Clinical Research On Clearing Heat And Nourishing Yin, Promoting Blood Circulation To Remove Meridian Obstruction Remedy In The Treatment Of Ischemic Stroke

ObjectiveTo investigate the therapeutic efficacy of clearing heat and nourishing yin, promoting blood circulation to remove meridian obstruction remedy in ischemic stroke by studing the change of Neurological Functional Deficit Scales. And to study the change of inflammatory factor levers in serum for exploring the effect of inflammation in the pathomechanism of this disease.Methods60 patients with ischemic stroke were be selected and randomly divided into two groups, 32 in treated group and 28 in control group,all of which were according to TCM syndrome differentiation. In treated group,there were 14 patients in the syndrome of wind-phlegm and blood stasis grope(WPBS),9 in The syndrome of visceral phlegm-heat accumulation grope (VPHA), 9 in the syndrome of wind-phlegm and hyperactivity of fire grope(WPF). Comparely in control group, there were 13 in the WPBS grope,8 in the VPHA grope, and 7 in the WPF grope. Treated group were be given 20ml Mailuoning injection dissolved into 250m10.9% NS for 14 days addition to the base treatment. At the beginning and the 14th day of the treatment, their serum were be taken to test CAP(C-reactive protein), sP-selection, D-D(D-dimmer), sICAM-1 (soluble intercellular adhesion molecule-1), LeL-C(low-density lipoprotein), TG(triglyceride), TC(total cholesterol) HDL-C(high-density lipoprotein) and other salty index, the Neurological Functional Deficit Scales were also be observed at the same time.ResultsThe change of the Neurological Functional Deficit Scales between before and after treatment were significant in each group(P＜0.01 or P＜0.05).the totle scores in treated group were lower than that in control group (P＜0.05). Among the three type gropes according to TCM syndrome differentiation, the Neurological Functional Deficit Scales in the WPF and the VPHA grope was significantly higher than that in the WPBS group(P＜0.05),but the difference between the WPF and the VPHA grope were not significant. After treatment, the Neurological Functional Deficit Scales reduced significantly in the three type groups(P＜0.01),but the difference among those were not significant(P＞0.05).Blood levels of sICAM-land CRP expression in treated group fell significantly after treatment compared to those in control grope(P＜0.05).The levels of D-D and sP-selection also fell, but the difference between the two groups were not significant (P＞0.05).In each group, the level of TC,TG and LDL-C pre-treatment differed from that post-treatment (P＜0.01). Compared with the control group the difference were not significant(P＞0.05).ConclusionClearing heat and nourishing yin, promoting blood circulation to remove meridian obstruction remedy had good therapeutic effect in ischemic stroke, possiblely better for the syndrome of WPF and VPHA.This remedy were better in improving neurologic manifestations of the patients than base treatment. CRP, sICAM-1, D-D and sP-selection were in high levels in ischemic stroke patients. After treatment, the inflammatory factors were lower than before. These evidences suggest that imflamm may be the key pathogenic facter of ischemic stroke.