论文部分内容阅读
[目的]观察辨证分型联合西药治疗中风疗效。[方法]使用随机平行对照方法,将150例门诊及住院患者按中医辨证分为四组。风火上扰(A组):镇肝熄风,镇肝熄风汤(怀牛膝12g,代赭石15g,龙骨、牡蛎各12g,白芍、玄参、龟板、天冬、茵陈、川楝子、生麦芽各8g,甘草6g),1剂/d,水煎200m L,早晚口服;30m L醒脑静+500m L生理盐水,1次/d,静滴;风痰瘀阻(B组):祛风、养血、活血、化痰通络,大秦艽汤(秦艽、羌活、独活、防风各12g,当归、白芍、熟地、川芎、白术、茯苓、黄芩、石膏、生地各8g),1剂/d,水煎200m L,早晚口服;6m L疏血通+500m L生理盐水,1次/d,静滴;阿司匹林,300mg/次,1次/d;风痰上扰(C组):化痰通腑,星蒌承气汤:胆南星、全瓜蒌各10g,生大黄、芒硝各6g,1剂/d,水煎100m L,早晚口服;6m L疏血通+500m L生理盐水,1次/d,静滴;阿司匹林,300mg/次,1次/d;气虚血瘀(D组):补气活血,补阳还五汤(生黄芪15g,当归尾、川芎、赤芍、桃仁、红花、地龙各10g),1剂/d,水煎100m L,早晚口服。连续治疗14d为1疗程。观测临床症状、Barthel指数、运动功能评分、不良反应。连续治疗2疗程,判定疗效。[结果]A组痊愈16例,显效8例,有效4例,无效0例,总有效率100.00%。B组痊愈18例,显效7例,有效6例,无效2例,总有效率93.94%。C组痊愈49例,显效10例,有效7例,无效11例,总有效率85.71%。D组痊愈5例,显效3例,有效3例,无效1例,总有效率91.67%。临床疗效A组>B组>D组>C组,临床疗效无明显差异(P>0.05)。运动功能评分四组均有改善(P<0.05,P<0.01),C组>B组>D组>A组,四组间无明显差异(P>0.05)。[结论]辨证分型联合西药治疗中风效果显著,无严重不良反应,值得推广。
[Objective] To observe the effect of syndrome differentiation and western medicine in treating stroke. [Methods] Using randomized parallel control method, 150 outpatients and inpatients were divided into four groups according to TCM syndrome differentiation. Wind and fire on the disturbance (A group): Zhengan Xifeng, Zhengan Xifeng soup (Achyranthes bidentata 12g, generation ocher 15g, keel, oyster each 12g, white peony root, Scrophulariaceae, turtle shell, Asparagus, capillaris, Sichuan Radix et Rhizoma Atractylodis Macrocephalae, Radix Astragali, Radix Astragali, Radix Astragali, Radix Astragali, Radix Astragali, Group): Qufeng, nourishing, promoting blood circulation, phlegm meridians, large Qin Tang (Gentiana, Notopterygium, independent living, wind 12g, Angelica, white peony root, Rehmanniae, Chuanxiong, Atractylodes, Poria, skullcap, ), 1 dose / d, decoction 200m L, sooner or later oral; 6m L Shuxuetong + 500m L normal saline, 1 / d, intravenous; aspirin, 300mg / time, C group): phlegm Tongfu, Xinglou Chengqi Tang: gall Southern Star, the whole melon 蒌 10g, rhubarb, Glauber’s salt 6g, 1 / d, decoction 100m L, sooner or later oral; 6m L Shuxuetong + 500ml normal saline, once / d, intravenous infusion; aspirin, 300mg / time, 1 time / d; qi deficiency and blood stasis (D group): qi and blood, Buyang Huanwu Decoction (raw Astragalus 15g, Angelica tail, , Red peony, peach kernel, safflower, earthworm each 10g), 1 / d, decoction 100m L, morning and evening oral. Continuous treatment 14d for a course of treatment. Clinical symptoms were observed, Barthel index, motor function score, adverse reactions. Continuous treatment of 2 courses to determine the efficacy. [Result] In group A, 16 cases were cured, 8 cases were markedly effective, 4 cases were effective, 0 was ineffective and the total effective rate was 100.00%. B group cured 18 cases, markedly effective in 7 cases, effective in 6 cases, 2 cases, the total effective rate 93.94%. In group C, 49 cases were cured, 10 cases were markedly effective, 7 cases were effective, 11 cases were ineffective, and the total effective rate was 85.71%. In group D, 5 cases were cured, 3 cases were markedly effective, 3 cases were effective, 1 case was ineffective and the total effective rate was 91.67%. Clinical efficacy A group> B group> D group> C group, no significant difference in clinical efficacy (P> 0.05). Motor function score improved in all four groups (P <0.05, P <0.01). There was no significant difference between the four groups in C group> B group> D group> A group (P> 0.05). [Conclusion] Syndrome differentiation combined with Western medicine has significant effect on stroke and no serious adverse reactions, which deserves promotion.