养阴益气活血方治疗气阴两虚证、瘀血阻络证缺血性中风疗效观察  

Treating Ischemic Stroke Patients of Deficiency of Qi and Yin Syndrome and Static Blood Obstructing Collaterals Syndrome by Yangyin Yiqi Huoxue Recipe: a Clinical Study of Therapeutic Effect

作　　者：万海同[1] 别晓东[2] 姚政[3] 徐彬[4] 刘华[2] 杨洁红 张宇燕[1] 何昱[1] 周惠芬[1] 

机构地区：[1]浙江中医药大学心脑血管病研究所,杭州310053 [2]浙江大学医学院附属第二医院中医科,杭州310053 [3]浙江省中医院神经内科,杭州310053 [4]浙江省新华医院神经内科,杭州310053

出　　处：《中国中西医结合杂志》2015年第3期281-286,共6页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：国家自然科学基金资助项目(No.81374053;No.81173647;No.81073139);浙江省自然科学基金资助项目(No.LR12H27001);浙江省卫生高层次创新人才培养工程项目;浙江省中医药(中西医结合)重点学科(No.2012-XK-A06)

摘　　要：目的研究养阴益气活血方(养阴通脑颗粒基本方)治疗缺血性中风气阴两虚证、瘀血阻络证临床疗效。方法将312例患者采用分层随机分配法分为对照组和治疗组,其中养阴益气活血方随证加减治疗组(治疗组)226例,血栓心脉宁对照组(对照组)86例。疗程均为4周。观察两组气阴两虚证、瘀血阻络证及其兼证急性期、恢复期构成比;治疗前后临床疗效、临床症状积分、全血黏度比、血浆黏度比、红细胞压积、ESR、TC、TG、HDL-C、LDL-C变化。结果缺血性中风急性期、恢复期的气阴两虚证、瘀血阻络证及其兼证构成比差异有统计学意义(P<0.01),气阴两虚证、瘀血阻络证是两组的基本证型。治疗组愈显率(71.24%,161/226)明显高于对照组(43.02%,37/86),治疗组总有效率(91.15%,206/226)高于对照组(76.74%,66/86),差异均有统计学意义(P<0.01)。治疗组症状积分、全血黏度比、血浆黏度比、红细胞压积、ESR、TC、TG、HDL-C和LDL-C较治疗前显著改善,差异均有统计学意义(P<0.05,P<0.01)。结论养阴益气活血方随证加减可显著改善缺血性中风症状,并对全血黏度比、血浆黏度比、红细胞压积、ESR、血脂异常代谢等指标有显著改善作用。缺血性中风患者存在气阴两虚致血瘀的病理变化,气阴两虚证、瘀血阻络证是缺血性中风的基本证型。Objective To observe the clinical effect of Yangyin Yiqi Huoxue Recipe （YYHR, the basic recipe of Yangyin Tongnao Granule） in treatment of ischemic stroke patients of deficiency of qi and yin syndrome （DQYS） and static blood obstructing collaterals syndrome （SBOCS）. Methods Totally 312 patients were assigned to the control group （86 cases） and the treatment group （226 cases） using strati- fied randomized allocation method. Patients in the treatment group were treated with modified YYHR, while those in the control group took Xueshuan Xinmaining. The treatment course was 4 weeks for all. Constituent ratios of the acute stage and the recovery stage of DQYS and SBOCS and their complicated syndromes were observed in the two groups. Changes of the clinical curative effect, clinical symptoms integral, whole blood viscosity ratio, plasma viscosity ratio, hematocrit, erythrocyte sedimentation rate （ESR）, total cho-lesterol （TC）, triglyceride （TG）, high density lipoprotein cholesterol （HDL-C）, and low density lipoprotein cholesterol （LDL-C） were detected in the two groups before and after treatment. Results There was sta- tistical difference in constituent ratios of the acute stage and the recovery stage of DQYS SBOCS and its complicated syndromes between the two groups （P 〈0.01 ）. DQYS and SBOCS was basic syndrome types of the two groups. The cured and markedly effective rate was 71.24% （161/226） in the treatment group and 43.02% （37/86） in the control group. The total effective rate was 91.15% （206/226） in the treatment group, higher than that of the control group （76.74%, 66/86） with statistical difference （P 〈0.01 ）. There was sta- tistical difference in the clinical symptoms integral, whole blood viscosity ratio, plasma viscosity ratio, hematocrit, ESR, TC, TG,HDL-C, and LDL-C （P 〈0.05, P 〈0.01 ）. Conclusions Symptoms of ischemic stroke patients could be improved by modified YYHR. Indices such as the whole blood viscosity, plasma viscosity rat

关 键 词：养阴益气活血方 缺血性中风 气阴两虚证 瘀血阻络证 中医治则治法 

分 类 号：R277.7[医药卫生—中医学]