安宫牛黄丸联合西药治疗急性缺血性脑卒中临床研究

Clinical Study on Angong Niuhuang Pills Combined with Western Medicine for Acute Ischemic Stroke

目的:观察安宫牛黄丸联合西药治疗急性缺血性脑卒中(AIS)痰热内闭证的临床疗效,以及对神经功能缺损程度、血脂指标、血液流变学的影响。方法:选取64例AIS痰热内闭证患者,以随机数字表法分为对照组和研究组各32例。研究过程中2组各剔除2例,最终均纳入30例。对照组给予西药治疗,研究组在对照组基础上给予安宫牛黄丸治疗,2组均治疗14 d。比较2组临床疗效、血脂指标[低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)]水平、血液流变学指标[血浆黏度(PSV)、全血低切黏度(LSV)、全血高切黏度(HSV)、纤维蛋白原(FIB)]水平及美国国立卫生研究院卒中量表(NIHSS)评分,记录不良反应。结果:治疗14 d,研究组总有效率100%,与对照组93.33%比较,差异无统计学意义(P>0.05)。治疗3 d、7 d、14 d,2组血清TG、TC、LDL-C水平均较治疗前降低(P<0.05),研究组血清TG、TC、LDL-C水平均低于同期对照组(P<0.05);2组血清HDL-C水平均较治疗前升高(P<0.05),研究组血清HDL-C水平均高于同期对照组(P<0.05)。治疗3 d、7 d、14 d,2组PSV、LSV、HSV及FIB水平均较治疗前降低(P<0.05),研究组PSV、LSV、HSV及FIB水平均低于同期对照组(P<0.05)。治疗3 d、7 d、14 d,2组NIHSS评分均较治疗前降低(P<0.05),研究组NIHSS评分均低于同期对照组(P<0.05)。治疗期间,2组均无明显不良反应发生。结论:安宫牛黄丸联合西药治疗AIS痰热内闭证疗效显著,有利于减轻神经功能缺损程度,调节血脂代谢,改善血液流变学指标,安全性高。

Objective:To observe the clinical effect of the therapy of Angong Niuhuang Pills combined with western medicine on acute ischemic stroke(AIS)with syndrome of internal block of phlegm-heat and its effects on neurological impairment degree,blood lipid indexes and hemorheology.Methods:A total of 64 cases of patients with AIS with syndrome of internal block of phlegm-heat were selected and divided into the control group and the study group according to the random number table method,with 32 cases in each group.During the study,2 cases were excluded from each of the two groups,finally 30 cases were included in both group.The control group was treated with western medicine,and the study group was additionally treated with Angong Niuhuang Pills based on the treatment of the control group.The two groups were treated for 14 days.The clinical effects,the levels of blood lipid indexes[low-density lipoprotein cholesterol(LDL-C),total cholesterol(TC),triglyceride(TG)and high-density lipoprotein cholesterol(HDL-C)],and hemorheology indexes[plasma viscosity(PSV),low-shear blood viscosity(LSV),high-shear blood viscosity(HSV)and fibrinogen(FIB)],and the scores of National Institute of Health Stroke Scale(NIHSS)were compared between the two groups.The incidence of adverse reactions was recorded.Results:After 14 days of treatment,the total effective rate was 100%in the study group,compared with that of 93.33%in the control group,differences being no significance(P>0.05).After 3,7 and 14 days of treatment,the levels of serum TG,TC and LDC-C in the two groups were respectively decreased when compared with those before treatment(P<0.05),and the above three levels in the study group were lower than those in the control group at the same stage(P<0.05);the serum HDL-C levels in the two groups were increased when compared with those before treatment(P<0.05),and the serum HDL-C level in the study group was higher than that in the control group at the same stage(P<0.05).After 3,7 and 14 days of treatment,the levels of PSV,LSV,HSV and FIB in the two groups were respectively decreased when compared with those before treatment(P<0.05),and the above four levels in the study group were lower than those in the control group at the same stage(P<0.05).After 3,7 and 14 days of treatment,the NIHSS scores in the two groups were decreased when compared with those before treatment(P<0.05),and the NIHSS score in the study group was lower than that in the control group at the same stage(P<0.05).During treatment,there was no obvious adverse reaction in the two groups.Conclusion:The therapy of Angong Niuhuang Pills combined with western medicine has a significant curative effect on AIS with syndrome of internal block of phlegm-heat,which can help mitigate the neurological impairment degree,regulate the blood lipid metabolism and improve the hemorheology indexes,with great safety.