| Objective To investigate the effects of Tongnao decoction on symptoms、signs、prognosis recovery、recurrence rate and mortality of patients through the observation and research on the hospitalized patients with acute cerebral infarction with symptom of phlegm and blood stasis blocking collaterals,and to provide basis for clinical application of Tongnao decoction.Methods 400 patients with acute cerebral infarction with symptom of phlegm and blood stasis blocking collateral who were hospitalized in the department of neurology of Jiangsu provincial hospital of traditional Chinese medicine from January 1,2017 to December 31,2017 are randomly divided into the control group and the observation group by random alphabet method.The patients in control group are given routine treatment of acute cerebral infarction,such as anticoagulation,anti-platelet aggregation,lipid-regulating and stable plaques to improve cerebral metabolism and circulation,and neuroprotection.In the observation group,the patients add 200ml of Tongnao decoction twice a day on the basis of conventional treatment.Observe and follow up for 1 year.There are 186 cases in the control group and 194 cases in the observation group except the lost to follow-up.Record and evaluate the results of the scale of NIHSS,mRS,Barthel,Chinese symptom and examination,the number of relapses and deaths at Od,14d,90d,6 months,and 1 year in both groups.Use the Statistical software SPSS to analyze the data,and to evaluate the clinical efficacy of Tongnao decoction.In addition,according to the length of the treatment course of Tongnao decoction,the patients in observation group are further divided into a total of 118 cases of the first group and a total of 76 cases of the second group,called TCM group 1(the course of Tongnao decoction is less than or equal to 2 weeks)and TCM group 2(the course of Tongnao decoction is more than 2 weeks).Conduct statistical analysis of the data again.Explore the effect of the length of treatment of Tongnao decoction on the prognosis recovery and recurrence and death of acute cerebral infarctionResults1.Comparison between the observation group and control group1.1 NIHSS score:The scores of the observation group in the four stages from 0-14 days,14-90 days,90days to 6 months,6 months to 1 year are significantly decreased(P<0.05).And the scores in the two stages from 90 days-6 months,6 months to I year are highly statistically significant(P<0.01).The NIHSS score of the control group shows no statistical difference in the first three stages(P>0.05).But it shows statistical significance in the stage of six months to 1 year(P<0.05).1.2 mRS score:The decrease of mRS score in the observation group is statistically significant in all four stages.(P<0.05).In the control group,there is no statistical difference in the first three stages(P>0.05).But it shows statistical significance in the stage of six months to one year(P<0.05).1.3 Barthel index:In the observation group,Barthel index is increased at 0-14days,but there is no statistical difference(P>0.05).It shows statistical significance in the stages of 14 days to 90days,90days to 6 months,6 months to 1 year(P<0.05).While the control group shows no statistical difference in all four stages(P>0.05).1.4 Chinese symptom score:The scores of the observation group are significantly decreased in all four stages with statistical significance(P<0.05).And the scores in the stages of 6 months to 1 year are highly statistically significant(P<0.01).There is no significant difference in al four stages in the control group(P>0.05).1.5 Deaths:The number of death in the observation group within one year is significantly less than that in the control group,and it has a high statistical significance(P<0.01).It also has a statistically significant difference in the stage of 0-14days and 6 months to 1 year(P<0.05).1.6 Recurrence:The number of relapse in the control group is significantly higher than that in the observation group in the two periods of 14 days to 90days and 6 months to 1 year,and in the total number of recurrence within 1 year,and with a statistical significance(P<0.05).2.Comparison between TCM group 1 and TCM group 2Since the treatment of the two groups are identical in the stage of 0-14days,there is no statistically significant difference in stroke indicators,death and recurrence.2.1 NIHSS score:The scores of TCM group 2 in the three stages of 14days to 90days,90days to 6 months,6 months to 1 year are significantly decreased(P<0.05).And the scores in the stage of 6 months to 1 year are highly statistically significant(P<0.01).There is no signi:ficant difference in TCM group 1 in the three stages(P>0.05).2.2 mRS score:The score of TCM group 2 decrease significantly in the two stages of 90days to 6 months and 6 months to 1 year(P<0.05).While there is no statistically significant difference in the three stages of TCM group 1(P>0.05).2.3 Barthel index:The score of TCM group 2 increase significantly in the two stages of 90days to 6 months and 6 months to 1 year(P<0.05).And it is highly statistically significant in the stage of 6 months to 1 year(P<0.01).There is also a statistically significant difference in the stage of 6 months to 1 year in the TCM group 1(P<0.05).2.4 Chinese symptom score;The scores of TCM group 2 are significantly decreased in the three stages(P<0.05).And the scores are highly statistically significant in the TCM stage of 6 months to 1 year(P<0.01).It has a statistically significant difference in the TCM group 1 in the two stages of 90days to 6 months and 6 months to 1 year(P<0.05).2.5 Deaths:No one died within 1 year in TCM group 2,while 2 people died in each of the three stages in TCM group 1.But it has no statistical significance.There is just a statistically significant difference in the number of deaths within I year.(P<0.05).2.6 Recurrence:The number of relapse of TCM group 1 is more than that in TCM group 2 in each stage,but only in the period of 90days to 6 months and the total number of relapse within 1 year,it has statistically significant difference(P>0.05).And the total number of relapse within 1 year is highly statistically significant(P<0.01).Conclusion Tongnao decoction has significant curative effect on improving the neurological function defect and daily living ability,reducing the degree of illness and Chinese symptom score,as well as reducing recurrence and death of patients with acute cerebral infarction.In addition,the curative effect of the patients with long course of treatment of oral Tongnao decoction(>2 weeks)is superior to the short course of treatment(≤2 weeks).And the long-term effect is superior to the short-term effect. |
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