真方白丸子加减联合依达拉奉右莰醇治疗风痰阻络型首次缺血性中风急性期临床观察

Zhenfang Baiwanzi Decoction Combined with Edaravone and Dexborneol Concentrated Solution in the Treatment of First Ischemic Stroke of Wind-phlegm Obstructing Collaterals Type in Acute Stage

目的观察真方白丸子加减联合依达拉奉右莰醇治疗风痰阻络型首次缺血性中风急性期的临床效果及对炎症因子的影响。方法选取首次缺血性中风患者78例,根据治疗方法分为治疗组、对照组,各39例。对照组给予依达拉奉右莰醇治疗,治疗组在对照组基础上给予真方白丸子加减治疗,均连续治疗14 d。观察两组临床疗效,以美国国立卫生研究院卒中量表(NIHSS)和改良Rankin量表(mRS)评估神经功能缺损严重度和残疾程度,并监测人血浆脂蛋白磷脂酶A2(Lp-PLA2)、C-反应蛋白(CRP)水平。结果治疗组总有效率为97.44%(38/39),高于对照组的89.74%(35/39)(P<0.05)。治疗后,两组NIHSS、mRS评分及Lp-PLA2、CRP水平均降低,且治疗组低于对照组(P<0.05)。两组均无不良反应。结论真方白丸子加减联合依达拉奉右莰醇治疗首次缺血性中风急性期风痰阻络证临床效果确切,可显著降低其Lp-PLA2、CRP水平,减轻神经功能缺损和残疾程度,且安全性较好。

Objective To observe the clinical effect of Zhenfang Baiwanzi decoction combined with Edaravone and Dexborneol Con⁃centrated Solution in the treatment of wind-phlegm obstructing collaterals type in acute stage of first ischemic stroke,and its effects on inflammation.Methods A total of 78 patients with first ischemic stroke were selected and divided into treatment group and control group,with 39 patients in each group.The control group was treated with Edaravone and Dexborneol Concentrated Solution,and the treatment group was treated with Zhenfang Baiwanzi decoction on the basis of the control group.Both groups were treated for 14 con⁃secutive days.National Institutes of Health Stroke Scale(NIHSS)and Modified Rankin Scale(mRS)were used before and after treat⁃ment to evaluate the severity and disability of neurological impairment.Plasma lipoprotein-associated phospholipase A2(Lp-PLA2),C-reactive protein(CRP)were monitored.Results The total effective rate of the treatment group was 97.44%(38/39),which was higher than that of the control group(89.74%,35/39)(P<0.05).After treatment,the scores of NIHSS and mRS,and the levels of Lp-PLA2 and CRP in the two groups were lower than before treatment,and the above indexes in the treatment group were lower than those in the control group(P<0.05).Conclusion Zhenfang Baiwanzi decoction combined with Edaravone and Dexborneol Concentrated Solu⁃tion has definite efficacy in the treatment of wind-phlegm obstructing collaterals type in acute stage of first stroke,which can signifi⁃cantly reduce serum Lp-PLA2 and CRP levels,reduce the degree of neurological impairment and disability,and has good safety.