星蒌承气汤治疗急性脑梗死痰热腑实证患者的临床疗效

Clinical efficacy of Xinglouchengqi decoction in treating phlegm-heat Fu-organs syndrome of acute cerebral infarction

目的观察星蒌承气汤治疗急性脑梗死(ACI)痰热腑实证患者的临床疗效。方法选取2018年8月—2020年9月莱西市市立医院收治的ACI患者80例,按照随机数字表法分为对照组与观察组,各40例。对照组予以神经保护、抗血小板聚集、抗凝、控制原发病等常规治疗,观察组在常规治疗基础上加用星蒌承气汤治疗。2组均连续治疗12周。比较2组临床疗效,治疗前后中医证候积分、美国国立卫生研究院卒中量表(NIHSS)评分、日常生活能力量表(ADL)评分、血液流变学指标(全血高切黏度、血浆黏度及全血低切黏度),并观察2组不良反应。结果观察组临床总有效率为95.00%,高于对照组的77.50%(χ^(2)=5.165,P<0.05)。治疗后,2组中医证候积分、NIHSS评分低于治疗前,ADL评分高于治疗前,且观察组中医证候积分、NIHSS评分低于对照组,ADL评分高对照组(P<0.01)。治疗后,2组全血高切黏度、血浆黏度、全血低切黏度低于治疗前,且观察组全血高切黏度、血浆黏度、全血低切黏度低于对照组(P<0.01)。治疗期间2组均未见明显不良反应。结论星蒌承气汤治疗ACI痰热腑实证患者的临床疗效确切,能有效改善患者神经功能、血液流变学,提高日常生活能力,且安全性较高。

Objective To investigate the clinical efficacy of Xinglouchengqi decoction in treating phlegm-heat Fu-organs syndrome of acute cerebral infarction(ACI).Methods A total of 80 cases of patients with phlegm-heat Fu-organs syndrome of ACI were selected from August 2018 to September 2020 in Laixi Municipal Hospital,which were randomly divided into control group and observation group according to the random number table method,40 cases in each group.The control group was given routine treatment such as neuroprotection,antiplatelet aggregation,anticoagulation and primary disease control.The observation group was treated with Xinglouchengqi decoction on the basis of conventional treatment.Both groups were treated continuously for 12 weeks.Clinical efficacy,TCM syndrome score,National Institutes of Health Stroke Scale(NIHSS) score,Activity of Daily Living Scale(ADL) score,hemorheological indexes(whole blood high shear viscosity,plasma viscosity and whole blood low shear viscosity) before and after treatment were compared between the two groups,and the incidence of adverse reactions were observed.Results The total clinical effective rate in the observation group was 95.00%,higher than 77.50% in the control group(P< 0.05).After treatment,the scores of TCM syndromes and NIHSS in the control group and the observation group were lower than those before treatment,while the scores of ADL were higher than those before treatment,respectively,and the scores of TCM syndromes and NIHSS in the observation group were lower than those in the control group,while the scores of ADL were higher than those in the control group(P< 0.05).After treatment,the whole blood high-shear viscosity,plasma viscosity and whole blood low-shear viscosity in the control group and the observation group were lower than those before treatment,respectively,and the whole blood high-shear viscosity,plasma viscosity and whole blood low-shear viscosity in the observation group were lower than those in the control group(P< 0.05).No obvious adverse reactions were found in both groups during the treatment period.Conclusion Xinglouchengqi decoction have an exact clinical effect for phlegm-heat Fu-organs syndrome of ACI,which can effectively improve patients′ neurological function,hemorheology and daily living ability,and with high safety.