续命汤化裁方治疗脑梗死(风痰瘀阻证)的疗效及对脑血流动力学指标的影响

Efficacy Observation on Modified Xuming Decoction in the Treatment of Cerebral Infarction(Syndrome of Blockade of Wind-phlegm-static Blood)and Its Effect on Cerebral Hemodynamics

目的观察续命汤化裁方治疗脑梗死(风痰瘀阻证)的疗效及对脑血流动力学指标的影响。方法将脑梗死患者80例按随机数字表法分为对照组与治疗组各40例。对照组根据指南进行常规治疗;治疗组在对照组的基础上给予续命汤化裁方内服。两组均治疗2周。比较美国国立卫生院神经功能缺损量表(NIHSS)评分、生活能力Barthel指数评分、风痰瘀阻证症状评分、疗效以及脑血流动力学指标。结果治疗后,两组的NIHSS评分明显降低,Barthel指数评分显著上升,治疗组上述指标评分改善更为显著(P<0.01);治疗后,两组风痰瘀阻证症状评分明显降低,治疗组降低更为明显(P<0.01);治疗组总有效率为92.50%,明显高于对照组的72.50%(P<0.05);治疗后,两组双侧大脑中动脉的平均血流流速(Vm)明显升高,血管阻力指数(RI)显著降低,治疗组以上指标较对照组改善更为明显(P<0.01)。结论在西医常规干预措施基础上,运用续命汤化裁方治疗脑梗死(风痰瘀阻证)的疗效更优,能够更有效地改善患者的神经功能缺损、生活质量以及脑血流动力学指标。

Objective:To investigate the efficacy of modified Xuming Decoction in the treatment of cerebral infarction(syndrome of blockade of wind-phlegm-static blood)and its effect on cerebral hemodynamics.Methods:Eighty cerebral infarction patients were divided into the control group and treatment group according to random number table method,with 40 cases in each group.The control group received routine treatment according to the guidelines,and the treatment group was given modified Xuming Decoction on the basis of the control group.Both groups were treated for 2 weeks.Scores of National Institutes of Health Neurological Impairment Scale(NIHSS),Barthel index for living ability,symptom of wind-phlegm stasis syndrome,the clinical efficacy,and cerebral hemodynamics were compared between the two groups.Results:After treatment,the NIHSS scores were significantly decreased and Barthel index scores were significantly increased in both groups,and the improvement of the above indexes was more obvious in the treatment group(P<0.01).After treatment,the symptom scores of wind-phlegm stasis syndrome in both groups were significantly decreased,and the decrease was more obvious in the treatment group(P<0.01).The total effective rate of the treatment group was 92.50%,which was significantly higher than 72.50%of the control group(P<0.05).After treatment,the mean flow velocity(Vm)of bilateral middle cerebral artery was significantly increased and the vascular resistance index(RI)was significantly decreased in the two groups,and the above indexes in the treatment group were improved more obviously than those in the control group(P<0.01).Conclusion:Based on the conventional intervention measures of western medicine,the application of modified Xuming Decoction in the treatment of cerebral infarction(syndrome of blockade of wind-phlegm-static blood)has a better curative effect,which can further improve the neurological deficit,quality of life,and cerebral hemodynamics.