Clinical Study On The Effect Of Tongnao Decoction On Cerebral Hemodynamics And Platelet Parameters In Patients With Acute Cerebral Infarction With Phlegm And Blood Stasis Blocking Collaterals Syndrome

Objective:To study the clinical effect of Tongnao Decoction on acute cerebral infarction with phlegm and blood stasis obstructing collaterals syndrome,and to observe its effect on cerebral hemodynamics and platelet parameters of patients with acute cerebral infarction.Methods:From April 2018 to January 2019,patients with phlegm and blood stasis obstruction syndrome of acute anterior circulation cerebral infarction hospitalized in Encephalopathy C.enter of Jiangsu Hospital of Traditional Chinese Medicine were randomly assigned to clopidogrel group(control group,n=30)and Tongnao Decoction plus clopidogrel group(observation group,n=30).The control group was given clopidogrel 75 mg/time,once a day;the observation group was given clopidogrel on the basis of Tongnao Decoction 200 ml/time,twice a day,for 90 days.NIHSS score,modified Rankin scale(mRS)score and Barthel index score were evaluated before treatment,10 days and 90 days after treatment.Platelet aggregation rate,platelet count(PLT),platelet hematocrit(PCT),mean platelet volume(MPV),platelet volume distribution width(PDW)were tested.The cerebral hemodynamics(maximum peak velocity(Vs),mean velocity(Vm)and pulsation index(PI)of bilateral middle cerebral artery(MCA)were examined by transcranial Doppler ultrasound before and 90 days after treatment.Results:1.The NIHSS score,mRS score and Barthel index of the two groups at J10 and 90 days after treatment were significantly improved compared with those before treatment(P<0.05),and the observation group was significantly better than the control group(P<0.05).2.The Vs and Vm of the two groups at 90 days after treatment were significantly higher than those before treatment,and the PI value was significantly lower than that before treatment(P<0.05),and the observation group was significantly changed compared with the control group(P<0.05).3.The platelet aggregation rate of the two groups at 10 and 90 days after treatment was significantly improved(P<0.05),and the observation group was significantly better than the control group at 10 days(P<0.05).4.After 10 days of treatment,PLT increased significantly and MPV decreased significantly in the two groups(P<0.05),and the changes in the observation group were more obvious than those in the control group(P<0.05).At 10 days,the PCT and MPV in the two groups increased significantly(P<0.05).7There was no significant difference between the two group(P>0.05).At 90 days,there was no significant difference between the two groups(P>0.05),and there was no significant difference between the two groups(P>0.05).On the 10th and 90th day,the PDW of the observation group was significantly lower than that of the control group(P<0.05),and there was a significant difference on the 90th day(P<0.05).5.The overall efficacy of the observation group was significantly better than that of the control group(P<0.05)after 90 days of treatment.Conclusion:1.The efficacy of clopidogrel combined with Tongnao Decoction in treating acute cerebral infarction patients with phlegm and blood stasis obstruction syndrome is significantly better than that of clopidorel alone.2.Tongnao Decoction can significantly improve the symptoms of neurological impairment in patients with acute cerebral infarction.improve the ability of daily living,and reduce the disability rate.3.Tongnao Decoction can improve cerebral blood flow and blood supply in patients with acute cerebral infarction to a certain extent.4.Tongnao Decoction can play a more synergistic role with antiplatelet drugs in the early stage of acute cerebral infarction,significantly inhibit platelet aggregation and improve platelet-related parameters.