Clinical Study Of Tongfu Mixture Combined Conventional Western Medicine Impact On The Brain Edema After Acute Massive Cerebral Infarction

Objective:To observe the clinical efficacy of patients with brain edema after acute massive cerebral infarction by combined treatments of the Tongfu Mixture and conventional Western medicine and to assess the clinical value and guiding role in patients with cerebral edema by non-invasive dynamic monitoring of brain edemaMethods:60 patients of qualified massive cerebral infarction (all patients were in neurology of Wuhan Hospital of Integrated Chinese and Western Medicine). All patients were randomly divided into control group and experimental group of 30 cases. The patients in former group were given with the treatment of mannitol dehydration alone, while the latter one was adopted the combination therapy of Tongfu Mixture and mannitol, and the rest were symptomatic treatment of conventional Western medicine. At the same time, the BORN-BE non-invasive cerebral edema were used to observe the disturbance coefficient change of contralateral cerebral hemispheres at the time before treatment and 30 min after treatment, 1h,3h,3d,5d,7d; and to observe the low-density volume situation around the infarct after the onset of 1d,3d,7d by brain CT scan; through the nervous system examination, to assess the efficacy before and after treatment according to "stroke in patients with neurological impairment score standards "in the Fourth National Cerebrovascular Diseases 1995, and the United States National Institutes of Health Stroke Scale (NIHSS); Meanwhile, stroke illness score and efficacy evaluation were diagnosed according to "stroke diagnosis and efficacy evaluation standard".Results:(1),Cerebral edema disturbance factor:at the the first day of onset, whether the experimental group or the control group, cerebral edema disturbance factor in affected side were lower than the contra lateral side(P<0.05); With the progress of the disease, at the 3rd day, cerebral edema disturbance factor was the most significant different between the affected side with the contralateral side, the affected side was obviously higher than contralateral one(P<0.01); at the 5th day, disturbance factor in the affected side was still higher than the unaffected side, but the difference was not significant as good as the 3rd day; but the difference became approximately equal in the 7th day in the two group, no statistical signif icance(P>0.05). The experimental group compared with the control group, brain edema disturbance factor was no significant difference between the two groups in the course of the 1st day (P>0.05); while in the course of the 3rd,5th and 7th days, disturbance factor's differences in the two groups were significant (P<0.05), coefficients in the experimental group were lower than that in the control group.(2),The level of edema:at the 1st day of onset, low-density volume around infarct size was no statistical significance (P> 0.05) in the two groups by the brain CT scan; With the progress of the disease, at the 3rd,7th days, low-density volume size around infarct increased more significantly than those in the former in the experimental group and the control group, but there are differences in the two groups (P<0.05), especially the difference was the most significant in the 7th day (P<0.01).(3),Neurological function and stroke illness diagnosis rate, efficacy determination:at the first incidence of one day, the assessment points of stroke illness diagnosis rate and neurological impairment(NIHSS)was no statistical significance in the two groups; but in the 3rd and 7th days of the treatment, there were differences in the two points, particularly,the difference was significant at the 7th day, the assessment points of stroke illness diagnosis rate and neurological impairment (NIHSS) in the experiment group were both lower than that in the control group, and the difference had statistical significance(P<0.01).Efficacy of stroke illness score before and after treatment was assessed in two groups, both of the groups were effective, but the experimental group was significantly better than the control group(P<0.01).Conclusions:(1),Combined treatment of Chinese and Western medicine is better than Western medicine treatment alone, Tongfu mixture can effectively improve brain edema (BE)after the acute massive cerebral infarction, the assessment points of stroke illness diagnosis and neurological impairment (NIHSS) in the experimental group were superior to that in the control group, it was statistical significance; (2),BORN-BE non-invasive dynamic monitoring can dynamic monitor and evaluate brain edema after cerebral infarction, and there are characteristics of accurate, sensitive, practical, non-invasive, and it has a certain significance in the clinical diagnosis and therapy.