卫气营血辨证治疗对进展性卒中患者神经功能缺损及日常生活能力的影响  

Effect of Syndrome Differentiation and Treatment of Wei,Qi,Ying and Xue on Neurologic Impairment and Activity of Daily Living in Patients with Progressive Stroke

作　　者：兰希福[1] 吴红玉[1] 张法伟[2] 赵曼丽[1] 王泽颖[1] 

机构地区：[1]潍坊市中医院 [2]潍坊医学院

出　　处：《中医杂志》2016年第12期1041-1044,共4页Journal of Traditional Chinese Medicine

基　　金：山东省中医药科技发展计划资助项目(2009-208)

摘　　要：目的观察应用卫气营血理论辨治进展性卒中中的临床疗效。方法将120名进展性卒中患者分为治疗组和对照组各60例,治疗组卫分证、气分证、营分证、血分证患者各15例,在西药常规治疗基础上卫分证加用自拟驱风汤,气分证加用星蒌承气汤合玉女煎,营分证加用清营汤,血分证加用桃核承气汤或补阳还五汤;对照组中肝阳暴亢、风火上扰证,风痰瘀血、痹阻脉络证,痰热腑实、风痰上扰证,气虚血瘀证,阴虚风动证组各12例,在西药常规治疗基础上肝阳暴亢、风火上扰证加用天麻钩藤饮,风痰瘀血、痹阻脉络证加用化痰通络汤,痰热腑实、风痰上扰证加用星蒌承气汤,气虚血瘀证加用补阳还五汤,阴虚风动证加用镇肝熄风汤治疗。分别于治疗前及治疗30天、90天观察两组各证候患者美国国立卫生院神经功能缺损评分(NIHSS)、Barthel指数量表评分(BI)情况。结果治疗组及对照组各证型治疗30天、90天的NIHSS均较本证型治疗前明显降低,BI明显升高(P<0.01),且治疗90天时NIHSS、BI改善均优于本证型治疗30天(P<0.01)。治疗组治疗30天、90天NIHSS、BI改善均优于对照组(P<0.01)。结论应用卫气营血辨证治疗进展性卒中患者可显著改善神经功能缺损情况及日常生活能力,疗效优于传统脏腑辨证。Objective To observe the clinical effect of syndrome differentiation and treatment on progressive stroke based on the theory of Wei,Qi,Ying and Xue. Methods Totally 120 patients with progressive stroke were divided into a treatment group and a control group,with 60 cases in each. There were 15 cases of Weifen syndrome,15 of Qifen syndrome,15 of Yingfen syndrome,and 15 of Xuefen syndrome in treatment group. Based on the routine treatment of western medicine,those with Weifen syndrome were added with Qufeng Decoction（ 驱风汤）,those with Qifen syndrome were added with Xinglou Chengqi Decoction（ 星蒌承气汤） combined with Yunv Jian Decoction（ 玉女煎）,those with Yingfen syndrome were added with Qingying Decoction（ 清营汤）,and those with Xuefen syndrome were added with Taohe Chengqi Decoction（ 桃核承气汤） or Buyang Huanwu Decoction（ 补阳还五汤）. In the control group,there were 12 cases of liver Yang hyperactivity and wind fire pathogen syndrome,12 of wind phlegm with blood stasis and stagnating collaterals syndrome,12 of phlegm-heat accumulation and wind-phlegm invading upward syndrome,12 of Qi deficiency with blood stagnation syndrome,and 12 of wind formation from Yin deficiency syndrome. Based on the routine western medicine treatment,those with liver Yang hyperactivity and wind fire pathogen syndrome were added with Tianma Gouteng Yin（ 天麻钩藤饮）,those with wind phlegm with blood stasis stagnating collaterals syndrome were added with Huatan Tongluo Decoction（ 化痰通络汤）,those with phlegm-heat accumulation and wind-phlegm invading upward syndrome were added with Xinglou Chengqi Decoction,those with Qi deficiency with blood stagnation syndrome were added with Buyang Huanwu Decoction,and those with wind formation from Yin deficiency syndrome were added with Zhengan Xifeng Decoction（ 镇肝熄风汤） for treatment. National Institute of Health Stroke Scale（ NIHSS） and scale score of Barthe index（ BI） of patients with each syndrome in each gro

关 键 词：进展性卒中 卫气营血辨证 神经功能缺损 

分 类 号：R277.7[医药卫生—中医学]