涤痰逐瘀汤联合西药治疗缺血性中风恢复期痰瘀阻络型疗效观察及对血液流变学、血脂的影响

目的：观察涤痰逐瘀汤联合西药治疗缺血性中风恢复期痰瘀阻络型的疗效及对血液流变学、血脂的影响。方法：选取60例缺血性中风恢复期痰瘀阻络型患者，按随机数字表法分为对照组与治疗组各30例。对照组给予西药和康复治疗，治疗组在对照组基础上联合涤痰逐瘀汤治疗。比较2组临床疗效及不良反应发生率，比较2组治疗前后中医证候评分、血液流变学指标值、美国国立卫生研究院卒中量表（NIHSS）、Barthel指数（BI）、血脂[总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C） ]的变化。结果：对照组临床总有效率为80.00%，治疗组为96.67%，2组比较，差异有统计学意义（P＜0.05）。治疗后，2组半身不遂、口舌歪斜、偏身麻木、头晕目眩评分均较治疗前下降（P＜0.05），治疗组上述4项评分均低于对照组（P＜0.05）。治疗后，2组全血比黏度、血浆比黏度、纤维蛋白原指标值均较治疗前下降（P＜0.05），治疗组全血比黏度、血浆比黏度、纤维蛋白原指标值均低于对照组（P＜0.05）。治疗后，2组NIHSS评分均较治疗前下降（P＜0.05），BI评分均较治疗前升高（P＜0.05）；治疗组NIHSS评分低于对照组（P＜0.05）， BI 评分高于对照组（P＜0.05）。治疗后， 2 组TC、TG、LDL-C 水平均较治疗前下降（P＜0.05），HDL-C 水平均较治疗前升高（P＜0.05）；治疗组TC、TG、LDL-C 水平均低于对照组（P＜0.05），HDL-C 水平高于对照组（P＜0.05）。对照组不良反应发生率为6.67%，治疗组不良反应发生率为3.33%，2组比较，差异无统计学意义（P＞0.05）。结论：涤痰逐瘀汤联合西药治疗缺血性中风恢复期痰瘀阻络型疗效确切，能缓解临床症状，改善血液流变学指标值，提高神经功能及日常生活活动能力，调节血脂水平，安全性高。

Observation on the Clinical Efficacy of Ditan Zhuyu Decoction and Western Medicineon Ischemic Stroke of Phlegm-Blood Stasis Obstructing the Collaterals Type inConvalescence Stage and Its Effects on Hemorheology and Blood Lipid

Abstract： Objective： To explore the effect of the therapy of Ditan Zhuyu Decoction combined withwestern medicine on ischemic stroke of phlegm-blood stasis obstructing the collaterals type inconvalescence stage and its effects on hemorheology and blood lipid. Methods：A total of 60 patients withischemic stroke of phlegm-blood stasis obstructing the collaterals type in convalescence stage wereselected and divided into the control group and the treatment group according to the random number tablemethod， with 30 cases in each group. The control group was treated with western medicine andrehabilitation， and the treatment group was additionally treated with Ditan Zhuyu Decoction based on thetreatment of the control group. The clinical effects and incidence of adverse reactions，and the changes oftraditional Chinese medicine syndrome scores， hemorheology indexes， scores of National Institute ofHealth Stroke Scale (NIHSS)， Barthel Index (BI)， and levels of blood lipid (TC， TG， LDL-C and HDL-Cwere compared before and after treatment between the two groups. Results： The total clinical effectiverate was 80.00% in the control group and 96.67% in the treatment group with significant difference (P＜0.05). After treatment， the scores of hemiplegia， deviation of mouth and tongue， hemianesthesia， anddizziness in the two groups were decreased，and the above four scores in treatment group were lower thanthose in control group (P＜0.05). After treatment，the values of whole blood viscosity，plasma viscosity andfibrinogen in the two groups were decreased， and the above three values in treatment group were lowerthan those in control group (P＜0.05). After treatment，the NIHSS scores in the two groups were decreased(P＜0.05)， and BI scores were increased(P＜0.05)； the NIHSS score in treatment group was lower thanthat in control group (P＜0.05)， and the BI score was higher than that in control group (P＜0.05). Aftertreatment， the levels of TC， TG and LDL-C in wo groups were decreased (P＜0.05)， and the HDL-Clevels were increased (P＜0.05)；the levels of TC，TG and LDL-C in the treatment group were lower thanthose in control group (P＜0.05)，and the HDL-C level was higher than that in control group (P＜0.05). Therate of adverse reactions was 6.67% in the control group and 3.33% in the treatment group，there being nosignificance in the difference (P＞0.05). Conclusion： The therapy of Ditan Zhuyu Decoction and westernmedicine has a definite curative effect on ischemic stroke of phlegm-blood stasis obstructing the collateralstype in convalescence stage， which can mitigate the clinical symptoms， improve the hemorheologyindexes，nerve function and activity of daily living，and regulate the level of blood lipid with great safety.