中风祖方治疗溶栓窗外急性缺血性中风血瘀证患者的临床研究  

Clinical Study of Zhongfeng Zu Recipe in Treating Acute Ischemic Stroke with Blood-stasis Syndrome Beyond Therapeutic Time Window for Thrombolysis

作　　者：文龙龙[1] 林伟龙 黄培新[1] WEN Long-Long;LIN Wei-Long;HUANG Pei-Xin(Guangdong Provincial Hospital of Traditional Chinese Medicin;The First Affiliated Hospital of Guangzhou University of Chinese Medicin)

机构地区：[1]广东省中医院,广东广州510120 [2]广州中医药大学第一附属医院,广东广州510405

出　　处：《广州中医药大学学报》2018年第6期981-986,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省中医药局科研项目(编号:粤中医[2014] 25号)

摘　　要：【目的】评价中风祖方(以丹参、益母草、毛冬青为基础方)对溶栓窗外急性缺血性中风血瘀证患者的临床疗效。【方法】采用多中心、Marker随机对照研究,将166例溶栓窗外急性缺血性中风血瘀证患者随机分为试验组82例和对照组84例。对照组给予西医标准治疗,试验组在西医标准治疗基础上,加用中药中风祖方治疗,2组疗程均为90 d。观察2组患者治疗7 d、14 d、90 d后的美国国立卫生院卒中评分量表(NIHSS)评分和改良Rankin量表(MRS)评分的分值及减少率变化情况,并于治疗90 d后进行疗效评价。【结果】(1)治疗7 d、14 d、90 d后,2组患者MRS评分及NIHSS评分均较治疗前有一定程度下降,但差异均无统计学意义(P> 0.05);试验组治疗7 d、90 d后MRS评分的减少率和治疗7 d、14 d、90 d后NIHSS评分的减少率均优于对照组(P <0.05)。(2)治疗90 d后,试验组MRS疗效的总恢复率为79.27%,对照组为72.62%;组间比较,2组患者的MRS疗效相仿(P> 0.05)。(3)治疗90 d后,试验组NIHSS疗效的总好转率为79.27%,对照组为59.52%;组间比较,试验组的NIHSS疗效优于对照组(P <0.05)。(4)试验组有8例出现并发症,对照组有19例出现并发症,试验组的并发症有少于对照组趋势,但差异均无统计学意义(P> 0.05)。(5)2组患者治疗前后均未出现由于治疗因素引起的肝、肾功能损伤及血、尿、大便三大常规的异常变化。【结论】中风祖方能有效改善溶栓窗外急性缺血性中风血瘀证患者的神经功能,降低致残程度。Objective To evaluate the clinical effect of Zhongfeng Zu Recipe（ZZR）for the treatment of acute ischemic stroke（AIS）patients with blood-stasis syndrome beyond therapeutic time window for thrombolysis.Methods A multi-center and Marker randomized controlled study was carried out. A total of 166 AIS patients withblood-stasis syndrome beyond therapeutic time window for thrombolysis were divided into test group（82 cases）andcontrol group（84 cases）. The two groups were given standard western medicine treatment,and additionally thetest group was given ZZR treatment,the treatment for the two groups covering 90 days. The scores of NationalInstitutes of Health Stroke Scale（NIHSS）and modified Rankin Scale（MRS）as well as the changes of the decreaserate after treatment for 7,14 and 90 days were observed in the two groups,and the clinical effect was evaluatedafter treatment for 90 days. Results（1）After treatment for 7,14 and 90 days,the scores of MRS and NIHSS inthe two groups were decreased to certain degree as compared with those before treatment,but the difference wasinsignificant（P 〉 0.05）. The decrease rate for MRS scores after treatment for 7 and 90 days and the decrease ratefor NIHSS scores after treatment for 7,14 and 90 days in the test group were superior to those in the control group（P 〈 0.05）.（2）After treatment for 90 days,the total effective rate for MRS scores was 79.27% in the test groupand was 72.62% in the control group. The inter-group comparison results showed that the difference of effect onMRS scores was insignificant（P 〉 0.05）.（3）After treatment for 90 days,the total effective rate for NIHSS scoreswas 79.27% in the test group and was 59.52% in the control group. The inter-group comparison results showed thatthe clinical effect on NIHSS scores in the test group was superior to that in the control group（P 〈 0.05）.（4）Thecomplications occurred in 8 cases from the test group,and in 19 cases from the control group. The incidence ofcomplications in t

关 键 词：中风祖方 急性缺血性中风 血瘀证 MRS评分 NIHSS评分 

分 类 号：R277.7[医药卫生—中医学] R743.33