Clinical Retrospective Study On The Treatment Of Acute Cerebral Hemorrhage With Western Medicine Basic Therapy Combined With Traditional Chinese Medicine Decoction

Background: In China,cerebrovascular disease is the leading cause of death among residents.Among them,intracerebral hemorrhage is a kind of cerebrovascular disease with rapid onset,rapid change,and dangerous condition.Its incidence,disability,and fatality rate have always been high.Timely and effective diagnosis and treatment of intracerebral hemorrhage in the acute stage is of great significance to the good prognosis of patients.For a long time,Western medicine treatment has played a pivotal role in the treatment of acute intracerebral hemorrhage,but the results are not satisfactory,and the incidence of intracerebral hemorrhage is showing a younger trend.In our country,traditional Chinese medicine has a long history of preventing and treating stroke.It has good curative effect in the prevention,recovery and sequelae treatment of stroke.At present,the traditional Chinese medicine decoction based on syndrome differentiation and treatment has the advantage of flexible adjustment of prescription according to the change of the disease,and conforms to the reality of rapid changes in the acute phase of intracerebral hemorrhage,and has attracted the attention of clinicians.The basic treatment of western medicine combined with traditional Chinese medicine decoction to treat the acute phase of intracerebral hemorrhage is gradually emerging,but the efficacy and safety need to be further confirmed and improved.Objective: To study the clinical efficacy of basic western medicine combined with traditional Chinese medicine decoction in the acute phase of intracerebral hemorrhage,to explore the clinical application value of traditional Chinese medicine decoction in the acute phase of intracerebral hemorrhage,and to summarize the distribution of common TCM syndrome types in the acute phase of hemorrhagic stroke in this study,To provide clinical basis for the optimization of the diagnosis and treatment plan of integrated traditional Chinese and western medicine in the acute phase of intracerebral hemorrhage.Methods: A retrospective study was adopted to collect 114 cases of acute intracerebral hemorrhage in Hunan Provincial Brain Hospital and the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine from January 1,2014 to June 30,2019.Case data and clinical efficacy comparison of patients.According to the different treatment plans received by the patients,those who received basic Western medicine treatment were included in the control group(63 cases),and those who received basic Western medicine treatment combined with traditional Chinese medicine decoction treatment were included in the observation group(51 cases).On the one hand,the volume of intracranial hematomas,National Institute of Health Stroke Scale(NIHSS)scores,and Activity of Daily Living Scale(ADL)scores of the two groups of patients before and after treatment were collected.According to the data of the patient’s neurological deficit recovery,the overall effective rate was calculated according to the efficacy evaluation standard.The data of the two groups were analyzed using statistical methods and the changes in the scores of the two groups before and after treatment and the difference in efficacy were compared.On the other hand,the distribution of TCM syndrome types in the observation group was counted,and the distribution of TCM syndrome types common in the acute phase of intracerebral hemorrhage was summarized.Results: 1.Changes in the scores before and after treatment in the two groups: NIHSS score and ADL score after treatment in the two groups were improved compared with before treatment,and the difference was statistically significant(P<0.05).In the comparison between the two groups,the improvement of NIHSS score and ADL score of the observation group was more significant than that of the control group,and the difference was statistically significant(P<0.05).2.Volume change of intracranial hematoma: Comparing the two groups,the volume of intracranial hematoma after treatment was smaller than before treatment,and the difference was statistically significant(P<0.05).However,in the comparison of intracranial hematoma volume between the observation group and the control group after treatment,P>0.05,the difference was not statistically significant.3.Evaluation of clinical efficacy: 63 cases in the control group,of which 0cases were basically cured,15 cases were markedly effective,31 cases were effective,and 17 cases were ineffective,with an overall effective rate of73.02%;51 cases in the observation group,of which 3 cases were basically cured,21 cases were markedly effective,24 cases were effective and 3 cases were ineffective.The overall effective rate was 94.12%.After the level of curative effect was analyzed by Ridit,the results showed that the difference in curative effect between the two groups was statistically significant(P<0.05).4.TCM syndrome distribution: 51 cases in the observation group,46 cases in the meridian,5 cases in the viscera.Among them,there were 21 cases of wind-heat disturbance syndrome,12 cases of qi deficiency and blood stasis syndrome,7 cases of phlegm-heat syndrome syndrome,3 cases of blood stasis blocking orifice syndrome,3 cases of wind-phlegm blocking collateral syndrome,3 cases of phlegm-heat internal closure syndrome,phlegm and mental 2 cases of orifice syndrome.Among them,the frequency of occurrence of disturbance of wind and fire,qi deficiency and blood stasis syndrome,and phlegm-heat fu organs occupies the top three.5.Adverse reactions: During the treatment period,by observing the three major routines before and after treatment,liver and kidney function,electrolytes,myocardial enzymes and other test indicators,no adverse reactions related to the use of drugs were found.Conclusion: In the treatment of patients with acute intracerebral hemorrhage in the control group and observation group,not only can significantly improve the NIHSS score and ADL score of the patients,but also can reduce the volume of intracranial hematoma and improve the clinical symptoms and signs of the patients.Clinical application Relatively safe and effective.The observation group was more significant than the control group in improving the overall effective rate of the curative effect and improving the NIHSS score and ADL score.However,there is no statistically significant difference between the observation group and the control group in reducing the volume of intracranial hematoma.It is not clear that the combination of traditional Chinese medicine decoction treatment in reducing the volume of intracranial hematoma is better than the basic treatment of Western medicine.Wind-heat disturbance syndrome,Qi deficiency and blood stasis syndrome,and phlegm-heat and fu-organ syndromes are the top three in frequency,which are common TCM syndrome types in the acute phase of intracerebral hemorrhage in this study.