中西医结合治疗轻症脑干梗死  

Treating mild brainstem infarction in the integrative medicine

作　　者：姜金鹏 梁颖茵[1] 孙海兴[1] 陈松林[1] JIANG Jinpeng;LIANG Yingyin;SUN Haixing;CHEN Songlin

机构地区：[1]中山大学附属第一医院,广东广州510700

出　　处：《中医临床研究》2023年第21期48-52,共5页Clinical Journal Of Chinese Medicine

摘　　要：目的:探讨中西医结合方法门诊治疗轻症脑干梗死[美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NHISS)评分≤4分]的疗效及安全性。方法:对确诊为轻症脑干梗死及其合并症,如高血压病、高血脂、糖尿病等的患者,均按西医相应指南处理,同时按照中医中风理论予患者辨证分型:(1)气虚血瘀;(2)风痰瘀阻;(3)阴虚风动;(4)痰热腑实;(5)风阳上扰。依据证型,辨证论治:气虚血瘀型,予益气养血,化瘀通络,用脑安滴丸等治疗;风痰瘀阻型,予搜风化痰,行瘀通络,用脑栓通胶囊治疗;阴虚风动型,予滋阴潜阳,息风通络,用复方银杏通脉治疗。对于多证型患者:(1)气虚血瘀合并风痰瘀阻,予益气养血,化瘀通络兼顾搜风化痰,行瘀通络,用通心络胶囊加脑栓通胶囊协同治疗;(2)阴虚风动合并气虚血瘀,予滋阴潜阳,息风通络兼顾益气养血,化瘀通络,用复方银杏通脉加脑安滴丸协同治疗;(3)气阴两虚合并风痰瘀阻,予补气养阴兼顾搜风化痰,行瘀通络,用脑栓通胶囊加复方血栓通胶囊协同治疗。结果:经过3周以上的治疗,3例患者症状完全消失;其余两例症状明显减轻。总有效率为100%,治愈率为60%。结论:对轻症脑干梗死的患者,在严格掌握适应证的情况下予以中西医结合治疗,疗效可靠,安全性高,医疗费用明显降低。Objective:To investigate the efficacy and safety of the integrative medicine in the outpatient treatment of mild brainstem infarction(NHISS score≤4).Methods:The mild cases of brainstem infarction and its complications,such as hypertension,hyperlipidemia,diabetes,were treated according to the corresponding guidelines of Western medicine.At the same time,according to the stroke theory of TCM,the patients were divided into 5 syndrome differentiation types:①Qi(气)deficiency and blood stasis;②Wind-phlegm stagnation;③Yin(阴)deficiency and wind disturbance;④Phlegm-heat accumulation;⑤Disturbingup of wind and Yang(阳).Syndrome differentiation and treatment was given based on the syndrome type:the Qi deficiency and blood stasis type was treated by supplementing Qi and nourishing blood to disperse blood stasis and dredge collateral,and the Naoan dropping pills(脑安滴丸)were given;For wind-phlegm stagnation type,the Naoshuantong capsule(脑栓通胶囊)was used to soothe the wind and dissipate phlegm,promote blood stasis and dredge collaterals;For Yin deficiency and wind disturbance type,Compound Yinxing Tongmai(复方银杏通脉)was given to nourish Yin and conceal Yang,quench wind and dredge collaterals.For the patients with multiple syndromes,for example:①For Qi deficiency and blood stasis combined with wind-phlegm stagnation,the Tongxinluo capsule(通心络胶囊)combined with the Naoshuantong capsule were given for supplementing Qi and nourishing blood,dispersing blood stasis and dredging collateral in addition to soothing the wind and dissipating phlegm,promoting blood stasis and dredging collaterals;②For Yin deficiency and wind disturbance combined with Qi deficiency and blood stasis,compound Yinxing Tongmai combined with the Naoan dropping pills were given for nourishing Yin and concealing Yang,quenching wind and dredging collaterals combined with supplementing Qi and nourishing blood,and dispersing blood stasis and dredging collateral;③For Qi and Yin deficiency combined with wind-phlegm sta

关 键 词：脑干梗死 结合医学 门诊治疗 

分 类 号：R743.33[医药卫生—神经病学与精神病学]