基于温阳化痰理论探究白附蒲藿方治疗缺血性脑卒中疗效及对颈动脉斑块、相关证候积分影响

Curative Effect of Probing into Baifu Puhuo Recipe in the Treatment of Ischemic Stroke Based on the Theory of“Warming Yang and Eliminating Phlegm”and Its Influence on Scores of Carotid Artery Plaque and Related Symptoms

目的:基于“温阳化痰”理论探究白附蒲藿方治疗缺血性脑卒中疗效及对颈动脉斑块、相关证候积分等影响。方法:选取2019年4月~2021年4月来我院就诊的缺血性脑卒中恢复期患者123例为研究对象,依据治疗方法的不同可分为观察组和参照组,参照组60例,观察组63例。参照组患者入院后给予降压、降糖、降脂等基础干预,口服阿司匹林肠溶片,1片/次,1次/d;口服阿托伐他汀钙片,1片/次,1次/d;静脉滴注银杏二萜内酯葡胺注射液,将25mg银杏二萜内酯葡胺注射液和250ml生理盐水相融,静脉滴注,1次/d。在病情稳定后,可开展功能锻炼,促进患者康复。观察组在参照组治疗的基础上,口服白附蒲藿方治疗。两组分别治疗2周。比较两组治疗前后阳虚痰瘀阻络证相关证候积分,血脂指标总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)、颈动脉斑块指标颈总动脉最大斑块面积、颈动脉内膜-中层厚度和硬化斑块指数、相关量表评分(NIHSS、mRS评分)和治疗疗效。结果:观察组治疗疗效优于参照组(P<0.05);观察组治疗后阳虚痰瘀阻络证相关证候积分低于参照组(P<0.05);观察组颈总动脉最大斑块面积、颈动脉内膜-中层厚度和硬化斑块指数低于参照组(P<0.05);观察组血脂指标TC、TG和LDL-C含量低于参照组,HDL-C含量高于参照组(P<0.05);观察组NIHSS和mRS评分低于参照组(P<0.05)。结论:基于“温阳化痰”理论以白附蒲藿方治疗缺血性脑卒临床效果显著,可改善患者的临床症状和血脂指标,减少颈动脉斑块,促进神经功能的恢复,提高独立生活能力和治疗效果。

Objective:Based on the theory of“warming Yang and eliminating phlegm”,this study explored the curative effect of Baifu Puhuo Recipe in the treatment of ischemic stroke and its influence on carotid artery plaque and related symptom score.Methods:From April 2,019 to April 2,021,123 patients with ischemic stroke in our hospital during the recovery stage were selected as the research objects.According to the different treatment methods,they could be divided into an observation group and a reference group,60 cases in the reference group and 63 cases in the observation group.After admission,the controlled group was given basic interventions such as hypotensive,hypoglycemic and lipid-lowering,oral aspirin enteric-coated tablet,1 tablet per time,once a day.Atorvastatin Calcium Tablet was taken orally,1 tablet per time,once a day.Ginkgo Diterpene Lactone Glumine Injection was intravenously injected,25mg Ginkgo Diterpene Lactone Glumine Injection and 250ml normal saline were intravenously injected,once a day.After the condition was stable,functional exercise could be carried out to promote the recovery of patients.The observation group was treated with Baifu Puhuo Decoction orally on the basis of the treatment of the reference group.The two groups were treated for 2 weeks respectively.The scores of symptoms related to Yang deficiency,phlegm stasis and collateral-blocking syndrome were compared between the two groups before and after treatment.Blood lipid indexes total cholesterol(TC),triglyceride(TG),low density lipoprotein(LDL-C),high density lipoprotein(HDL-C),carotid plaque indexes maximum plaque area of common carotid artery,carotid intima-media thickness and sclerotic plaque index,related scale score(NIHSS,mRS score)and therapeutic efficacy.Results:The therapeutic effect of the observation group was better than that of the controlled group(P<0.05).After treatment,the scores of syndromes related to Yang deficiency and phlegm and blood stasis syndrome in the observation group were lower than those in the controlled group(P<0.05).The maximum plaque area,intima-media thickness and plaque index of the common carotid artery in the observation group were lower than those in the controlled group(P<0.05).The contents of TC,TG and LDL-C in the observation group were lower than those in the controlled group,while the content of HDL-C in the observation group was higher than that in the controlled group(P<0.05).NIHSS and mRS scores in the observation group were lower than those in the controlled group(P<0.05).Conclusion:Based on the theory of“warming Yang and eliminating phlegm”,Baifu Puhuo Recipe has a significant clinical effect in the treatment of ischemic brain death,which can improve the clinical symptoms and blood lipid index of patients,reduce carotid artery plaque,promote the recovery of nerve function,improve the ability of independent living and treatment effect.