化痰通络汤治疗中风(风痰瘀阻)随机平行对照研究

A Randomized Parallel Control Study on Treatment of Apoplexy(Wind-Phlegm and Blood Stasis) with Phlegm-Eliminating and Collateral-Dredging Decoction

[目的]观察化痰通络汤治疗中风(风痰瘀阻)疗效。[方法]使用随机平行对照方法,将76例住院及门诊患者按随机数字表分两组。对照组38例奥扎格雷钠80mg+250mL氯化钠(浓度0. 9%),1次/d,静滴;同时给氧,保证呼吸通畅,监测体征,预防感染,维持水电解质平衡等对症治疗。治疗组38例化痰通络汤(法半夏、丹参、茯苓各15g,白术、川芎、天麻各12g,陈皮、地龙各10g,水蛭9g;痰火加黄连,竹茹,黄芩;气虚血瘀加当归,黄芪;肝肾阴虚加白芍,龟板;痰热腑实加火麻仁,生大黄),1剂/d,水煎200mL,早晚口服。连续治疗7d为1疗程。观测临床表现、BI指数计分、Fugl-Meyer运动功能评分、不良反应。治疗1疗程,判定疗效。[结果]治疗组治愈7例,显著进步12例,进步18例,无效1例,恶化0例,总有效率97. 37%;对照组治愈4例,显著进步12例,进步18例,无效3例,恶化1例,总有效率89. 47%;治疗组疗效优于对照组(P <0. 05)。BI指数计分、Fugl-Meyer运动功能评分两组均有明显升高(P <0. 05),治疗组升高优于对照组(P <0. 05)。[结论]化痰通络汤治疗中风(风痰瘀阻),疗效满意,无严重不良反应,值得推广。

[Objective]To observe the curative effect of Huatan Tongluo Decoction in the treatment of apoplexy( wind-phlegm and blood stasis).[Methods]Seventy-six inpatients and outpatients were randomly divided into two groups according to the order number. In the control group,38 cases of ozagrel were treated with 80 mg + 250 m L of sodium chloride( concentration 0. 9%),1 time/day by intravenous dripping,while oxygen was given to ensure the smooth respiration,the monitoring of the signs,the prevention of infectionand the maintenance of water electrolyte balance and other symptomatic treatment. The treatment group had 38 cases which were treated with Huatan Tongluo Decoction[Banxia( Rhizoma Pinelliae) 15 g,Danshen( Saviae Miltiorrhizae Radix) 15 g,Fuling( Poria) 15 g,Baizhu( Rhizoma Atractylodis Macrocephalae) 12 g,Chuanxiong( Bulbus Fritillariae Cirrhosae) 12 g,Tianma( Rhizoma Gastrodiae) 12 g,Chenpi( Pericarpium Citri Tangerinae) 10 g,Dilong( Lumbricus) 10 gand Shuizhi( Hirudo) 9 g. If there is phlegm and fire,the formula can add Huanglian( Coptidis Rhizoma),Zhuru( Caulis Bambusae),Huangqin( Radix et Rhizoma Rhei). If there is Qi deficiency and blood stasis,the formula can add Danggui( Radix Angelicae Sinensis) and Huangqin( Radix et Rhizoma Rhei). If there is Yin deficiency of liver and kidney,Baishao( Radix Paeoniae Alba) and Guiban( Carapax et Plastrum Testudinis. If there is phlegm-heat in the Fu-oragns,the formula can add Huomaren( Cannabis sativa) and Dahuang( Rheum palmatum)]. The water decoction was 200 m L,taking orally in the morning and evening. And the continuous treatment for 7 days was a course of treatment. The clinical manifestation,the score of the BI index,the function of the Fugl-Meyer exercise and the adverse reactions were observed. The curative effect was judged according to the treatment course of 1 course of treatment.[Results] In the treatment group,7 cases were cured,12 cases were significantly improved,18 cases were improved,1 case was not valid,0 case were deteriorated,the total effective rate was 97. 37%,4 cases were cured in the control group,12 cases were significantly improved,18 cases were improved,and 3 cases were invalid. The total effective rate was 89. 47%. The efficacy of treatment group was better than that of control group( P < 0. 05). The score of BI index was significantly higher in both groups( P < 0. 05).[Conclusion]In the treatment of stroke( wind-phlegm stasis),the effect is satisfactory and there is no serious adverse reaction.