醒神汤联合常规西医疗法治疗急性缺血性脑卒中临床观察

Clinical Observation of Xingshen Tang Combined with Routine Western Medicine Therapy for Acute Ischemic Stroke

目的:观察醒神汤联合常规西医疗法治疗急性缺血性脑卒中痰湿蒙神证患者的疗效。方法:将102例急性缺血性脑卒中痰湿蒙神证患者随机分为对照组和观察组各51例。对照组给予吸氧与呼吸支持,控制血压、血糖,营养支持,改善脑血循环及保护神经等综合处理,观察组在对照组治疗的基础上加用醒神汤治疗,2组疗程均14天。治疗前后评定2组患者的美国国立卫生研究院卒中量表(NIHSS)评分、痰湿蒙神证评分,采用Barthel指数(BI)评价日常生活能力,采用Ashworth痉挛评定量表评价肢体痉挛程度。结果:观察组总有效率为92.16%,对照组为76.47%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组NIHSS评分、Ashworth评分和痰湿蒙神证评分均较治疗前下降,BI较治疗前升高,差异均有统计学意义(P<0.01);观察组NIHSS评分、Ashworth评分和痰湿蒙神证评分均低于对照组,BI高于对照组,差异均有统计学意义(P<0.01)。结论:在西医常规治疗的基础上采用醒神汤治疗急性缺血性脑卒中痰湿蒙神证患者,能有效减轻神经功能缺损程度,改善临床症状,缓解肢体痉挛程度,提高患者的生活自理能力。

Objective： To observe the clinical effect of Xingshen tang combined with routine western medicine therapy for acute ischemic stroke of phlegm-dampness confusing mind syndrome. Methods： Divided 102 cases of patients with acute ischemic stroke of phlegm-dampness confusing mind syndrome into the control group and the observation group randomly, 51 cases in each group. Both groups received oxygen inhalation and respiratory support, control of blood pressure and glucose,nutritional support, improvement of brain circulation, neural protection and other comprehensive treatment. The observation group additionally received Xingshen tang for treatment. The course for both groups lasted for 14 days. Determined National Institute of Health stroke scale（NIHSS） and scores of phlegm-dampness confusing mind syndrome in both groups after treatment. Observed activity of daily living using Barthel indexes, and evaluated degree of spasm using Ashworth scoring method in both groups after treatment. Results： The total effective rate was 92.16% in the observation group and 76.47% in the control group, the difference being significant（P〈0.05）. After treatment, comparing with those before treatment, scores of NIHSS, Ashworth and phlegm-dampness confusing mind syndrome in both groups were decreased, while scores of Barthel indexes in both groups were increased（P〈0.01）. Scores of NIHSS, Ashworth and phlegm-dampness confusing mind syndrome in the observation group were lower than those in the control group, while scores of Barthel indexes in the observation group were higher than those in the control group（P〈0.01）. Conclusion： The therapy of Xingshen tang based on routine western medicine therapy for acute ischemic stroke of phlegm-dampness confusing mind syndrome can effectively reduce the degree of neurologic impairment, improve clinical symptoms, relieve the degree of spasm, and enhance the activity of daily living. Its clinical effect is superior to that of pure western medicine therapy.