加味半夏白术天麻汤合桃红四物汤联合西药治疗风痰瘀阻证中风的临床观察

Clinical Effects of Jiawei Banxia Baizhu Tianma Decoction and Taohong Siwu Decoction Combined with Western Medicine in the Treatment of Wind Phlegm Stasis Syndrome in Cerebral Apoplexy

目的探讨加味半夏白术天麻汤合桃红四物汤联合西药治疗风痰瘀阻证中风的临床疗效。方法选择急性脑梗死病人90例,符合西医急性脑梗死及中医风痰瘀阻证中风诊断标准,将90例病人随机分为两组。对照组42例,采用西药常规治疗;观察组48例,在对照组基础上联合加味半夏白术天麻汤合桃红四物汤治疗。比较两组临床疗效以及治疗前后中医痰证积分、血瘀证积分、美国国立卫生研究院脑卒中量表(NIHSS)评分;同时应用经颅多普勒(TCD)屏气试验检测屏气指数(BHI)评价脑血管储备功能;观察治疗过程中的不良反应。结果观察组治疗总有效率为85.42%,高于对照组的66.67%,差异有统计学意义(P<0.05);与治疗前比较,对照组治疗后中医痰证及血瘀证积分无显著变化(P>0.05),观察组治疗后中医痰证及血瘀证积分均有改善(P<0.05);两组治疗后NIHSS评分及BHI均有所改善(P<0.05),且治疗后观察组NIHSS评分及BHI均优于对照组(P<0.05);两组病人治疗过程中无明显不良反应。结论加味半夏白术天麻汤合桃红四物汤联合西药治疗中风风痰瘀阻证病人疗效显著,能改善痰证及血瘀证证候,提高脑血管储备功能。

Objective To observe the clinical efficacy of Jiawei Banxia Baizhu Tianma Decoction and Taohong Siwu Decoction combined with western medicine in the treatment of wind phlegm stasis syndrome in cerebral apoplexy,to provide theoretical basis for the treatment of wind phlegm stasis syndrome in cerebral apoplexy.Methods Ninety patients with acute cerebral infarction were divided into the control group(n=42)and the observation group(n=48).The control group were treated with western medicine,the observation group were treated with Jiawei Banxia Baizhu Tianma Decoction and Taohong Siwu Decoction on the basis of the control group.The clinical efficacy and scores of phlegm syndrome,blood stasis syndrome and National Institutes of Health Stroke Scale(NIHSS)score were compared between two groups.The function of cerebrovascular reserve(CVR)was evaluated by transcranial Doppler(TCD)to measure breath hold index(BHI)that was compared between two groups.The adverse reactions of two groups were observed.Results The total clinical efficacy of the observation group(85.42%)was significantly higher than that of the control group(66.67%,P<0.05).Compared with data before treatment,there was no significant difference between the scores of phlegm syndrome and blood stasis syndrome in the control group after treatment(P>0.05),and after treatment the scores of phlegm syndrome and blood stasis syndrome in the observation group were significantly improved(P<0.05).After treatment,the scores of NIHSS and BHI in two groups were improved(P<0.05),and the scores of NIHSS and BHI in the observation group were better than those in the control group(P<0.05).There were no adverse reactions in two groups.Conclusion Jiawei Banxia Baizhu Tianma Decoction and Taohong Siwu Decoction combined with western medicine in the treatment of wind phlegm stasis syndrome in cerebral apoplexy could significantly improve the phlegm syndromem,blood stasis syndrome,and improve CVR function.The treatment was safe.