星蒌承气汤治疗急性脑梗病痰热腑实证的临床效果

Clinical Observation on Xinglou Chengqi Decoction in the Treatment of Acute Ischemic Stroke Excess Syndrome of Phlegm Heat

目的:探讨星蒌承气汤治疗对急性脑梗死病痰热腑实证的疗效特点及其对疾病证候演变的影响。方法:选取2014年3月至2016年10月北京中医药大学东直门医院收治的急性脑梗死病痰热腑实证患者40例纳入研究,根据随机对照表以2∶1的比例分为观察组27例,对照组13例。对照组予以内科常规基础治疗,观察组在其基础上,加星篓承气汤加减口服;记录2组治疗前后的中医症状体征评分、痰热腑实证评分、美国国立卫生研究院卒中量表(NIHSS)评分,评价其疗效差异。同时检测分析2组血液流变学和脂代谢水平的变化。结果:治疗前2组中医症状体征评分比较,差异无统计学意义(P>0.05)。治疗后,观察组中医症状体征评分改善,差异有统计学意义(P<0.05),组间比较差异有统计学意义(P<0.05)。2组痰热腑实证评分治疗后,观察组的内火、痰湿、阴虚和总分均比对照组低(P<0.05)。治疗后观察组NIHSS评分较对照组降低(P<0.05)。治疗后,2组血液流变学和脂代谢水平均明显降低(P<0.05),且观察组优于对照组(P<0.05)。2组血液流变学与痰热腑实证总评分正相关(P<0.05),NIHSS评分未见明显相关性(P>0.05)。结论:使用星蒌承气汤对急性脑梗死病痰热腑实证患者,可以有效改善患者的中医证候积分及指标,缓解临床症状,充分体现中医辨证论治优势。

Objective： To explore the clinical characteristics of Xinglou Chengqi Decoction on acute ischemic stroke of phlegm heat excess syndrome and its effects on the evolution of disease syndrome.Methods： Forty cases of acute ischemic stroke with phlegm heat and bowel excess syndrome were studied.According to the ratio of 2∶ 1,they were divided into treatment group（ 27 cases）and control group（ 13 cases）.The control group received routine therapy,and the treatment group on the basis of adding Xinglou Chengqi Decoction orally.TCM symptoms score,phlegm heat and bowel excess syndrome score,NIHSS score of two groups before and after treatment were recorded,and the efficacy differences was evaluated.At the same time,the changes of hemorheology in the two groups were detected,and lipid metabolism were analyzed.Results： 1） There was no difference between the two groups of TCM symptoms and signs before treatment（ P〈0.05）.The score of TCM symptoms and signs in the treatment group was improved,and the difference was statistically significant after treatment（ P〈0.05）,but there was no significant difference between the two groups（ P〈0.05）.2） Two groups of phlegm heat excess syndrome score in treatment group after treatment,the fire,phlegm,yin deficiency and total score were lower than the control group（ P〈0.05）.3） The NIHSS score of the treatment group was lower than that of the control group after treatment（ P〈0.05）.4） The hemorheological indexes and lipid metabolism of the two groups were significantly decreased（ P〈0.05）,and the treatment group was better than the control group after treatment（ P〈0.05）.5） The blood rheology index of the two groups was positively correlated with the total score of phlegm heat and bowel excess.There was no significant correlation between NIHSS score（ P〉0.05）.Conclusion： Xinglou Chengqi Decoction on acute ischemic stroke in the patients with syndrome of phlegm heat,can effectively improve the patient＇s symptom scores and index,alleviate the clinical symptoms of TCM,fully embodies the advantages,which is worthy of promotion.