天麻钩藤饮联合安宫牛黄丸治疗中风中脏腑阳闭证临床研究

Clinical Study on the Treatment of Tianma Gouteng Decoction Combined with Angong Niuhuang Pill for the Stroke Patients with Viscera Yang Syndrome

目的观察天麻钩藤饮联合安宫牛黄丸治疗中风中脏腑阳闭证患者的临床疗效和安全性。方法把63例符合纳入标准的中风中脏腑阳闭证患者按随机数字表法分为3组,分别为观察组23例(常规西药治疗+天麻钩藤饮加减+安宫牛黄丸)、对照组A 20例(常规西药治疗+安宫牛黄丸)和对照组B 20例(常规西药治疗+天麻钩藤饮加减)。结果经治疗2周后,观察组从昏迷至清醒时间天数及临床疗效、中医证候疗效的总有效率优于对照组A和B(P<0.05),对照组A和对照组B比较,差异无统计学意义(P>0.05);3组患者的美国国立卫生研究院卒中量表(National health research stroke scale,NIHSS)评分、格拉斯哥昏迷评分(Glasgow coma score,GCS)、中医证候积分、血清同型半胱氨酸(Homocysteine,Hcy)水平均得到不同程度的改善,观察组较对照组A和对照组B改善程度更为显著(P<0.01);两组对照组进行比较,差异无统计学意义(P>0.05)。结论天麻钩藤饮联合安宫牛黄丸可缩短昏迷至清醒时间,降低血清Hcy浓度及改善NIHSS评分,从而提高患者生活质量。

Objective To observing the clinical efficacy and safety of addition and subtraction Tianma Gouteng Decoction combined with Angong Niuhuang Pill in the treatment of stroke patients with viscera yang syndrome. Methods Sixty-three patients with Yang shutting syndrome of central viscera of stroke who met the inclusion criteria were included,in line with random number table method divided into three groups,respectively for 23 cases of observation group(conventional Western medicine treatment + addition and subtraction Tianma Gouteng Decoction + Angong Niuhuang Pill)and control group of A 20 cases(conventional Western medicine treatment + Angong Niuhuang Pill)and control group B 20 cases(conventional Western medicine treatment + addition and subtraction Tianma Gouteng Decoction). Results After 2 weeks of treatment,the total effective rate of the observation group from coma to wakefulness days,clinical efficacy and therapeutic effect of TCM symptoms was better than that of control group A and B(P<0.05). The difference between control group A and control group B was not statistically significant(P>0.05).The national institutes of health stroke scale score(NIHSS score),Glasgow score(GCS),TCM syndrome score and serum homocysteine(Hcy)level of the three groups were all improved to different degrees. The improvement degree of the observation group was more significant than that of control group A and control group B(P<0.0). The difference between the two groups was not statistically significant(P>0.05). Conclusion Tianma Gouteng Decoction combined with Angong Niuhuang Pill can shorten the time from coma to wakefulness,reduce the serum Hcy concentration and improve the NIHSS score,thus improving the quality of life of patients.