| BackgroundStroke is a common cerebrovascular disease clinically.With the advancement of the ageing process and changes in lifestyle,the incidence of stroke increased year by year.High morbidity rate,high mortality rate and high recurrence rate of stroke cause serious damage to human life and health.Varies of complications could happen after stroke.According to reports in the literature,30%-60%of the stroke patients could suffer from constipation.Constipation not only brings patients discomfort on the body,but also influences their mental health and daily life ability.Alarming is that excessively forcible defecation can increase intracranial pressure,which will aggravate brain damage futher and do harm to the rehabilitation of stroke.Meanwhile increased abdominal pressure can also cause stroke recurrence,myocardial infarction or even sudden death.For the treatment of constipation,western medicine commonly use gentle laxatives or lubricants,if long-term use will cause side effects such as drug dependence.The study about stroke has a long history of traditional Chinese medicine.On the basis of summarizing the experiences of predecessors as well as through long-term clinical observation,Professor Wang Yongyan found that after a stroke phlegm-heat and bowel-qi-obstructed syndrome becomes general syndrome evolution law of most patients and the degree of phlegm-heat and bowel-qi-obstruction is closely related to the prognosis of stroke.Therefore,therapy of resolving phlegm-heat and relaxing bowels is crucial for the treatment of acute stage of stroke.As the representative of prescription Xinglouchengqi Decoction had already been widely used in clinical practice and brought about significant effect.Our study from the perspective of disease and syndrome explored Xinglouchengqi Decoction efficacy for the treatment of constipation after stroke.ObjectiveOur study was aiming at exploring the efficacy of Xinglouchengqi Decoction on acute ischemic stroke and constipation,as well as the influence on phlegm-heat and bowel-qi-obstructed syndrome.MethodsWe investigated 57 patients suffering from acute ischemic stroke and categorized as phlegm-heat and bowel-qi-obstructed syndrome.They were randomly divided into treatment group and control group in a ratio of 2:1 and both received western medicine routine treatment.The treatment group accepted Xinglouchengqi Decoction oral intervention,while the control group was given conventional western laxative treatment.The treatment course is 5±2 days.We observed for 6 days to evaluate patients with constipation symptoms integral everyday.Our aim is to contrast total integral of two groups,the proportion of patients having already defecated,the percentage of patients with defecation difficulties,defecation speed,Bristol stool character and constipation accompanying symptoms.Besides,we also recorded phlegm-heat and bowel-qi-obstructed syndrome integral and stroke symptoms and signs integral on the day of enrollment and after relaxing bowels to compare scale scores of two groups.Results1.Baseline comparison:general data,such as age,gender,basic diseases,progression and infarction area had no statistical differences between two groups(P>0.05).2.Observation index:Constipation symptom integral of treatment group were significantly lower than control group at the time point of the 4th and 6th day(P<0.05),while scores at the other time points had no significant difference between two groups(P>0.05);Proportion of patients with abdominal distension in the two groups had no significant difference during observation period(P>0.05);There was no statistical difference in proportion of patients loss of appetite at the first 3 days between two groups,while patients loss of appetite in treatment group were significantly less than those in control group from the 4th day(P<0.05);Proportion of patients who had defecated,the ratio of patients with defecation difficulty,Bristol stool character and defecation speed between the two groups had no significant difference in 6 days(P>0.05);The phlegm-heat and bowel-qi-obstructed syndrome integral after treatment significantly decreased in both groups(P<0.05),while the integral of post-treat between two groups showed no significantly difference(P>0.05);The stroke symptoms and signs integral of treatment group after treatment obviously reduced(P<0.05),but the integral comparison of the control group before and after treatment and two groups after treatment had no significant difference(P>0.05).3.Safety evaluation:During the period of clinical observation,no subjects appeared obvious discomfort,which indicated this scheme was safe and reliable.ConclusionXinglouchengqi Decoction can effectively relieve the acute phase of stroke phlegm-heat and bowel-qi-obstructed syndrome,obviously alleviate constipation and its accompanying symptoms.In addition,it can also decrease the degree of nerve function damage and promote the recovery of neural function.To conclude,Xinglouchengqi Decoction has good efficacy for acute ischemic stroke patients with phlegm-heat and bowel-qi-obstructed syndrome and deserves being popularized in clinic. |
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