treatment group（ 96. 1%） was significantly higher than that of the control group（ 69. 7%）,P 〈 0. 05. There was no significant adverse reaction during treatment. Conclusion： Application of Qingre Liangxue Tongyu Decoction in the adjuvant treatment of acute ischemic stroke can significantly improve the clinical symptoms and hemodynamics,improve clinical outcomes,and has a certain security.