中西医结合治疗脑梗死恢复期气虚血瘀证的临床研究

Clinical study on the treatment of convalescent cerebral infarction with Qi deficiency and blood stasis syndrome by combination of traditional Chinese and Western medicine

目的探讨中西医结合在脑梗死恢复期气虚血瘀证患者中的临床治疗效果。方法600例脑梗死恢复期气虚血瘀证患者为研究对象,采用简单化随机法分为对照组和观察组,每组300例。对照组采取口服阿司匹林肠溶片进行治疗,观察组在对照组基础上联用中药汤剂补阳还五汤进行治疗。观察并比较两组患者的临床疗效、中医证候积分、美国国立卫生研究院卒中量表(NIHSS)评分、血浆纤维蛋白原(FIB)水平、血小板最大聚集率(MAR)及不良反应发生情况。结果治疗后,与对照组(88.3%)比较,观察组患者的临床总有效率(97.3%)明显更高(P<0.05)。与治疗前比较,两组患者治疗后的中医证候积分均有所改善(P<0.05);观察组患者治疗后的中医证候积分(0.79±0.15)分显著低于对照组的(1.67±0.41)分(P<0.05)。与治疗前比较,两组患者治疗后3、7、14 d的NIHSS评分均有所降低(P<0.05);治疗后3、7、14 d,观察组患者的NIHSS评分分别为(10.08±2.69)、(6.83±2.31)、(4.81±1.46)分,明显低于对照组的(11.32±2.58)、(9.64±2.25)、(7.23±2.05)分(P<0.05)。与治疗前比较,治疗后两组患者的FIB、MAR水平均有所降低(P<0.05);与对照组的(3.67±0.82)g/L和(63.55±6.05)%比较,观察组患者治疗后FIB(2.85±0.49)g/L和MAR(51.39±5.16)%降低幅度更显著(P<0.05)。对照组患者不良反应发生率为2.7%,观察组患者不良反应发生率为2.0%,两组患者不良反应发生率比较差异无统计学意义(P>0.05)。结论中西医结合治疗在脑梗死恢复期气虚血瘀证患者中的临床效果显著,能有效缓解患者的临床症状和神经功能损伤程度,降低血栓形成,且安全性良好,值得临床推广使用。

Objective To explore the clinical effect of combination of traditional Chinese and Western medicine in the treatment of convalescent cerebral infarction with Qi deficiency and blood stasis syndrome.Methods 600 cases of convalescent cerebral infarction with Qi deficiency and blood stasis syndrome were divided into a control group and an observation group by simplified random method,with 300 cases in each group.The control group was treated with oral aspirin enteric-coated tablets,and the observation group was treated with Buyang Huanwu decoction based on the control group.The clinical efficacy,traditional Chinese medicine syndrome score,National Institutes of Health Stroke Scale(NIHSS)score,plasma fibrinogen(FIB)level,maximum platelet aggregation rate(MAR)and the occurrence of adverse reactions were observed and compared between the two groups.Results After treatment,the total clinical effective rate of the observation group(97.3%)was significantly higher than that of the control group(88.3%)(P<0.05).Compared with before treatment,the traditional Chinese medicine syndrome score of both groups improved after treatment(P<0.05).The traditional Chinese medicine syndrome score of(0.79±0.15)points in the observation group was significantly lower than(1.67±0.41)points in the control group(P<0.05).Compared with before treatment,the NIHSS scores in both groups decreased at 3,7 and 14 d after treatment(P<0.05).At 3,7 and 14 d after treatment,the NIHSS scores of the observation group were(10.08±2.69),(6.83±2.31)and(4.81±1.46)points,which were significantly lower than(11.32±2.58),(9.64±2.25)and(7.23±2.05)points of the control group(P<0.05).Compared with before treatment,the levels of FIB and MAR in both groups decreased after treatment(P<0.05).Compared with(3.67±0.82)g/L and(63.55±6.05)%in the control group,FIB of(2.85±0.49)g/L and MAR of(51.39±5.16)%in the observation group reduced significantly after treatment(P<0.05).The incidence of adverse reactions was 2.7%in the control group and 2.0%in the observation group.There was no statistical significance in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The combination of traditional Chinese and Western medicine has significant clinical effect in patients with convalescent cerebral infarction with Qi deficiency and blood stasis syndrome,which can effectively alleviate the clinical symptoms and neurological impairment of patients,reduce thrombosis,and has high safety,which is worthy of clinical promotion and use.