| ObjectiveTo begin to understand method in treatment of acute ischemic stroke,meridian wind phlegm obstruction in collaterals syndrome patients by observing the patients before and after the treatment of nerve function defect score(NIHSS)scores,degree of disability(mRS),ischemic stroke syndrome factors score and plasma lipoprotein associated phospholipase A2(Lp-PLA2),hypersensitive c-reactive protein(hs CRP levels of change,more blessed are begin to understand method(represented by refreshing static)and the method of eliminating phlegm to begin to understand(to liu Chang YuShang for curative effects,begin to understand the method to treat stroke mechanism of action of wind phlegm obstruction collaterals syndrome,evaluate its clinical value.MethodsResearch object is derived from June 2017 to December 2017 in the first affiliated hospital of guangzhou university of TCM encephalopathy division hospital treatment of acute ischemic stroke meridian wind phlegm obstruction in collaterals syndrome patient 189 cases,33 cases were randomly divided into control group,refreshing static group of 57 cases,liu Chang YuShang group of 48 cases,refreshing static+liu Chang YuShang group of 51 cases.The control group was given a guide based western medicine treatment,which was used alone or combined with xingnajing and liushi boyu tang on the basis of the basic and consistent western medicine treatment with the control group.The drug regimen of xingnaojing injection was 20ml diluted with 0.9%sodium chloride injection 250ml.Once a day,liu's chang yu tang was treated with 1 dose per day,twice oral or nasal feeding,and 1 course of treatment in 10 days.Before and after treatment,the patients were graded according to NIHSS,mRS,ischemic stroke syndrome factor and evaluation scale,and the patients were extracted from the venous blood before and after treatment to detect Lp-PLA2 and hs-CRP.Observation:(1)the effect of the method on the factors of ischemic apoplexy syndrome(internal wind,internal fire,phlegm,blood stasis,qi deficiency,Yin deficiency)and NIHSS and mRS score;(2)the influence of the opening method on lp-pla2 and hs-crp and the mechanism of different orifices in the treatment of acute ischemic stroke.Rresults1.Overall improvement of TCM syndrome.The total effective rate of the control group was 36.4%.The total effective rate of the Xingnaojing Injection group was 57.9%.The total effective rate of the liu's changyu decoction group was 87.5%.The total effective rate of the Xingnaojing Injection+liu's changyu decoction group was 83.4%.The total effective rate of the liu's changyu decoction group and the Xingnaojing Injection+liu' s changyu decoction group was higher than that in the control group(P<0.01).The total effective rate of the liu's chang yu tang group was higher than that in the Xingnaojing Injection group(P<0.01).2.Change of factor integral of ischemic stroke syndromeInternal wind:after treatment,the internal wind score of each group decreased(P<0.05).The difference between before and after treatment of the Xingnaojing Injection group and the liu' s changyu decoction group was greater than that of the Xingnaojing Injection+liu's changyu decoction group(P<0.01).All the groups had therapeutic effect on the internal wind syndrome,and Xingnaojing Injection group and the liu' s changyu decoction group was better than that of Xingnaojing Injection+liu's changyu decoction group.Internal fire:after treatment,there was a decrease in the number of fire syndromes in the three TCM treatment groups(P<0.05).The integral fire difference between before and after treatment of the Xingnaojing Injection group,the liu' s changyu decoction group and the Xingnaojing Injection+liu' s changyu decoction group was greater than that of the control group(P<0.01).Phlegm wet:after treatment,the scores of the three TCM treatment groups were reduced(P<0.05).The Phlegm wet difference between before and after treatment of the Xingnaojing Injection+liu's changyu decoction group was greater than that of the Xingnaojing Injection group,the liu's changyu decoction group and the control group(P<0.01),and the liu' s changyu decoction group was greater than that of the Xingnaojing Injection group and the control group(P<0.01).The three TCM treatment groups were effective in hlegm-dampness syndrome,and the efficacy was the most effective in the Xingnaojing Injection+liu' s changyu decoction group,followed by the liu1 s changyu decoction group,and then to the Xingnaojing Injection group.Blood stasis:after treatment,the blood stasis score increased in the control group and the Xingnaojing Injection group,and the blood stasis score decreased in the liu's changyu decoction group(P<0.05).The difference between before and after treatment of the liu's changyu decoction group was greater than that of the Xingnaojing Injection group and the control group(P<0.01).Qi deficiency:after treatment,the qi deficiency in the Xingnaojing Injection group increased(P<0.05).The difference between before and after treatment of the liu's changyu decoction group was greater than that of the Xingnaojing Injection group(P<0.01).Yin deficiency:after treatment,the yin deficiency score increased in the liu' s changyu decoction group and the Xingnaojing Injection+liu' s changyu decoction group(P<0.05).There was no statistically significant difference between groups before and after treatment.It is suggested that the liu' s changyu decoction group,the Xingnaojing Injection+liu's changyu decoction group can not improve Yin deficiency syndrome.3.Improvement of neurological defectsThe total effective rate in the control group was 27.3%,the total effective rate in the Xingnaojing Injection group was 73.7%,the total effective rate in the liu's changyu decoction group was 50%,and the total effective rate in the Xingnaojing Injection+liu's changyu decoction group was 64.7%.The total effective rate of the Xingnaojing Injection group and the Xingnaojing Injection+liu's changyu decoction group was higher than that of the control group(P<0.01),and the total efficiency of the Xingnaojing Injection group was higher than that of liu's changyu decoction group(P<0.01).4.Improvement of mRS levelAfter treatment,the mRS level of the Xingnaojing Injection group and the Xingnaojing Injection+liu' s changyu decoction group was decreased(P<0.05).Among them,the improvement in the level of the Xingnaojing Injection group was superior to that of the control group,and the difference was statistically significant(P<0.01).5.Changes in Lp-PLA2 levelAfter treatment,Lp-PLA2 level of the three TCM treatment groups decreased,(P<0.05).The level reduction of Lp-PLA2 the liu's changyu decoction group and the Xingnaojing Injection group was greater than that of the control group(P<0.01).The results showed that there was a decrease in the plasma lp-pla2 level in the three TCM treatment groups,and the effect was better than that in the control group.6.Changes in hs-CRP levelAfter treatment,the level of hs-CRP in the the Xingnaojing Injection group was decreased(P<0.05).There was no significant difference in hs-CRP level before and after treatment in the control group,the liu's changyu decoction group and the Xingnaojing Injection+liu's changyu decoction group(P>0.05).Conclusion(1)The total effective rate of ischemic stroke syndrome factor integrals of the resuscitation-inducing therapy is better than that of the that of pure western medicine,and the curative effect of resuscitation-inducing therapy with expectorant herbs is better than that of resuscitation-inducing therapy with heat-clearing drugs.Resuscitation-inducing therapy is better than simple western medicine to improve internal fire and phlegm and humidity syndrome.The effect of removing blood stasis of resuscitation-inducing therapy with expectorant herbs is better than that of resuscitation-inducing therapy with heat-clearing drugs.Combined use of two resuscitation-inducing therapy method,the effect of phlegm is enhanced.(2)The total effective rate of improve nerve kinetic energy of the resuscitation-inducing therapy is better than that of the that of pure western medicine.It is the most effective method for resuscitation-inducing therapy with heat-clearing drugs,followed by the combination of two resuscitation-inducing therapy method,and than the resuscitation-inducing therapy with expectorant herbs.(3)Resuscitation-inducing therapy can improve the mRS grade of patients with acute ischemic stroke,and the effect is better than that of simple western medicine.(4)Resuscitation-inducing therapy can reduce the level of Lp-PLA2 in patients with cerebral infarction,in which the combination of two resuscitation-inducing therapy method,and the resuscitation-inducing therapy with expectorant herbs is better than that of the resuscitation-inducing therapy with heat-clearing drugs,the resuscitation-inducing therapy with heat-clearing drugs can reduce the level of hs-CRP in patients with cerebral infarction.In general,the resuscitation-inducing therapy with expectorant herbs and the resuscitation-inducing therapy with heat-clearing drugs can improve the clinical curative effect by improving the syndrome differentiation,improving the nerve function defect and improving the mRS grade of the patient.The two methods combined use can improve the effect of Phlegm wet.The treatment of ischemic stroke might be related with reduction of Lp-PLA2 and hs-crp level. |
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