| The thesis mainly includes the following parts:The first part is about literature summarizing: it includes the study of acute cerebral infarction(ACI) with intravenous thrombolysis in modern medicine, the evoloving of ACI on Traditional Chinese Medicine(TCM), and the remedies of promoting blood circulation and removing blood stasis(PBC&RBC)for ACI.The second part is about Meta-analysis of acute cerebral infarction treated with TCM of PBC&RBC: Methods: all the papers of clinical studys that used PBC&RBC as the main intervention to treat ACI were retrived and collected and random-effect modol of meta-analysis was performded by using the statistical soft ware Revman 4.2 on the basis of strict quality evalution. Funnel-plot was used to identify the publication bias. Resultes: 24 papers were selected according with criteria ,of which there were 19 randomized controlled trial(RCT),5 clinical controlled trial(CCT). Meta-analysis suggested synthesized efficacy(Odds Ratio,OR) of efficent probability between groups was 3.34,95%CI[2.56,4.34],P<0.00001.Funnel-plot showed the possible existence of publication bias.Conclusion: it initially proved that TCM of PBC&RBC has positive efficacy of Acute cerebral infarction.The third part is the clinical research.All the cases about ultra-early cerebral infarction according with criteria were involoved in the study from encephalopathy section of DongFang Hospital.The syndromic quantitative diagnose of 32 patients with ultra-early cerebral infarction were performed,The higher distribution probability of ultra-early cerebral infarction syndrome was wind syndrome(风证),phlegm-dampness(痰湿),fire-hot(火热) and blood stasis(血瘀), Syndrome had its rule,Most had three or two syndromes,accounted for 65.6%,The proability of two syndromes coexisting at the same time was highest(34.4%),wind-phlegm(风痰) and wind- stasis (风瘀) coexisting at the same time were 45.5%,Accounted for 15.6% in All cases; The proability of three syndromes coexisting at the same time was 31.2%,and wind-phlegm - stasis (风痰瘀) coexisting at the same time were 30%,accounted for 9.4% in All cases.It showed wind syndrome,phlegm-dampness,fire-hot and blood stasis were the main cause and mechanism of ultra-early cerebral infarction.13 ultra-early cerebral infarction cases treated with intravenous thrombolysis therapy were divided into two groups: cases treated with intravenous thrombolysis therapy were regarded as controlled groups and which treated with drugs of PBC&RBC based on intravenous thrombolysis therapy were regarded as treated groups. The fluctuation of every index were observed.The Chinese stroke scale (CSS) and Activities of daily living (ADL) of patients in two groups were used to evaluate the recovery of neurological functions after treatment for 24 hours, 7 days and 30 days.And observe the syndrome of TCM in two group after treatment for 7 days and 30 days.Result: In treated groups,the CSS significant effective rate was 57.1 percent at 7days and 85.7 percent at 30days after thrombolysis. In controlled groups,the CSS significant effective rate was 50 percent at 7days and 66.6 percent at 30days after thrombolysis. but the result was discrepancy(P>0.05) although ADL of treated groups is lower than that of controlled groups. The total score of traditional medicine symptom descended after treatment based on symdrome differentiation in treated groups, especially in Blood stasis syndrome(after treatment for 24 hours,7 days and 30 days )and phlegm syndrom. (after treatment for 7 days ).Conclusion: Ultra-early infarction Treated with combined PBC&RBC and intravenous thrombolysis therapy is better than thrombolytic therapy.Which may be attributed to the treatment of invigorate the circulation of blood and Collaterals.It is necessary to carry out further clinic research on Chinese symptoms observed ,Different dose thrombolytic and Bleeding adverse reactions. |
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