通脉舒络胶囊联合康复疗法治疗气虚血瘀型缺血性中风临床研究

目的:观察通脉舒络胶囊联合康复疗法治疗气虚血瘀型缺血性中风的临床疗效。方法:选取114例气虚血瘀型缺血性中风患者,随机分为对照组和观察组,各57例。对照组采用常规药物治疗和康复治疗,观察组在此基础上联合通脉舒络胶囊,疗程为28 d,对比两组患者疗效及中医证候(主症、兼症、舌脉)改善情况,并采用美国国立卫生研究院卒中量表(national institute of health stroke scale,NIHSS)、Fugl-Meyer(FMA)量表、日常生活活动能力量表(Barthel指数)等评价患者治疗前后功能状态改变情况,采用凝血酶原时间(prothrombin time,PT)、活化部分凝血酶时间(activated partial thromboplastin time,APTT)、血小板聚集率(platelet aggregation rate,PAR)、D-二聚体(D-Dimer,D-D)血清含量等评价患者治疗前后凝血功能改善情况。结果:观察组有效率为75.44%,明显优于对照组的56.14%,差异有统计学意义(P0.05);两组中医证候主症评分、NIHSS、FMA、Barthel指数、PT、APTT、PAR、D-D等治疗前后比较,差异均有统计学意义(P0.05)。观察组兼症评分、舌脉评分均明显低于治疗前,差异有统计学意义(P0.05),对照组兼症评分、舌脉评分治疗前后比较,差异无统计学意义(P0.05)。治疗后观察组主症评分、兼症评分、舌脉评分、NIHSS评分、PAR、D-D等均明显低于对照组,FMA、Barthel评分、PT、APTT等均明显高于对照组,差异均有统计学意义(P0.05)。结论:通脉舒络胶囊联合康复疗法用于气虚血瘀型缺血性中风患者,可改善患者血液高凝状态,减少神经缺损,提高肢体功能及日常生活能力,减轻临床症状,疗效确切。

Clinical Study of Tongmai Shuluo Capsule Combined with Rehabilitation Therapy in Treatment of Ischemic Stroke with Qi Deficiency and Blood Stasis Syndrome

Objective:To observe the clinical efficacy of Tongmai Shuluo Capsule combined with rehabilitation therapy in treatment of Ischemic Stroke with Qi Deficiency and Blood Stasis Syndrome.Methods:From January 2015 to October 2016,114 patients with Ischemic Stroke with Qi Deficiency Blood Stasis Syndrome were randomly divided into control group and observation group,with 57 cases in each group.The control group was treated with conventional drug and rehabilitation approach,while the observation group was treated with Tongmai Shuluo capsule and rehabilitation approach.After 28 days' treatment,the clinical effect and the improvement situation of TCM syndrome were observed.The national institute of health stroke scale (NIHSS),Fugl-Meyer assessment (FMA) and Activity of Daily Living (Barthel Index) were applied to measure the function status of the patients.The prothrombin time (PT),activated partial thrombin time (ApIT),platelet aggregation rate (PAR) and D-dimer (D-D) were observed to find out the coagulation function of patients after treatment.Results:,the total remarkable progress rate of the observation group was 75.44％,which was significantly better than that (56.14％) of the control group (P ＜ 0.05).The primary symptom score and the results of NIHSS,FMA,Barthel score,PT,ApTT,PAR,D-D of both groups after treatment were significantly different from those before treatment respectively (P ＜ 0.05).The accompanying syndrome scores and tongue pulse scores after treatment of the observation group were significantly lower than those before treatment (P ＜ 0.05),but the those of the control group were not (P ＞ 0.05).After treatment,the primary symptom scores,accompanying symptom scores,tongue pulse scores,NIHSS scores,the PAR and D-D result of the observation group were significantly lower than those of the control group (P ＜ 0.05),while the results of FMA,Barhel,PT,APTT of the observation group were significantly higher than those of the control group (P ＜ 0.05).Conclusion:Tongmai Shuluo Capsule combined with rehabilitation therapy in treatment of Ischemic Stroke with Qi Deficiency and Blood Stasis Syndrome can significantly improve patient's hypercoagulable state,decrease the neurologic defect,improve the limb function and the daily activity,and lessen the clinical symptoms of patients.It was worthy of further research and more extensive application in clinics.