涤痰汤联合大承气汤加减辅助西医常规治疗缺血性卒中痰蒙清窍证合并顽固性呃逆的临床研究  

Clinical study of modified Ditan Decoction combined with Dachengqi Decoction and conventional Western medicine on ischemic stroke of TanmengQingqiao syndrome with stubborn hiccups

作　　者：王冉 王新 齐锡友 李连英[1] 谢春荣[1] 张肖 刘东洋 WANG Ran;WANG Xin;QI Xiyou;LI Lianying;XIE Chunrong;ZHANG Xiao;LIU Dongyang(Department of Encephalopathy,Beijing Huairou Hospital of Traditional Chinese Medicine,Beijing 101400;Department of Emergency,Beijing Huairou Hospital of Traditional Chinese Medicine,Beijing 101400)

机构地区：[1]北京市怀柔区中医医院脑病科,北京101400 [2]北京市怀柔区中医医院急诊科,北京101400

出　　处：《河北中医》2024年第10期1608-1611,1616,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：北京中医医院怀柔医院科研项目(编号:2020-MP04)。

摘　　要：目的观察涤痰汤联合大承气汤加减辅助西医常规疗法治疗缺血性卒中痰蒙清窍证合并顽固性呃逆的临床疗效。方法将95例缺血性卒中痰蒙清窍证合并顽固性呃逆患者用随机数字表法分为对照组(48例)、治疗组(47例)。对照组予常规西医常规疗法治疗,治疗组予涤痰汤联合大承气汤加减辅助常规西医常规疗法治疗。比较2组临床疗效、神经功能[美国国立卫生研究院卒中量表(NIHSS)]、呃逆症状评分、血清炎症因子水平[肿瘤坏死因子α(TNF-α)、核因子κB(NF-κB)、C反应蛋白水平(CRP)]、日常生活能力(Barthel指数)及不良反应发生情况。结果治疗组总有效率93.62%(44/47)高于对照组75.00%(36/48),差异有统计学意义(P<0.05);治疗2周,治疗组NIHSS评分、呃逆症状评分、TNF-α、NF-κB、CRP水平均低于对照组,Barthel指数评分高于对照组,差异有统计学意义(P<0.05);2组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论涤痰汤联合大承气汤加减辅助西医常规疗法治疗缺血性卒中痰蒙清窍证合并顽固性呃逆患者效果较好,可改善神经功能,减轻呃逆症状,降低炎症因子水平,提升日常生活能力,且安全性好。Objective To observe the clinical effect of modified Ditan Decoction combined with Dachengqi Decoction and conventional western medicine(CWM)in the treatment of ischemic stroke of TanmengQingqiao syndrome with stubborn hiccup.Methods Ninety-five patients with ischemic stroke of TanmengQingqiao syndrome with stubborn hiccup visited our hospital from April 2021 to November 2022 were enrolled.They were divided into control group(n=48)and treatment group(n=47)by a random number table.All patients were treated with CWM,and those in the treatment group were additionally treated with modified Ditan Decoction combined with Dachengqi Decoction.The clinical efficacy,neurological function(National Institutes of Health Stroke Scale[NIHSS]),hiccup symptom score,serum inflammatory factor levels(tumor necrosis factor-α[TNF-α],nuclear factor kappaB[NF-κB],C-reactive protein[CRP]),daily living ability(Barthel index[BI])were compared between groups.The adverse reactions were assessed.Results The total effective rate of the treatment group was significantly higher than that of the control group(93.62%[44/47]vs 75.00%[36/48],P<0.05).After 2 weeks of treatment,the treatment group had significantly lower the scores of NIHSS and hiccup symptom,significantly decreased the levels TNF-α,NF-κB and CRP,and significantly higher BI score relative to the control group(P<0.05).There was no significant difference in the total incidence of adverse reactions between groups(P>0.05).Conclusion Modified Ditan Decoction combined with Dachengqi Decoction and CWM is effective on ischemic stroke of TanmengQingqiao syndrome with stubborn hiccup.It can improve neurological function,reduce hiccup symptoms,reduce the level of inflammatory factors,and improve daily living ability,with good safety.

关 键 词：缺血性卒中 痰蒙清窍证 顽固性呃逆 涤痰汤 大承气汤 

分 类 号：R289.6[医药卫生—方剂学]