| Objective:By observing the improvement of sweating remission and secondary sym Ptoms of traditional Chinese medicine in Patients with hyperhidrosis secondary to deficiency of Qi and Yin after stroke,and comparing the differences of skin sympathetic response(SSR),plasma catecholamine(plasma norepinephrine(NA),epinephrine(E)and dopamine(DA))and the changes of related hyperhidrosis related scale between the treatment group and the control group,the combination of sweating laboratory index,electromyography and hyperhidrosis scale,Confirm the clinical efficacy and safety of Zhihan mixture for patients with secondary hyperhidrosis after stroke(deficiency of Qi and Yin),and provide laboratory basis for the clinical treatment of patients with secondary hyperhidrosis after stroke.Methods:65 Patients with secondary hyperhidrosis after stroke who met the diagnostic criteria of deficiency of Qi and Yin in traditional Chinese medicine were selected.32 cases in the treatment group and 33 cases in the control group were randomly divided into two groups.The two groups were treated according to the Principle of neurosurgical stroke treatment,such as reducing intracranial pressure,preventing epilepsy,improving circulation and scavenging oxygen free radicals;patients with dysphagia were given nasal feeding diet.The treatment group was treated with basic symptomatic treatment plus addition and subtraction of Zhihan mixture + oral administration of oryzanol,and the control group was treated with basic symptomatic treatment plus oral administration of oryzanol tablets for 2 weeks.The remission degree of sweating,the improvement of traditional Chinese medicine symptoms,the score of HDSS scale and the improvement of Primary and secondary hyperhidrosis in the two groups before and after treatment were counted.At the same time,the expression changes of SSR and plasma catecholamine levels(mainly norepinephrine,epinephrine and dopamine levels)were observed before and after treatment,and the adverse reactions during medication were recorded for safety evaluation.Results:During the study period,the cases in the two groups fell off(including 1 case in the treatment group and 2 cases in the control group),and 62 cases were actually completed,with 31 cases in the treatment group and 31 cases in the control group.1.Baseline data analysis: before treatment,there was no significant difference between the treatment group and the control group in age,gender,GCS,degree score of diagnostic criteria of traditional Chinese medicine before treatment,score of Primary and secondary hyperhidrosis,SSR and Plasma catecholamine(P> 0.05).2.Remission degree of sweating: after treatment(day 14),the effective rate of the treatment group was 77.4%,and the total effective rate was 90.3%.The effective rate of the control group was 70%,and the total effective rate was 74%.There was significant difference between the control group and the treatment group before treatment(P< 0.05),and there was significant difference between the two groups after treatment(P<0.05),indicating that the degree of sweating in the two groups after treatment was significantly relieved compared with hyperhidrosis main symptom score of the two groups after treatment was lower than that before treatment;The comparison between groups was statistically significant(P < 0.05),indicating that the main symptoms,secondary symptoms,TCM syndrome score and HDSS score of hyperhidrosis in the treatment group decreased significantly compared with the control group.3.The improvement of hyperhidrosis main symptom,secondary symptom,hyperhidrosis TCM syndrome score and HDSS score: compared within the group,P<0.05,the hyperhidrosis main symptom score of the two groups after treatment was lower than that before treatment;The comparison between groups was statistically significant(P<0.05),indicating that the main symptoms,secondary symptoms,TCM syndrome score and HDSS score of hyperhidrosis in the treatment group decreased significantly compared with the control group.4.Comparison of plasma catecholamines: compared within the group,the p value was lower than 0.05,and the plasma catecholamines of the two groups after treatment were lower than those before treatment;After treatment,the plasma catecholamine level in the treatment group was significantly higher than that in the control group.5.SSR comparison: compared within the group,the p value was lower than 0.05.The initial latency and amplitude of SSR in the upper and lower limbs of the two groups after treatment were lower than those before treatment;After treatment,the initial latency and amplitude of SSR in the treatment group were significantly lower than those in the control group.Conclusion:In the treatment of hyperhidrosis with deficiency of Qi and Yin secondary to stroke,the effect of Zhihan mixture combined with oryzanol in the treatment of hyperhidrosis is better than that of oryzanol alone.It can significantly improve the hyperhidrosis symptoms of patients,improve the symptoms of traditional Chinese medicine such as fatigue,upset,dry mouth,hot hands and feet,dry stool and significantly reduce the initial latency,amplitude and plasma catecholamine level of upper and lower limbs of SSR,and no obvious adverse reactions are found,with high safety,It is worthy of further study. |
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