黄芪赤风汤合独活寄生汤加减治疗缺血性卒中恢复期的临床研究

Clinical effect of Huangqi Chifeng Decoction combined with modified Duhuo Jisheng Decoction in the treatment of ischemic stroke during recovery

目的评价黄芪赤风汤合独活寄生汤加减治疗缺血性卒中(IS)恢复期患者临床疗效。方法前瞻性队列研究。将符合入选标准的2015年1月-2020年7月北京市东城区第一人民医院220例IS恢复期患者,按随机数字表法分为2组,每组110例。对照组采用基础治疗,观察组采用黄芪赤风汤合独活寄生汤加减治疗。2组均治疗1个月。分别于治疗前后进行中医证候评分,采用Barthel指数评价患者日常生活活动能力,脑卒中专用生命质量量表(SS-QOL)评估患者生命质量,美国国立卫生研究院卒中量表(NIHSS)评估患者神经功能损伤程度,改良Rankin量表评估卒中后功能恢复情况。观察记录治疗期间的不良反应。结果观察组治疗后中医证候评分、改良Rankin量表分级、NIHSS评分低于对照组(t值分别为21.87、4.66、12.06,P<0.01),Barthel指数、SS-QOL评分高于对照组(t值分别为14.13、5.80,P<0.01);2组治疗期间均未发生明显不良反应。结论黄芪赤风汤合独活寄生汤加减可有效改善IS恢复期患者的临床症状、神经功能,有利于患者的转归及生命质量的提高。

Objective To evaluate the clinical curative effect of Huangqi Chifeng Decoction combined with modified Duhuo Jisheng Decoction on patients with ischemic stroke(IS)during recovery.Methods Prospective cohort study.A total of 220 patients with IS during recovery who met inclusion criteria in the First People's Hospital of Dongcheng District in Beijing,were enrolled and divided into control group(n=110)and observation group(n=110)by random number table method between January 2015 and July 2020.The control group was given basic treatment,while observation group was given Huangqi Chifeng Decoction combined with modified Duhuo Jisheng Decoction.All were treated for 1 month.Before and after treatment,Traditional Chinese Medicine(TCM)syndromes were scored.The activities of daily living were evaluated by Barthel index.The quality of life was evaluated by stroke specific quality of life scale(SS-QOL).The severity of neurological impairment was evaluated by National Institute of Health Stroke Scale(NIHSS).The functional recovery of stroke was evaluated by modified Rankin scale(mRS).The adverse reactions during treatment were observed and recorded.Results After treatment,scores of TCM syndromes,mRS and NIHSS in observation group were significantly lower than those in the control group(t=21.87,4.66,12.06,P<0.01),while scores of Barthel index and SS-QOL were significantly higher than those in the control group(t=14.13,5.80,P<0.01).During treatment,there were no obvious adverse reactions in either group.Conclusion Huangqi Chifeng Decoction combined with modified Duhuo Jisheng Decoction can improve clinical symptoms and nerve function in patients with IS during recovery,which is beneficial to improve outcomes and quality of life.