Clinical Studies Of Acute Ischemic Stroke Of Diagnosis And Treatment Regimens

Stroke have the characteristic of high incidence, high disabilities and high mortality. Therational and effective treatment at acute stage will affect the prognosis and quality of life ofthe stroke patients. The complex nature of paroxysm mechanism and clinical manifestation demands that theremedy of stroke should be multiway, individual, staggered and combined. All the previousstudies about the prevention and cure of stroke with traditional Chinese medicine(TCM) ,which mainly contained some single invention,didn't fit the cinical practice and couldn't drawa conclusion that could be widely used.The lack of standard combined therapeutic schemewith reliabled evidence brings about irregularities in use of drugs,which in turn leads to thewaste of medical resources. This research contains the data of one centre of the national tenth five-year key project:study of combined therapeutic scheme for stroke at acute stage. According to evidence-basedmedicine (EBM), from January 2003 to August 2004 in Dongzhimen Hospital,random andcontrol studies between combined therapeutic scheme and western medicinal therapeutic onewere made, in which 41 inpatients of acute ischemic apoplexy were involved and devided intotwo groups:treat group with 20 cases and contrast group with 21 cases. The combinedtherapeutic scheme mainly comprises such therapies as Chinese materia medical injection anddecoction, rehabilitation training, standard nurse ,acupuncture ,and intervenes differently inaccordance with the time of the course of disease. Western medicinal therapies applythrombolytic therapy, anticoagulant, ect. The results indicated that both groups could improve neural functions, the daily viabilityand the quality of life of the patients. The combined therapeutic scheme show somesuperiority to western medicinal therapeutic one in respect of improving the syndrome. Bothgroups could improve the laboratory examination, such as PT, APTT, TT, FIB, ect. During theperiod of observation, there are 4 cases with adverse events. Two cases belonged to the treatgroup whose adverse events had nothing with the combined therapetic scheme, while othersbelonged to the contrast group with adverse events having something with the drugs beingused. Among the contrast group , two cases belonging to reoccurred and one patient died. In addition, the development law of the syndrome was observed:feng syndrome,tansyndrome and huo syndrome was the syndrome characteristic at the beginning ,qixu syndromearised after 7 days of that ,tan syndrome and yu syndrome runed through the whole acuteperiod. The research suggested that The optimized combined therapeutic scheme for stroke,based on the theory of TDS,can provide the patients optimal treatment and be worthpopularizing.Besides, by means of combining individual treatment by differentiatingsyndromes(TDS) with colonial curative effect evaluation , the research explored the indexevaluation system of clinical effect on apoplexy at different time point and the mode ofclinical study in line with not only clinical characteristic of TCM but also method of clinicalepidemiology.