化痰通腑逐瘀汤辅助治疗急性缺血性脑卒中临床研究

Clinical Study on Huatan Tongfu Zhuyu Decoction for Acute Ischemic Stroke

目的:观察化痰通腑逐瘀汤辅助治疗急性缺血性脑卒中的临床疗效及对血小板活性的影响。方法:采用随机数字表法将98例急性缺血性脑卒中患者分为观察组、对照组各49例。对照组给予常规西药治疗,观察组在对照组基础上加用化痰通腑逐瘀汤治疗,2组均连续治疗2周。比较2组治疗前后中医证候积分、美国国立卫生研究院卒中量表(NIHSS)评分、脑血流指标、血小板活性指标,评估2组临床疗效及治疗安全性。结果:观察组总有效率93.88%,高于对照组79.59%(P<0.05)。2组治疗后脑血流量、脑血容量均较治疗前升高(P<0.05),血流平均通过时间较治疗前缩短(P<0.05),且观察组治疗后脑血流量、脑血容量高于对照组(P<0.05),血流平均通过时间较对照组缩短(P<0.05)。2组治疗后中医证候积分、NIHSS评分均较治疗前降低(P<0.05),且观察组治疗后中医证候积分、NIHSS评分低于对照组(P<0.05)。2组治疗后血小板黏附率、血小板活化率较治疗前降低(P<0.05),且观察组治疗后血小板活性指标低于对照组(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:化痰通腑逐瘀汤辅助治疗急性缺血性脑卒中疗效确切,能够降低患者血小板活性,改善脑血流及神经功能,安全性较高。

Objective:To observe the clinical effect of Huatan Tongfu Zhuyu Decoction on the adjuvant treatment of acute ischemic stroke and its influence on platelet activity.Methods:A total of 98 patients with acute ischemic stroke were divided into the observation group and the control group by random number table method,with 49 cases in each group.The control group was treated with conventional western medicine,and the observation group was additionally treated with Huatan Tongfu Zhuyu Decoction based on the treatment of the control group.Both groups were treated for two weeks.Before and after treatment,the traditional Chinese medicine(TCM)syndrome scores,National Institutes of Health Stroke Scale(NIHSS),cerebral blood flow indexes and platelet activity indexes were compared between the two groups;the clinical effects and treatment safety were evaluated in the two groups.Results:The total effective rate was 93.88%in the observation group,higher than that of 79.59%in the control group(P<0.05).After treatment,the cerebral blood flow and cerebral blood volume in the two groups were increased when compared with those before treatment(P<0.05),and the average blood flow passing time were shorter than that before treatment(P<0.05);the cerebral blood flow and cerebral blood volume in the observation group were higher(P<0.05),and the average blood flow passing time in the control group was shorter than those in the control group(P<0.05).After treatment,the scores of TCM syndrome and NIHSS in the two groups were decreased when compared with those before treatment(P<0.05),and the scores of TCM syndrome and NIHSS in the observation group were lower than those in the control group(P<0.05).After treatment,the platelet adhesion rate and platelet activation rate in the two groups were decreased when compared with those before treatment(P<0.05),and the platelet activity indexes in the observation group after treatment were lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Huatan Tongfu Zhuyu Decoction has a definite therapeutic effect on the treatment of acute ischemic stroke,which can reduce platelet activity,improve cerebral blood flow and nerve function,and has great safety.