化痰通腑法不同干预时点对急性脑梗死痰热腑实证患者预后的影响

Influence of different intervening time of the therapy of dissipating phlegm and relaxing bowels on the prognosis of patients with acute cerebral infarction

目的:观察化痰通腑法不同干预时点对急性脑梗死痰热腑实证患者预后的症状、体征及中风证候要素变化的影响,探讨化痰通腑法应用的最佳时机。方法:纳入急性脑梗死痰热腑实证患者68例,在通腑前后对患者进行《美国国立卫生研究院卒中量表》《中医症状与体征积分量表》《中风病痰热腑实证候评价量表》及《缺血性中风证候要素量表》的评价。结果:化痰通腑法早、中及晚期干预组对神经功能缺损及内风、内火、痰湿的实性证候要素均具有改善作用(P<0.01,P<0.05),早、中期干预组对阴虚证候要素具有改善作用(P<0.05),中期干预组对气虚及血瘀证候要素具有改善作用(P<0.05)。结论:对急性脑梗死痰热腑实证患者,越早使用化痰通腑法,越能体现化痰通腑法急下存阴、固护正气的效用。

Objective： To explore the optimum intervening time of the therapy of dissipating phlegm and relaxing bowels, the influence of different intervening time on the prognosis of acute cerebral infarction patients with syndrome of excessive fuviscera caused by phlegm-heat was observed. Methods： Sixty-eight acute cerebral infarction patients with syndrome of excessive fu-viscera caused by phlegm-heat who met the inclusion criteria were included. The patients were assessed with the National Institutes of Health Stroke Scale, TCM Symptom and Sign Integral Scale, Syndrome of Excessive Fu-viscera Caused by Phlegmheat Evaluation Scale and Syndrome Factors of Ischemic Stroke Evaluation Scale before and after treatment. Results： Therapy of dissipating phlegm and relaxing bowels could improve the neurologic impairment and syndrome factors as endogenous wind, endogenous heat and phlegm-damp（P0.01, P0.05）. Besides, the scores of yin deficiency dropped in both early and intermediate intervention group（P0.05）. The scores of qi deficiency and blood stasis reduced only in intermediate intervention group（P0.05）. Conclusion： Acute cerebral infarction patients with syndrome of excessive fu-viscera caused by phlegm-heat can get better prognosis with therapy of dissipating phlegm and relaxing bowels as soon as possible, which has effect of timely purgation to preserve yin and vital qi.