Clinical Observation Of Eliminating Phlegm And Extinguishing Wind Method On Ischeamic Stroke Patients With Phlegm-dampness Constitution

Objective:To observe the clinical effect of eliminating phlegm and extinguishing wind method on ischemic stroke patients with phlegm-dampness constitution,which can explore the effect of TCM constitution intervention on ischemic stroke and the treatment of ischemic stroke with TCM characteristics.Methods:Adopting the method of prospective randomized study,a total of 74 patients ischemic stroke patients with phlegm-dampness constitution were recruited from May 2020 to January 2021 in Dongguan hospital of Guangzhou University of Chinese Medicine,which was randomly divided into control group and TCM group,37 cases in each group.In the control group,routine drug treatment was given during the CIS acute phase according to the guidelines for the diagnosis and treatment of acute ischemic stroke in China 2018,and the secondary prevention treatment was given during the convalescent period according to the guidelines for the secondary prevention of ischemic stroke and transient ischemic attack in China 2014.On the basis of the treatment in control group,the TCM group added the method of eliminating phlegm and extinguishing wind(Tian Ma Jian Nao Granules,one package TID during acute phase,one package BID during convalescent period).The course of treatment and observation period was four weeks.The general data of the patients were recorded,and the changes of the therapeutic effect indexes including hs-CRP,Hey and score of NIHSS,phlegm-dampness constitution,TCM syndrome,modified Barthel index,were observed before treatment,7 days after treatment and 4 weeks after treatment.Finally,to determine the therapeutic effect of TCM symptom in the 4th week after treatment of the two groups.Results:(1)In the process of the research,1 case fell off in the control group,1 case fell off in the TCM group and 2 cases were eliminated.In the end,36 cases were included in the control group and 34 cases in the TCM group.(2)The baseline data of the two groups were compared,the control group and the TCM group had no significant difference in sex,age,high risk factors(P>0.05).(3)There was no significant difference in TCM syndrome score between the two groups before treatment,which was comparable(P>0.05).The 7th day and 4th week after treatment in both groups improved significantly compared with before treatment(P<0.05),and the improvement of experimental group was more obvious;Both groups had no significant difference in scores of NIHSS and phlegm-dampness constitution before the treatment,which were comparable(P>0.05).The scores of 7 days and 4 weeks after treatment were significantly lower than those before treatment(P<0.05),and the decrease degree of TCM group was more obvious;Before the treatment,there was no significant difference in the MBI index score between the two groups,which was comparable(P>0.05).The score of 7 days and 4 weeks after treatment was significantly higher than that before treatment(P<0.05),and the increase of TCM group was more obvious;There was no significant difference in hs-CRP and Hcy before treatment between the two groups,which was comparable(P>0.05).The decrease of hs-CRP was more obvious on the 7th day after treatment than on the 4th week after treatment(P<0.05).The decrease of Hcy was more obvious at the 4th week after treatment than on the 7th day after treatment.(4)In the therapeutic efficacy,the effective rate of the control group and the TCM group were 75.0%and 94.12%.It was significantly different of the total effective rate of the two groups,and the TCM group was better than the other one(P<0.05).(5)In the course of the observation,there were two patients in the TCM group with symptoms such as stool rot,which may appear after taking traditional Chinese medicine.It was not belong to the adverse drug reaction and does not affect the daily life of the patients,which expressed tolerable and continues the clinical experiment.Blood routine,liver function and renal function of the two groups were not significantly damaged and no adverse drug events in both groups.(6)Except one patients in the TCM group failed to complete 80%of the dose of traditional Chinese medicine treatment,the other patients had good compliance.Conclusions:Comparing with western medicine treatment,the intervention of eliminating phlegm and extinguishing wind method on ischemic stroke patients with phlegm-dampness constitution have better therapeutic effect in improving the score of nerve function and TCM syndrome,reduce the ultra-sensitive C reaction protein(hs-CRP),homocysteine(Hcy),and improve the improved BI index score.It is suggested that the intervention of TCM constitution factors has unique advantages in the treatment of ischemic stroke,which is worth popularizing and applying in clinic.