祛风化痰通络汤、竹沥联合西药治疗痰瘀阻滞型脑梗死随机平行对照研究

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[目的]观察祛风化痰通络汤、竹沥联合西药治疗痰瘀阻滞型脑梗死疗效。[方法]使用随机平行对照方法,将100例住院患者按病志号抽签法简单随机分为两组。对照组50例维持电解质、水平衡,血压≥180/100mm Hg,依那普利10mg/次,1次/d;颅内压升高,125m L甘露醇;奥扎格雷钠80mg+0.9%氯化钠500m L,静滴;阿司匹林100mg/次,1次/d。治疗组50例祛风化痰通络汤(茯苓、陈皮、枳实、天麻、僵蚕、地龙各10g,胆南星、大黄、甘草各6g,法半夏9g,全蝎5g,鸡血藤25g,乌梢蛇15g;大便秘结加玄参10g,火麻仁30g;上肢偏瘫活血通络,加姜黄片、桑枝各10g;下肢萎软乏力强筋壮骨,加续断、牛膝各15g;不言语或言语蹇涩者化痰利窍,加石菖蒲10g,远志炙6g;手脚麻木通筋活络,加蜈蚣1条,稀莶草10g;热象加黄连5g);1剂/d,水煎400m L,早晚口服,200m L/次;竹沥,10m L/次,3次/d;西药治疗同对照组。连续治疗14d为1疗程。观测临床症状、神经功能评分、不良反应。治疗1疗程,判定疗效。[结果]症候积分疗效:治疗组痊愈2例,显效6例,有效39例,无效3例,总有效率94.00%。对照组痊愈0例,显效3例,有效34例,无效13例,总有效率74.00%。神经功能缺损疗效:治疗组痊愈2例,显效18例,有效27例,无效3例,总有效率94.00%。对照组痊愈0例,显效8例,有效34例,无效8例,总有效率80.00%。治疗组疗效优于对照组(P<0.05)。神经功能缺损评分两组均有改善(P<0.01),治疗组改善优于对照组(P<0.01)。[结论]祛风化痰通络汤、竹沥联合西药治疗痰瘀阻滞型脑梗死疗效满意,无严重不良反应,值得推广。 [Objective] To observe the curative effect of Qufeng Huatan Tongluo Decoction and Zhu Li combined with western medicine on phlegm and blood stasis block cerebral infarction. [Methods] Using randomized parallel control method, 100 inpatients were randomly divided into two groups randomly according to the random number of patients. Control group of 50 patients maintain electrolyte, water balance, blood pressure ≥ 180/100 mm Hg, enalapril 10mg / times, 1 time / d; increased intracranial pressure, 125m L mannitol; sodium ozagrel 80mg + 0.9% chlorine Sodium 500m L, intravenous infusion; aspirin 100mg / time, 1 time / d. 50 cases of treatment group Qufeng Huatan Tongluo soup (Poria, dried tangerine peel, Citrus aurantium, Gastrodia, silkworm, earthworm each 10g, bile Southern Star, rhubarb, licorice 6g, Pinellia 9g, Scorpio 5g, Millettia 25g , Black snake 15g; constipation plus Scrophulariaceae 10g, hemp seed 30g; upper limb hemiplegia Huoxuetongluo, plus turmeric tablets, mulberry each 10g; 15g; no words or words astringent who phlegm lucidum, plus Gladiolus 10g, Polygala 6g; hands and feet numbness tendons active, add centipede 1, sparse ragweed 10g; heat plus Coptis 5g); 1 / d , Decoction 400m L, morning and evening oral, 200m L / times; bamboo lee, 10m L / times, 3 times / d; Western medicine treatment with the control group. Continuous treatment 14d for a course of treatment. Observation of clinical symptoms, neurological function scores, adverse reactions. Treatment of a course of treatment to determine the efficacy. [Results] The symptom score: The treatment group recovered 2 cases, 6 cases markedly effective, 39 cases effective, 3 cases ineffective, the total effective rate 94.00%. The control group recovered 0 cases, markedly effective in 3 cases, effective in 34 cases, ineffective in 13 cases, the total effective rate was 74.00%. Efficacy of neurological deficit: The treatment group cured 2 cases, 18 cases markedly effective in 27 cases, 3 cases, the total effective rate 94.00%. The control group recovered 0 cases, markedly effective in 8 cases, effective in 34 cases, ineffective in 8 cases, the total effective rate was 80.00%. The treatment group was better than the control group (P <0.05). Neurological deficit scores were improved in both groups (P <0.01), and the treatment group improved better than the control group (P <0.01). [Conclusion] Qufeng Huatan Tongluo Decoction and Zhu Li combined with western medicine are effective in treating phlegm and blood stasis block cerebral infarction without serious adverse reactions, which is worthy of popularization.
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