化痰通络汤辨证加减辅助治疗轻中度中老年急性缺血性脑卒中(风痰瘀阻证)的疗效观察

Therapeutic Effect of Huatan Tongluo Decoction Combined with Conventional Western Medicine on Middle-aged and Elderly Patients with Mild to Moderate Acute Ischemic Stroke(Syndrome of Wind-Phlegm Obstruction)

目的 观察化痰通络汤辨证加减联合常规西医疗法治疗轻中度中老年急性缺血性脑卒中(风痰瘀阻证)的临床疗效。方法 将2020年1月—2022年1月上林县中医医院收治的80例轻中度中老年急性缺血性脑卒中(风痰瘀阻证)患者按密闭信封法分为对照组(40例)和观察组(40例)。对照组实施常规西医疗法治疗,观察组基于对照组治疗方案展开化痰通络汤辨证加减治疗,两组均连续治疗2周,比较两组治疗效果。结果 治疗后,观察组基本痊愈率(55.00%)高于对照组(27.50%,P <0.05);两组美国国立卫生研究院卒中量表(NIHSS)评分均较治疗前降低(P <0.05),且观察组评分低于对照组(P <0.01);两组神经元特异性烯醇化酶(NSE)、超敏C反应蛋白(hs-CRP)、同型半胱氨酸(Hcy)表达均较治疗前降低(P <0.05),脑源性神经生长因子(BDNF)表达均较治疗前升高(P <0.05),且观察组各项指标变化幅度均高于对照组(P <0.01)。结论 采用化痰通络汤辨证加减联合常规西医疗法治疗轻中度中老年急性缺血性脑卒中(风痰瘀阻证)能改善患者神经功能,并起到抗炎、修复神经元损伤的作用。

Objective To observe the clinical efficacy of Huatan Tongluo Decoction combined with conventional western medicine in treating middle-aged and elderly patients with mild to moderate acute ischemic stroke(syndrome of wind-phlegm obstruction).Methods A total of 80 middle-aged and elderly patients with acute ischemic stroke(syndrome of wind-phlegm obstruction) admitted to Shanglin County Hospital of Traditional Chinese Medicine from January 2020 to January 2022 were assigned into a control group(40 patients) and an observation group(40 patients) according to the sealed envelope method.The control group was treated with conventional western medicine,and the observation group with Huatan Tongluo Decoction combined with conventional western medicine.Both groups were treated for two consecutive weeks and then the therapeutic effect was compared between the two groups.Results After treatment,the basic recovery rate of the observation group(55.00%) was higher than that(27.50%) of the control group(P < 0.05).The treatment in both groups decreased the National Institutes of Health Stroke Scale(NIHSS) score(P < 0.05),and the score in the observation group was lower than that in the control group after treatment(P < 0.01).The treatment in both groups down-regulated the expression of neuron-specific enolase(NSE),hyper-sensitive C-reactive protein(hs CRP),and homocysteine(Hcy)(P < 0.05) and up-regulated the expression of brain-derived neurotrophic factor(BDNF)(P < 0.05).Moreover,the changes in the observation group were larger than those in the control group(P < 0.01).Conclusion Huatan Tongluo Decoction combined with conventional western medicine can improve the neurological function,alleviate inflammation,and repair neuronal damage in the middle-aged and elderly patients with mild to moderate acute ischemic stroke(syndrome of wind-phlegm obstruction).