柔肝通络汤联合西药治疗阴虚血瘀型脑梗死恢复期41例

Clinical effect of Rougan Tongluo decoction combined with Western medicine treatment in treatment of patients in the convalescent stage of cerebral infarction with Yin-deficiency and blood-stasis:An analysis of 41 cases

目的:观察柔肝通络汤联合常规西药治疗阴虚血瘀型脑梗死恢复期的临床疗效。方法:将82例阴虚血瘀型脑梗死恢复期患者随机分为治疗组和对照组,每组各41例。对照组予以阿司匹林肠溶片和瑞舒伐他汀钙片治疗,治疗组在对照组基础上加用柔肝通络汤治疗。比较2组治疗4周后的综合疗效,治疗前后的Barthel指数、简化Fugl-Meyer量表(FMA)评分、美国国立卫生研究院卒中量表(NIHSS)评分,脑血流动力学指标[收缩期峰流速值(Vs)、平均流速值(Vm)及搏动指数(PI)],血液流变学指标[全血高切黏度、纤维蛋白原(FIB)]及同型半胱氨酸(Hcy)水平。结果:总有效率治疗组为92.68%(38/41),对照组为75.61%(31/41),2组比较,差异有统计学意义(P<0.05)。治疗后2组NIHSS评分、PI、全血高切黏度、FIB及Hcy水平均较治疗前降低,Barthel指数、FMA评分、Vs、Vm均较治疗前升高,且治疗组改善程度均优于对照组(P<0.05)。结论:柔肝通络汤联合西药治疗阴虚血瘀型脑梗死恢复期疗效显著,能改善患者的生活质量、脑血流动力学及血液流变学指标,降低Hcy水平,值得临床推广运用。

Objective:To investigate the clinical effect of Rougan Tongluo decoction combined with conventional Western medicine treatment in the treatment of patients in the convalescent stage of cerebral infarction with Yin-deficiency and blood-stasis syndrome.Methods:A total of 82 patients in the convalescent stage of cerebral infarction with Yin-deficiency and blood-stasis syndrome were randomly divided into treatment group and control group,with 41 patients in each group.The patients in the control group were treated with enteric-coated aspirin tablets and rosuvastatin calcium tablets,and those in the treatment group were given Rougan Tongluo decoction in addition to the treatment in the control group.The two groups were compared in terms of overall response after 4 weeks of treatment and related indicators before and after treatment,such as Barthel Index,Fugl-Meyer Assessment(FMA)score,National Institutes of Health Stroke Scale(NIHSS)score,cerebral hemodynamic parameters[peak systolic velocity(Vs),mean flow velocity(Vm),and pulsatility index(PI)],hemorheological indices[high blood viscosity and fibrinogen(FIB)],and homocysteine(Hcy)level.Results:There was a significant difference in overall response rate between the treatment group and the control group[92.68%(38/41)vs 75.61%(31/41),P<0.05].After treatment,both groups had significant reductions in NIHSS score,PI,high blood viscosity,and levels of FIB and Hcy and significant increases in Barthel Index,FMA score,Vs,and Vm,and the treatment group had significantly better improvements than the control group(P<0.05).Conclusion:Rougan Tongluo decoction combined with conventional Western medicine treatment has a marked clinical effect in the treatment of patients in the convalescent stage of cerebral infarction with Yin-deficiency and blood-stasis syndrome and can improve quality of life,cerebral hemodynamics,and hemorheological indices and reduce Hcy level,and therefore,it holds promise for clinical application.