天麻钩藤饮加减方联合西药治疗肝阳上亢型急性缺血性脑卒中合并高血压的疗效观察

Therapeutic effect of modified Tianma Gouteng Decoction Formula combined with western medicine on acute ischemic stroke of liver yang ascendant hyperactivity pattern with hypertension

目的 观察天麻钩藤饮加减方联合西药治疗肝阳上亢型急性缺血性脑卒中合并高血压的疗效。方法 选取2022年2月~2024年2月在巴彦淖尔市医院诊治的106例急性缺血性脑卒中合并高血压患者,根据患者入院时间排序随机分为西药组和天麻组,各53例。西药组给予降压、抗卒中药物治疗;天麻组在西药组基础上予以口服天麻钩藤饮加减方治疗,两组均治疗14 d。比较两组治疗前后中医证候积分、神经功能缺损程度、神经功能恢复情况、脑血流动力学指标,血压波动性以及不良反应发生状况,评价两组患者临床疗效。结果治疗后,天麻组中医证候积分、24 h平均收缩压(24 h mSBP)、24 h平均舒张压(24 h mDBP)、24 h动态血压标准差、美国国立卫生研究院卒中量表(NIHSS)、改良Rankin(mRS)量表评分以及搏动指数(PI)均显著低于西药组(P<0.05);大脑中动脉平均血流速度(Vm)与总有效率显著高于西药组(P<0.05);两组不良反应发生率差异无统计学意义(P>0.05)。结论 天麻钩藤饮加减方联合西药疗法可明显减轻肝阳上亢型急性缺血性脑卒中合并高血压患者的临床症状,促进神经功能的恢复,调节脑部血流循环,稳定血压,且安全性好。

Objective To observe the therapeutic effect of modified Tianma Gouteng Decoction Formula combined with western medicine on acute ischemic stroke of liver yang ascendant hyperactivity pattern with hypertension.Methods A total of 106 patients with acute ischemic stroke complicated with hypertension who were treated at Bayannur Hospital from February 2022 to February 2024 were selected.According to the time of admission,they were assigned to the western medicine group and the Tianma group,with 53 patients in each group.The western medicine group was treated with antihypertensive and anti stroke drugs,the Tianma group was treated with oral modified Tianma Gouteng Decoction Formula.Both groups were treated for 14 d.The two groups were compared on TCM syndrome scores,the degree of neurological impairment,neurological function recovery cerebral hemodynamic indicators,blood pressure volatility,and adverse reactions.Clinical effects of two groups were evaluated.Results After treatment,the TCM syndrome score,24 h mSBP,24 h mDBP,24 h standard deviation of dynamic blood pressure,as well as scores on the NIHSS,mRS,and PI in the Tianma group were significantly lower than those in the western medicine group(P<0.05);the Vm and total effective rate in the Tianma group were significantly higher than those of the western medicine group;there was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The combined treatment with modified Tianma Gouteng Decoction Formula and western medicine can significantly alleviate clinical symptoms in patients with acute ischemic stroke of liver yang ascendant hyperactivity pattern and hypertension,promote the recovery of neurological function,regulate the cerebral blood flow circulation,and stabilize blood pressure,and with good safety.