Analysis Of The Efficacy Of Shuxuetong Injection In The Treatment Of Acute Ischemic Stroke In Patients With Different TCM Syndrome Types

[Objective]To observe the clinical efficacy of the combination of Shuxuetong Injection with conventional Western medicine in the treatment of patients with different types of ischemic stroke in the acute stage,and to find out more suitable indications for Shuxuetong Injection,so as to bring into play the advantages and characteristics of Chinese medicine.[Methods]120 hospitalized patients with acute cerebral infarction were divided into 6 groups:20 patients were from the Department of Neurology of the First Affiliated Hospital of Nanchang University.They were not divided into syndrome types.They were the control group and were given routine treatment of Western medicine;100 patients came from Jiangxi Provincial Hospital of traditional Chinese medicine.According to the diagnostic criteria of TCM syndrome types,they were divided into five groups: Qi deficiency and blood stasis type,wind phlegm and blood stasis type,yin deficiency and wind movement type,liver yang hyperactivity type and phlegm heat and viscera excess type.They were treated with Shuxuetong Injection on the basis of routine treatment of Western medicine.[Result](1)Observed indexes before treatment: Comparison of NIHSS score,TCM evidence score(Observation group),plasma D-dimer level and plasma triglyceride level in each group before treatment were not statistically significant(P>0.05).(2)NIHSS score: All six groups of patients showed improvement in neurological deficits after treatment.The NIHSS scores of five groups of patients with different types of syndrome treated with Shuxuetong Injection combined with conventional Western medicine were all greater before and after than those of the control group treated with conventional Western medicine alone,and the effect was most significant in patients with Yin deficiency and wind movement type(t=10.56,P<0.05).(3)ADL score: The ability to perform activities of daily living improved in all six groups after treatment.The difference between the ADL scores of patients in the five groups with different types of syndrome treated with the combination of western medicine conventional treatment was greater than that of the control group treated with western medicine conventional treatment alone,and the effect was most significant in the type of Yin deficiency and wind movement(t=-9.70,P<0.05).(4)The TCM syndrome points: The TCM syndrome points of all 5 Observation groups of patients improved after treatment.In the five groups of patients with different types of evidence treated with the combination of western medicine conventional treatment,the difference between before and after Chinese medicine syndrome points was greater than that of the control group treated with western medicine conventional treatment alone,and the efficacy was most significant in the phlegm-heat,internal organs solid type(t=4.72,P<0.05).(5)Plasma triglyceride and D-dimer levels: Plasma triglyceride levels were higher in the six groups of subjects after treatment than before treatment,but the differences were not statistically significant(P>0.05).Some subjects showed a decrease in plasma D-dimer levels after treatment,but none of the differences were statistically significant(P>0.05).(6)Adverse drug reactions: all six groups of patients had no significant adverse reactions after treatment.[Conclusion]1.The combination of Shuxuetong injection with conventional Western medicine treatment for ischemic stroke patients can effectively alleviate the symptoms of neurological deficits,as well as the Chinese medicine symptom scores and activities of daily living of patients,and has a better effect than conventional Western medicine treatment alone.It can be widely used in patients with ischemic stroke of different syndrome types.The mechanism may be that although the syndrome types of ischemic stroke are different,its basic pathogenesis is blood stasis blocking the brain collaterals.Shuxuetong injection is specialized in promoting blood circulation and removing blood stasis,dredging meridians and activating collaterals.2.Shuxuetong injection has a good effect on improving NIHSS score and ADL score in patients with Yin deficiency and wind movement type;The improvement of TCM syndrome score in patients with phlegm heat and viscera excess type is more significant.The mechanism may be that leeches break blood and expel blood stasis,earthworm clears heat and stops wind,and the pathogenesis of blood stasis and heat is more suitable.