Optimal Intervention Time And Risk Of The Activating Blood And Removing Stasis Method In Acute Cerebral Hemorrhage

Objective: Exploring the optimal medication time and safety of the activating blood and removing stasis method in the acute stage of hemorrhagic stroke,providing evidence-based medical evidence for the treatment of hemorrhagic stroke with the method of activating blood and removing stasis.Method: Meta-analysis was used to evaluate the application of the activating blood and removing stasis method in the acute phase of hemorrhagic stroke.Using prospective,doubleblind,placebo,randomized controlled research methods,through the inclusion and exclusion criteria,patients with acute hemorrhagic stroke with an onset time of 24-72 hours were stratified according to the onset time of 24-48 hours and 48-72 hours.The subjects were randomly divided into experimental group and placebo group by opaque envelope method.On the basis of routine treatment,the subjects were treated with Poxue Huayu granules or placebo granules for 14 days.Data were collected on the day of enrollment,14 days after onset,3 months after onset and 6 months after onset.The m RS scale was used to evaluate the disability of the subjects.BI scale was used to evaluate the self-care ability of the subjects;the NIHSS scale was used to evaluate the neurological deficits of the subjects.The hematoma enlargement rate of the subjects was calculated according to the amount of bleeding.The allcause mortality of the subjects was counted;the data of laboratory tests,examinations and other safety indicators before and after medication were counted,and the differences of the above data between the experimental group and the placebo group were compared.Result:(1)The meta-analysis included a total of 1701 participants from 15 clinical studies.The analysis results showed that the WMD(95% CI)was-2.53(-3.36,-1.69),and the statistical significance test was t=-3.47,P<0.00001,indicating that the use of blood breaking and stasis removing therapy in the acute stage of hemorrhagic stroke has an advantage in improving neurological function defects compared to the use of Western medicine alone.(2)The study included 40 subjects from the Traditional Chinese and Western Medicine Integrated Hospital in Songyuan City,Jilin Province,of which 36 subjects completed the experiment.Two groups of subjects were compared between groups in terms of demographic characteristics,medical history,vital signs,Glasgow Coma Scale,and other baseline data.The results showed that the vast majority of baseline data showed no statistically significant differences between groups(P>0.05),indicating clinical comparability.(3)After 3 months ± 7 days of onset and 6 months ± 7 days of onset,there was a statistically significant difference in the degree of disability evaluated by the m RS scale between the two groups(P<0.05),and the experimental group was significantly better than the placebo group.(4)After 14 ± 2 days of onset,there was no statistically significant difference in the BI scale scores between the two groups of subjects(P>0.05).After 3 months ± 7 days of onset and 6 months ± 7 days of onset,there was a statistically significant difference in the BI scale scores between the two groups(P<0.05),and the experimental group was superior to the placebo group.(5)On the 14 th ± 2nd day after the onset of the disease,there was no statistically significant difference(P>0.05)between the two groups in the reduction of NIHSS scale scores.(6)There was no statistically significant difference in the hematoma expansion rate between the two groups of subjects 24 hours ± 2 hours after medication,48 hours ± 2 hours after medication,72 hours ± 2 hours after medication,and 14 days ± 2 days after onset(P>0.05).(7)There was no statistically significant difference in the all-cause mortality rate between the two groups of subjects 14 days ± 2 days after onset,3 months ± 7 days after onset,and 6 months ± 7 days after onset(P>0.05).(8)In the 24-48 h time interval,the disability degree of the two groups of subjects was compared within the interval between 3 months ± 7 days after onset and 6 months ± 7 days after onset,and the difference was statistically significant(P<0.05).The experimental group was superior to the placebo group.(9)At the 48-72 hour time interval,there was no statistically significant difference in the degree of disability between the two groups of subjects at 3 months ± 7 days after onset and6 months ± 7 days after onset(P>0.05).(10)During the research process,there were 3 adverse events,including 0 in the experimental group,3 in the placebo group,and 3 in the severe adverse events.Conclusions: The evidence-based medical evidence of traditional Chinese medicine for the treatment of hemorrhagic stroke in the acute phase shows that the activating blood and removing stasis method combined with conventional western medicine has definite advantages in improving neurological deficits.The activating blood and removing stasis method in traditional Chinese medicine has advantages over simple western medicine in reducing the degree of disability and improving the ability of daily life in the treatment of acute hemorrhagic stroke.The use of activating blood and removing stasis method in the acute phase of hemorrhagic stroke will not cause hematoma enlargement or increased all-cause mortality,and will not cause abnormalities in safety indicators such as laboratory tests,which has good safety.