论著·社区中医药CHINESE COMMUNITY DOCTORS 中国社区医师2018年第34卷第3期缺血性中风的发病率出现逐年上升的趋势,且并发症多,给患者及家庭造成严重的影响[1]。研究发现对缺血性中风进行治疗时,加用中药可使患者临床症状较快改善,对神经功能恢复所起的作用是积极的[2]。本科将名老中医赵继福教授自拟验方豨莶草方用于缺血中风风痰瘀阻证患者的治疗,取得的疗效较好,现报告如下。资料与方法2016年5月-2017年2月收治缺血性中风患者72例,随机分两组。治疗组36例,男22例,女14例;年龄40~70岁,平均(59.5±6.0)岁;病程6~48h,平均(12.4±4.5)h。对照组36例,男19例,女17例;年龄40~70岁,平均(60.7±6.1)岁;病程3~64h,平均(15.8±4.6)h。两组一般资料比较,差异均无统计学意义(P >0.05),具有可比性。诊断标准:病例选择中医诊断标准参照的是国家中医药管理局脑病急症科研协作组1996年通过的《中风病诊断与疗效评定标准》(试行),且证类诊断标准符合风痰瘀阻证。西医诊断标准参照动脉粥样硬化性血栓性脑梗死的诊断,来源于中华医学会第4次全国脑血管病学术会议在1995年修订的《各类脑血管疾病诊断要点》。治疗方法:均给予常规基础治疗,如降脂、降压、降糖、抗血小板聚集及活血通络等。治疗组在常规治疗基础上加用豨莶草方,具体方药:豨莶草20g,秦艽20g,天麻15g,胆南星10g,半夏10g,川芎15g,黄连10g,石菖蒲15g,远志15g,生蒲黄10g,桂枝10g,当归10g,桃仁10g,丝瓜络10g。均采用北京康仁堂药业的颗粒剂型,加入100mL 水中,2次/d 冲服。观察指标:治疗后,观察两组临床
总疗效,对比神经功能缺损评分(NIHSS 评分)、中医证候积分及日常生活能力评分(ADL 评分)在治疗后的改善情况,观察用药期间两组不良反应情况。
疗效判定标准:参考《中药新药临床研究指导原则》评分标准对中医症状积分进行评定[3]。采用NIHSS 评分对神经功能缺损程度进行评定[4]:①基本痊愈:减少>90%的NIHSS 评分;②显效:上述评分减少46%~90%;③有效:减少18%~45%的NIHSS 评分;④无效:
NIHSS 评分<18%或甚至反而加重。总有
效率=(基本痊愈+显效+有效)例数/总例
数×100%。使用Barthel Index(BI)评分(满分100分)评估日常生活活动能力,得分与生活能力呈正相关[5]。
统计学方法:用SPSS 13.0统计软件进行分析,以(x ±s )表示计量资料,用t 检验;采用χ2检验标书计数资料,P <0.05为差异有统计学意义。
结果
两组临床疗效比较:治疗组总有效率83.33%,对照组总有效率72.22%,差doi:10.3969/j.issn.1007-614x.2018.3.54
摘要目的:评价豨莶草方加减治疗缺血性中风风痰瘀阻证的疗效。方法:72例患者随机平分两组,均给予常规治
疗,治疗组加用豨莶草方治疗。两组均治疗14d,观察相关指标。结果:治疗组总有效率83.33%,对照组72.22%,差
异有统计学意义(P <0.05)。与治疗前比,治疗后两组中医症状积分及神经功能缺损评分均降低(P <0.05),且治疗组改
善程度均优于对照组(P <0.05)。两组治疗后日常生活能力评分均升高(均P <0.05),两组用药期间均未出现严重不良反
应。结论:豨莶草方治疗缺血性中风风痰瘀阻证有较好的疗效。
关键词豨莶草方;缺血性中风;风痰瘀阻证
Clinical observation of herba siegesbeckiae decoction in the treatment of ischemic stroke phlegm and blood stasis
syndrome
Wang Yanhong,He Wei,Li Yanqiu
Traditional Chinese Medicine Hospital of Changchun City,Jilin Province 130000
Abstract Objective:To investigate the effect of herba siegesbeckiae decoction in the treatment of ischemic stroke phlegm and
blood stasis syndrome.Methods:72patients were randomly divided into the two groups on average.All patients were given
conventional treatment,and the treatment group was treated with herba siegesbeckiae decoction.The two groups were treated for 14
d.We observed the related indicators.Results:The treatment group total effective rate the was 83.33%,and that of the control group
was 72.22%;the difference between groups was statistically significant(P <0.05).The symptom scores and neurological deficit
scores of the two groups after treatment were lower than those before treatment(P <0.05).And the improvement degree of the
treatment group was better than the control group(P <0.05).The scores of daily living ability increased after treatment in the two
groups(all P <0.05).No serious adverse reactions occurred in the two groups during the medication.Conclusion:Herba
siegesbeckiae decoction in the treatment of ischemic stroke phlegm and blood stasis syndrome has significant effect.
Key words Herba siegesbeckiae decoction;Ischemic stroke;Phlegm and blood stasis syndrome
豨莶草方加减治疗缺血性中风风痰瘀阻证的临床观察
王彦红何威李艳秋
130000吉林省长春市中医院
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