The Clinic Study On The Treatment Of Syndrome Differentiation Of TCM According To The Cerebral Hemorrhage Staging

Objective : To study treatment by syndrome Differentiation of TCM accordingto Western Medicine Staging of Intracerebral Hemorrhage ,It provide new ideas and methods. for clinical treatment of cerebral hemorrhage.Method: The 96 cases are selected from the second hospital of Hebei Medicine University, consistent with the ICH diagnosis standard publicized by the《The manual of prevention to Chinese ICH(2005)》. According to the stroke staging standard of national Cerebral vessels special topic seminar in 2000, and combine the ICH pathology change and clinical symptom, we separate ICH into the ultra early stage, the acute peak stage and the convalescence early stage. The 96 patients were randomly divided into the treatment group (47cases)and the control group(49 cases ).The treatment group were adopted modern medicine and traditional Chineses medicine , the control group were adopted modern medicine therapy. The treatment time were both 28 days.Before and after the treament,we abserve the defective degree of neuronal system function score, living ability, the volume of brain hematoma,liver function and renal function.At the same time to observe changes in TCM, and then explore the relationship between treatment of syndrome Differentiation of TCM and curative effect.Result:1.Total effective rate: 4 weeks later , 44 effective cases and 3 ineffective cases were included in the treatment group , total effective rate was 93.61%, 39 effective cases and 10 ineffective cases were included in the control group, total effective rate was 79.59%. With statistical treatment (x2 = 4.0305, p = 0.0447) ,the treatment group was significantly higher than the control group on total effective rate (p<0.05). 34 obvious effective cases and 13 improvement and ineffective cases were included in the treatment group, obvious effective rate was 72.3%. 25 obvious effective cases and 24 improvement and ineffective cases were included in the control group, obvious effective rate was 51.0%. With statistical treatment (x2=4.6035,p=0.0319) , p<0.05 ,the treatment group was significantly higher than the control group on obvious effective rate (p<0.05).2. The defective degree of neuronal system function score: The level of score post- treatment group (6.70±5.82)is lower than pretherapy (18.02±11.35) in the treatment (p <0.01); The level of score post- treatment group (10.52±9.58)is lower than pretherapy (19.86±11.12) in the control group (p <0.01) .After treatment, the defective degree of neuronal system function score in treatment group decreased significantly than that in the control group ( p <0.05). It is show that the treatment group had better effect on the neuronal system function. 3. The volume of brain hematoma alteration: 2 weeks later , in treatment group ,the volume of hematoma was smaller (7.57±5.58)ml3vs(10.21±6.67)ml3,(u=2.172,p=0.0298,p<0.05),compared to the the control group;4 weeks later, in the treatment group , the volume of hematoma was no significant difference (1.52±2.59) ml3 vs (1.55±2.37) ml3 , (u = 0.9088, p = 0.3634, p> 0.05), compared to the the control group;2 weeks later,in the treatment group,the case of the basic and obvious hematoma absorption was 33, accounting for 70.2%. In the control group, the case of basic and obvious hematoma absorption was 24 cases, accounting for 49.0%, there was higher hematoma absorption rate in treatment group (p <0.05); 4 weeks later, in the treatment group(39case to recheck), the case of basic and obvious absorption was 37 cases, accounting for 94.9%, in the control group(41case to recheck) the case of basic and obvious absorption was 38 cases, accounting for 92.7%, indicating little difference between 2 groups(p> 0.05).4. GCS scores: The level of GCS scores post- treatment(14.62±0.85)is higher than pretherapy (13.68±2.09 ) in the treatment group 1 week later (p <0.01); The level of GCS scores post- treatment ( 13.96±1.31 ) is higher than pretherapy (13.41±1.88) in the control groupin 1 week later(p<0.01) .1 week later, the GCS scores in the treatment group (14.77±0.87)was higher than that (14.10±1.25)in the control group (t=2.3525,P=0.0217). In the treatment group ,the time of consciousness in instauration of Suffer was shorter(p<0.05). 5. Living ability status: Living capacity status classification of the 2 Group had better improved than pretherapy(P <0.01);4 Weeks later,living ability status in the treatment group was better than that in the control group (U = 2.2247, P = 0.0261) (P<0.05).6. TCM change:Before treatment, there was no significant difference in wind syndrome , heat syndrome,phlegm syndrome,syndrome of blood stasis,syndrome of deficiency of Qi and syndrome Yin asthenic between the treatment group and the control group (P>0.05 ). After treatment , heat syndrome (44.7%)and phlegm syndrome(59.6%) in treatment group, were lower than those in control group (73.5% and 79.6%,),p<0.01 and p<0.05. After treatment,there were no significant difference between the treatment group including wind syndrome (34.0%),syndrome of blood stasis (12.8%),syndrome of deficiency of Qi (17.0%) syndrome,Yin asthenic (14.9%) and the control group including wind syndrome e(28.6%),syndrome of blood stasis(26.5%),syndrome of deficiency of Qi (24.5%)and syndrome Yin asthenic (14.3%) (P>0.05 ).7. After treatment ,there were no patients with severe liver function and renal function damaged in 2 groups.It provided us traditional Chineses medicine was safe.Conclusion:1. The treatment of syndrome differentiation of TCM according to clinical staging can improve the effective rate , the obvious effective rate ,the neuronal system function ,GCS scores and the living ability status.It is show that the clinic stuty on the treatment of syndrome differentiation of TCM according to ICH staging have a better clinic effect.2. The treatment of syndrome Differentiation of TCM according to clinical staging can promote absorption of intracranial hematoma. It is showed that the traditional Chinese medicine in our stuty can promote absorption of intracranial hematoma.3. The treatment of syndrome Differentiation of TCM according to clinical staging can lower the occurrence rate of heat syndrome and phlegm syndrome.It is helpful to be recovered .