Effect Of Buyang Huanwu Decoction On The Clinical Efficacy And Hemodynamics Of Patients With Cerebral Infarction In The Very Early Stage Of Intravenous Thrombolysis

Objective:To investigate the effect in patients of Buyang Huanwu Tincture on patients with ultra-early stage intravenous thrombolysis of cerebral infarction,as well as its influence on patient hemodynamics,in order to provide an objective theoretical basis for the treatment of patients with ultra-early stage intravenous thrombolysis of cerebral infarction with Chinese medicine combined with Western medicine.Methods:60 inpatients from Guangxi University of Traditional Chinese Medicine’s Department of Neurology at Ruikang Hospital were chosen.They were divided into two groups,one for control the other for treatment,using the digital random table method,with 30 cases in each.Both groups received thrombolytic therapy with alteplase(Atonli-Actilyse,rt-PA,Boehringer Ingelheim Pharmaceutical Co,LTD,National Drug approval number S20160054,specification 50 mg、20mg)within 4.5h after onset.The total dose was 0.9mg/(kg·d),but the maximum dose was no more than 90mg.First,10%of the total dose was injected intravenously slowly within 1min,and the remaining dose was dissolved into 0.9%sodium chloride injection 50mL by micropump at uniform speed for 60min.The two groups of patients were monitored for oxygen uptake,temperature,blood pressure,blood sugar,etc.including eliminating oxygen free radicals,improving microcirculation,actively reducing intracranial pressure,and actively handling complications.The control group was treated with double anti-platelet aggregation therapy 24 hours after thrombolytic therapy.The medication was as following:The Aspirin enteric-coated tablets(Bayer Medical&Health Co,LTD,National Drug approval number J20130078,specification 100mg),oral,100mg/time,once a day;Clopidogrel Bisulfate(Hangzhou Sanofi Pharmaceutical Co,LTD,National Drug approval number J20180029,specification 75mg),oral,75mg/time,once a day.10 days later,long-term oral aspirin enteric soluble tablets 100mg/day monotherapy,those who cannot tolerate aspirin enteric soluble tablets can switch to clopidogrel sulfate 75mg/day;Atorvastatin calcium tablets(Pfizer Pharmaceutical Co,LTD,National Drug approval number H20051407,H20051408,H20051409,specification 10mg,20mg,40mg),taken before bedtime,20mg/time,once a day.The control group received conventional Western medicine treatment,and the treatment group was additionally given Buyang Huanwu Decoction for 28 days.All patients underwent transcranial Doppler(TCD)to detect the maximum peak blood flow velocity(Vs)of the anterior cerebral artery(ACA)、middle cerebral artery(MCA)、posterior cerebral artery(PCA)The average flow velocity(Vm)and pulsation index(PI)were evaluated,and the National Institute of Health Stroke Scale(NIHSS)and the integral score of traditional Chinese medicine symptoms were evaluated before and after treatment,and the clinical efficacy was evaluated through statistical treatment.Results:1、Neurological impairment score:After treatment,the neurological impairment score of both groups decreased compared with that before treatment,and the treatment group was significantly lower than the control group,with statistical significance(P<0.05),suggesting that Buyang Huanwu Decoction could improve the degree of neurological impairment.2、TCM syndrome score:after treatment,TCM syndrome scores of both groups were lower than before,and the improvement of treatment group was better than control group,the difference was statistically significant(P<0.05).The results showed that Buyang Huanwu Decoction could improve the TCM symptom score of apoplexy patients.3、Hemodynamic indexes:After treatment,PI velocity of AC A,MCA and PCA in 2 groups was significantly decreased compared with before treatment,Vm and Vs were significantly increased compared with before treatment,but the improvement was more obvious in the treatment group,the difference was statistically significant(P<0.05).4、Clinical efficacy:25 cases were effective and 5 cases were ineffective in the control group.The total effective rate of the control group was 83.3%.The total effective rate of the treatment group was 93.3%.The clinical effect of the treatment group was better than that of the control group,the difference was statistically significant(P<0.05),suggesting that Buyang Huanwu decoction could improve the clinical effect of stroke patients.5、Curative effect of TCM symptoms:24 cases were effective and 6 cases were ineffective in the control group.The total effective rate of the control group was 80.0%.The total effective rate of the treatment group was 90.0%.The curative effect of TCM syndrome in the treatment group was better than that in the control group,the difference was statistically significant(P<0.05).It is suggested that Buyang Huanwu Decoction can improve the curative effect of TCM symptoms in apoplexy patients.Conclusion:(1)In the treatment of patients with ultra-early cerebral infarction,Tonic Buyang Huanwu Decoction coupled with Western Conventional medicine performed significantly better than the Western medicine group alone.(2)Buyang Huanwu Decoction can significantly improve neurological deficit symptoms,Chinese medicine symptoms,patients’ ability to function in daily life,and reduce the disability rate in patients with ultra-early cerebral infarction.(3)Buyang Huanwu Decoction can improve cerebral hemodynamics and cerebral artery blood supply in patients with ultra-early cerebral infarction to a certain extent.