祛风化瘀通络方早期干预急性缺血性脑卒中42例

目的: 观察祛风化瘀通络方早期干预急性缺血性脑卒中（CIS）的临床疗效及作用机制。 方法: 85例CIS患者随机按数字法分为对照组43例和观察组42例。两组均参照“中国急性缺血性脑卒中诊治指南2010”给予西医常规治疗。观察组在对照组治疗的基础上加用祛风化瘀通络方，1剂/d，疗程2周。以美国国立卫生研究院卒中量表（NIHSS）评估神经功能缺损严重程度，以Fugl-Meyer运动功能评价量表（FMI）评估肢体运动功能，以改良Ashworth痉挛评定量表评价肢体痉挛程度;记录中医证候评分;检测血清血管假性血友病因子（vWF）、血栓素B₂（TXB₂）、6-酮-前列环素F_lα（6-Keto-PGF_lα）、同型半胱氨酸（HCY）水平及血小板功能。 结果: 治疗后第7、14天观察组NIHSS评分和改良Ashworth评分均低于对照组，FMI评分高于对照组（P<0.01）;治疗后第7、14天观察组中医证候评分下降幅度多于对照组（P<0.01）;治疗后观察组vWF，TXB₂及HCY水平均低于对照组，6-Keto-PGF_1α高于对照组（P<0.01）;治疗后观察组平均血小板体积及血小板聚集率均低于对照组（P<0.01）。 结论: 祛风化瘀通络方早期干预急性缺血性脑卒中，能改善患者中医临床症状及神经功能缺损症状，其作用机制可能与抑制血小板激活，抗血小板活化，改善血管缩舒功能有关。

Early Intervention of Qufeng Huayu Tongluo Formulae on 42 Cases Acute Ischemic Stroke Patients

Objective: The purpose is to observe the clinical curative effect and mode of action of Qufeng Huayu Tongluo Formulae in the early intervention of acute ischemic stroke (CIS). Method: Eiety-five cases of CIS patients were randomly divided into control group (43 cases) and observation group (42 cases) according to digital method. According to 'China Diagnosis and Treatment of Acute Ischemic Stroke Guidelines 2010',patients in both group were given conventional western medicine treatment. Based on the treatment of observation group,patients in the control group took Qufeng Huayu Tongluo Formulae,1 dose/day,treatment course 2 weeks. Nerve function defect severity was assessed by the United States National Institutes of Health Stroke Scale (NIHSS). Limb movement function was assessed by Fugl-Meyer motor function assessment scale (FMI). Limb spasm degree was assessed by modified Ashworth spasm rating scale. Traditional Chinese medicine syndrome scores were recorded.Levels of serum vascular pseudo willebrand factor (vWF),thromboxane B₂ (TXB₂),6-ketone-Prostcyclin F_1a (6-Keto-PG F_1a) and homocysteine (HCY) levels and platelet function were detected. Result: On the 7th day and 14th day after treatment,the NIHSS score and modified Ashworth score of observation group were lower than the control group,while FMI score higher than the control group (P<0.01). The falling range of traditional Chinese medicine syndrome scores of observation group was larger than the control group (P<0.01).After treatment,the levels of vWF,TXB₂ and HCY of observation group were lower than the control group,while 6-Ketone-PG F_1a was higher than the control group (P <0.01). The mean platelet volume and platelet aggregation rate of observation group were lower than control group (P<0.01). Conclusion: In the early intervention of acute ischemic stroke,Qufeng Huayu Tongluo Formulae can improve patient's clinical symptoms of Traditional Chinese Medicine and neural function defect symptom. Its mechanism may be related to inhibit platelet activation and platelet activation,improve the function of vasoconstriction.