通窍活血汤联合常规西药治疗气虚血瘀型脑血栓形成患者的效果

Effects of Tongqiao Huoxue decoction combined with conventional western medicine on patients with cerebral thrombosis of Qi deficiency and blood stasis type

目的:观察通窍活血汤联合常规西药治疗气虚血瘀型脑血栓形成患者的效果。方法:选取2018年4月至2020年12月该院收治的98例脑血栓形成患者进行前瞻性研究,按随机数字表法分为对照组(n=49)和研究组(n=49)。对照组采用常规西药治疗,研究组在对照组基础上采用通窍活血汤治疗,比较两组临床疗效、治疗前后脑血流动力学指标[搏动指数(PI)、阻力指数(RI)、平均血流速度(Vm)]水平、凝血功能指标[活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)、纤维蛋白原(Fib)]水平、神经功能缺损程度[美国国立卫生研究院卒中量表(NIHSS)]评分,以及不良反应发生率。结果:研究组治疗总有效率为95.92%(47/49),高于对照组的81.63%(40/49),差异有统计学意义(P<0.05);治疗后,两组PI、RI均低于治疗前,且研究组低于对照组,两组Vm均高于治疗前,且研究组高于对照组,差异有统计学意义(P<0.05);治疗后,两组APTT、PT、TT均长于治疗前,且研究组长于对照组,两组Fib水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);治疗后,两组NIHSS评分均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);研究组不良反应发生率为4.08%(2/49),低于对照组的20.41%(10/49),差异有统计学意义(P<0.05)。结论:通窍活血汤联合常规西药治疗气虚血瘀型脑血栓形成患者可提高治疗总有效率,改善脑血流动力学指标和凝血功能指标水平,减轻神经功能缺损程度,以及降低不良反应发生率,效果优于单纯常规西药治疗。

Objective:To observe effects of Tongqiao Huoxue decoction combined with conventional western medicine on patients with cerebral thrombosis of Qi deficiency and blood stasis type.Methods:A prospective study was conducted on 98 patients with cerebral thrombosis admitted to the hospital from April 2018 to December 2020.They were divided into control group(n=49)and study group(n=49)according to the random number table method.The control group was treated with conventional western medicine,while the study group was treated with Tongqiao Huoxue decoction on the basis of that of the control group.The clinical efficacy,the cerebral hemodynamic index levels[pulsatility index(PI),resistance index(RI),mean blood flow velocity(Vm)],the coagulation function index levels[activated partial thromboplastin time(APTT),prothrombin time(PT),thrombin time(TT),fibrinogen(Fib)],the neurological deficit degree[national institutes of health stroke scale(NIHSS)]score,and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate of treatment in the study group was 95.92%(47/49),which was higher than 81.63%(40/49)in the control group,and the difference was statistically significant(P<0.05).After the treatment,the levels of PI and RI in the two groups were lower than those before the treatment,and those in the study group were lower than the control group;the Vm levels of the two groups were higher than those before the treatment,and that of the study group was higher than that of the control group;and the differences were statistically significant(P<0.05).After the treatment,the levels of APTT,PT and TT in the two groups were longer than those before the treatment,and those in the study group were longer than the control group;the Fib levels of the two groups were lower than those before the treatment,and that of the study group was lower than that of the control group;and the differences were statistically significant(P<0.05).After the treatment,the NIHSS scores of the two groups were lower than those before the treatment,that of the study group was lower than that of the control group,and the differences were statistically significant(P<0.05).Further,the incidence of adverse reactions of the study group was 4.08%(2/49),which was lower than 20.41%(10/48)in the control group,and the difference was statistically significant(P<0.05).Conclusions:Tongqiao Huoxue decoction combined with conventional western medicine can improve the total effective rate of treatment,improve the levels of cerebral hemodynamics and coagulation function,reduce the degree of neurological deficits,and reduce the incidence of adverse reactions in the patients with cerebral thrombosis of Qi deficiency and blood stasis type.Moreover,it is superior to single conventional western medicine treatment.