| Object i veTo observe the changes of the value of inflammatory biomarkers(temperature, respiratory rate, heart rate, WBC count, IL-6, TNF-αand PCT), ischemia biomarkers(Syndrome Integral Scale of Chinese Medicine, National Institutes of Health Stroke Scale, NSE and FIB) and the conditions of SIRS and MODS before or after the treatment, using the therapeutic method of Benefiting Vital Energy and Activating Blood Circulation, Benefiting Vital Energy and Activating Blood Circulation combined with routine western medicine on treating the patients with acute ischemic stroke complicated by SIRS and Qi-deficiency-blood-stasis syndrome. And it is explored how to prevent the acute ischemic stroke patients with SIRS from developing to MODS by TCM therapeutic method.MethodsTake the acute ischemic stroke patients with SIRS as research object by using single-blind prospective randomized study. All the 80 patients with acute ischemic stroke complicated by SIRS were from the Emergency Department of Guangdong Provincial Hospital of Chinese Medicine between January,2008 and January,2010,38 males and 42 females, aged 52-93, averaged 72 years old. They were randomly divided into Qixu group, Xueyu group, Qixuxueyu group and control group in 20 cases. The difference of age, gender and previous history had no statistical significance (P>0.05).All groups with conventional treatment, including dehydration therapy, neuroprotective drugs, control blood glucose and blood pressure, anti-infection, nutritional support and so on. Astragalus injection was added in Qixu group; Xuebijing injection was added in Xueyu group; both astragalus injection and Xuebijing injection were added in Qixuxueyu group. Period of treatment was 7 days, once a day in 4 groups.The measurement data was show as (?)±s. Measurement data of Xueyu group, Qixuxueyu group and control group comparison between groups were analysed by Rank Sum test and ANOVA. Serologic indexes of all groups before and after the treatment were analysed by Paired Sample T test. After treatment of four group of SIRS, the results were analysed by R×2 Tables chi-square test. Grade material were analysed by Rank Sum test. Database established and analysis on the statistic software SPSS13.0.Results1. The changes of the inflammatory biomarkers values after 7 days'treatment were below:The values of temperature, respiratory rate, heart rate, WBC count, IL-6 and TNF-αdecreased in all groups. The decline of Qixuxueyu group was highest, secondly were Qixu group and Xueyu group, the decline of control group was lowest, the difference had statistical significance (P＜0.05). There was no statistical significance of PCT values before and after treatment in all groups (P>0.05).2. Syndrome Integral of Chinese Medicine (CM):7 days after treatment, Syndrome Integral of Chinese Medicine (CM) decreased in 4 groups, the decline in Qixuxueyu group was largest which had significant difference (P<0.05) compared with Qixu group, Xueyu group and control croup (P＜0.05).3. NIHSS:The value of NIHSS increased in 4 groups, the increase in Qixuxueyu group was lowest, there was significant difference (P＜0.05) compared with Qixu group, Xueyu group and Control Group.4. After 7 days'treatment, the values of NSE decreased in all groups. The decline of Control Group was lowest, which had statistical significance (P＜0.05) while other three groups had no statistical significance (P>0.05) There was no statistical significance of FIB values before and after treatment in all groups (P>0.05).5. The result of SIRS developing to MODS:all patients in 4 groups measured up to standard of SIRS before treatment. After 7 days treatment, the improvement rate of SIRS in Qixuxueyu group was highest while Control Group was lowest, the difference had statistical significance (P<0.05). The transmutation rate of MODS in Control Group was highest which Qixuxueyu group was lowest, the difference had statistical significance (P<0.05).Conclusions1. Syndrome Integral of blood stasis syndrome and qi deficiency syndrome is the prime mechanism in the patients with acute ischemic stroke complicated with SIRS. Benefiting Vital Energy and Activating Blood Circulation is the effect treatment.2. IL-6 and TNF-αlevels were increased in the patients with acute ischemic stroke complicated with SIRS, while the PCT increased slightly, suggesting that SIRS was caused by acute ischemic infarction.3. Benefiting Vital Energy and Activating Blood Circulation can lessen releasing inflammatory mediators, which could block the evolution of MODS effetely.4. Benefiting Vital Energy and Activating Blood Circulation can improve neural ischemic symptoms, which can treat Acute Ischemic Stroke... |
PDF Full Text Request