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目的:观察健脾化痰祛瘀汤联合常规疗法治疗脑卒中恢复期合并高脂血症患者的临床效果。方法:选取90例痰瘀阻络型脑卒中恢复期合并高脂血症患者,随机分为对照组和观察组各45例。对照组给予常规抗血小板聚集、降脂、稳定斑块、调控血糖、降压及改善心肌供血等治疗,观察组在对照组治疗基础上给予健脾化痰祛瘀汤治疗,2组均治疗4周。观察2组的临床疗效,治疗前后检测总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)及全血黏度(高切、低切)、血浆比黏度、红细胞刚性指数。结果:观察组总有效率93.33%,对照组总有效率77.78%,2组比较,差异有统计学意义(P<0.05)。与治疗前比较,2组治疗2周、4周时TG、TC及LDL-C均有不同程度降低,差异均有统计学意义(P<0.05);治疗4周时,2组3项指标水平均低于治疗2周时(P<0.05),观察组3项指标水平均低于对照组(P<0.05)。治疗2周、4周时,2组的全血黏度(高切、低切)、血浆比黏度、红细胞刚性指数均较治疗前降低,差异均有统计学意义(P<0.05);治疗4周时,2组4项指标值均低于治疗2周时(P<0.05),观察组4项指标值均低于对照组(P<0.05)。结论:在常规治疗的基础上加用健脾化痰祛瘀汤治疗痰瘀阻络型脑卒中恢复期合并高脂血症患者可有效缓解症状,调节血脂和改善血液流变学,疗效优于单纯使用西药治疗。
Objective: To observe the clinical effects of Jianpi Huatan Quyu Decoction combined with conventional therapy in patients with concomitant hyperlipidemia during recovery from stroke. Methods: Totally 90 patients with phlegm and blood stasis syndrome type convalescence and hyperlipidemia were randomly divided into control group and observation group (n = 45). The control group was given routine anti-platelet aggregation, lipid-lowering, stable plaques, blood sugar, blood pressure and improve myocardial blood supply and other treatment, the observation group was treated on the basis of the treatment group to treat the spleen phlegm and blood stasis group, two groups were treated 4 week. The clinical effects of two groups were observed. The levels of total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C) and whole blood viscosity (high and low cut), plasma viscosity, Rigidity index. Results: The total effective rate was 93.33% in the observation group and 77.78% in the control group. There was significant difference between the two groups (P <0.05). Compared with those before treatment, the levels of TG, TC and LDL-C in both groups were decreased to different extents at 2 and 4 weeks after treatment (P <0.05). At 4 weeks after treatment, the levels of 3 indexes (P <0.05). The levels of three indicators in the observation group were lower than those in the control group (P <0.05). After 2 weeks and 4 weeks of treatment, the whole blood viscosity (high and low cut), plasma specific viscosity and erythrocyte rigidity index of the two groups were lower than before treatment, the differences were statistically significant (P <0.05) (P <0.05). The four indexes in two groups were all lower than those in the control group (P <0.05). The four indexes in the observation group were lower than those in the control group (P <0.05). Conclusion: The treatment of phlegm and blood stasis with the treatment of phlegm and blood stasis on the basis of routine treatment can effectively relieve the symptoms, regulate blood fat and improve the hemorheology in patients with convalescent stage of stroke with better curative effect Simply use Western medicine treatment.