| Purpose Through the controlled clinical observation and magnetic resonance spectrum analysis, evaluating the effects of Tongnaoyin decoction in patients with acute cerebral infraction and the syndrome of phlegm and blood stasis in improving of intracranial new infarction area acidosis, energy metabolism, neurological deficits and the ability of living status. We also analyze the relationship between material metabolic changes in patients with intracranial infarction and the neurological deficits and the ability of living status.Method In this study, open controlled clinical trial design, selected in line with phlegm and blood stasis of acute cerebral infarction were randomly divided into treatment group and the conventional treatment control group each20cases. The control group uses conventional treatment methods, including brain protection, anti-platelet aggregation, controlling blood pressure and hyperglycemia, and lipid-lowering. Observing and comparing patients with intracranial new infarct zone and contralateral mirror area of NAA and Lac and Cr levels in the14th days. Evaluating the NIHSS, Barthel Index, the Quality of Life Index, Modified Rankin Scale points, degree of disability classification changes for group comparisons in the7th, the14th, the21th day separately.Results The two groups have no significant difference (P>0.05) in gender, age, time of onset, severity, clinical scores. At the end of treatment, NIHSS scores of both two groups have obviously reduced before treatment, Barthel index has significantly improved compared to the time before treatment (P<0.01); NIHSS scores of the treatment group are lower than that of the control group, when Barthel index of the former is higher (P<0.05). On the14th day of treatment, the decrease of NAA/Cr in both of central region and inside marginal region are significant in comparing with outside marginal region counterpart (P<0.05), but there’re no significant difference of NAA/Cr between the two groups in each region of interest (P>0.05). The level of Lac/Cr in the treatment group has no difference among the regions of interest (P>0.05) Compared with counterpart, the increase of Lac/Cr in cehtral region, inside marginal region,and outside marginal are significant in the control group (P>0.05).The decrease of Lac/Cr in central region and outside marginal region is obvious in the treatment group rather than in the control group (P<0.05).The research founds that the two between the level of NAA/Cr in central region and NIHSS scores in the14th day of treatment have linear related(r=-0.379, P<0.05), and the level of Lac/Cr in central region is related linearly with NIHSS scores and Barthel index in the14th day of treatment.Conclusions Tongnaoyin decoction can significantly improve the acute cerebral infarction in patients with clinical neurological deficits, improve activities of daily living; more objective evidence of magnetic resonance MRS shows Tongnaoyin decoction in improving energy metabolism of the intracellular acidosis in the brain infarct, and further validates a linear relationship of the brain tissue ratio of NAA/Cr, Lac/Cr levels in patients and clinical neurological defects, activities of daily living. The brain tissue ratio of NAA/Cr, Lac/Cr levels has a certain extent significance to judge clinical curative effect and determine the clinical outcome. Through Tongnaoyin decoction combined with western conventional treatment significantly better than conventional western medicine treatment, Tongnaoyin decoction has a significant effect. |
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