加味桃核承气汤治疗急性脑梗死(痰热腑实证)的疗效观察

Effects of Modified Taohe Chengqi Decoction in Treating Acute Cerebral Infarction with Phlegm-Heat Excess Syndrome

目的探讨加味桃核承气汤治疗急性脑梗死(痰热腑实证)的临床疗效。方法102例患者均行静脉溶栓治疗,随机分为对照组与观察组各51例。对照组给予常规治疗,观察组在对照组的基础上加用加味桃核承气汤口服。比较两组中医证候疗效,治疗前后美国国立卫生研究院卒中量表(NIHSS)评分、中医证候积分、血清炎性因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)]、大脑中动脉平均血流速度(VMCA)、阻力指数(RI)、最小血流速度(Qmin)、梗死区域CT灌注成像[脑血流量(CBF)、脑血容量(CBV)和平均通过时间(MTT)]。结果观察组的中医证候总有效率明显高于对照组(P<0.05);两组治疗后的NIHSS评分、中医证候积分,血清TNF-ɑ、IL-6、hs-CRP含量,RI和MTT均明显低于治疗前(P<0.05),且观察组治疗后各项指标均低于对照组(P<0.05);两组治疗后VMCA、Qmin、CBV、CBF均明显高于治疗治疗前(P<0.05),且观察组治疗后上述指标均高于对照组(P<0.05)。结论加味桃核承气汤治疗急性脑梗死(痰热腑实证)可以提高疗效,改善神经缺损功能,抑制炎症,提高大脑血流速度。

Objective:To explore the clinical efficacy of Modified Taohe Chengqi Decoction in treating acute cerebral infarction with phlegm-heat excess syndrome.Methods:A total of 102 patients with acute cerebral infarction with phlegm-heat excess syndrome were randomly divided into a control group and an observation group,with51 cases in each group.Both groups received conventional treatment while the observation group received additional Modified Taohe Chengqi Decoction.The efficacy of TCM syndromes,the National Institutes of Health Stroke Scale(NIHSS)scores,TCM syndrome scores,serum inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),high-sensitivity C-reactive protein(hs-CRP)],middle cerebral artery blood flow velocity(VMCA),RI,Qmin,CBF,CBV,MTT between the two groups were compared.Results:The total effective rate of TCM syndromes in the observation group was significantly higher than that in the control group(P<0.05);the NIHSS scores,TCM syndrome scores,serum TNF-α,IL-6,and hs-CRP levels and RI and MTT in the two groups decreased significantly after treatment(P<0.05),and all indicators of the observation group after treatment were lower than those of the control group(P<0.05);the VMCA,Qmin,CBV,CBF in the two groups increased significantly after treatment(P<0.05),and the above indicators in the observation group were higher than those in the control group after treatment(P<0.05).Conclusion:Modified Taohe Chengqi Decoction could improve the efficacy,nerve defect function,inhibit inflammation,and increase cerebral blood flow speed in patients of acute cerebral infarction with phlegm-heat excess syndrome.