| PurposeObserve blood stasis of the circulation through the HuaYuTongluo recipe side treatment of stroke clinical efficacy of the HuaYuTongluo (acute cerebral infarction), Of circulation through the HuaYuTongluo side of acute cerebral infarction in patients with vascular endothelial growth factor (VEGF), Analysis of the mechanism of the role of the circulation through the HuayuTongluo side to the treatment of acute cerebral infarction.Research Methods1. General clinical data Selected a total of60cases of acute cerebral infarction, the required subjects were selected from June2010to December2011in Hubei Province Chinese Medicine Hospital of neurology inpatient department or outpatient TCM clinical syndrome to stasis certificate for the blood of stroke. This60patients were randomly divided into treatment and control groups for all30cases. Treatment group, male20cases and10females, aged57to73years, average age of (69.50±7.24years); control group were18males and12females, aged53to75years; average age (62.30±7.37years). And all the neurological defect score statistics, based on the Edinburgh and the Scandinavian study group standard severity type, divided into light, medium and heavy. Treatment groups:light21down and9cases, medium, heavy0cases; control group:light20down and10cases, medium, heavy0cases. Another age, gender, and into the match in patients with acute cerebral infarction10cases of normal healthy individuals as the standard group,3males,7females, age52to74years old, mean age (65.60±6.64years). Three groups of patients such as age, gender, disease duration, severity, statistical analysis no significant difference.(P>0.05), comparable.2. Treatment Control group using conventional Western medicine treatment group plus side circulation collaterals in the control group on the basis of (Specific prescriptions:Of10g of peach kernel, safflower10g10g red peony, angelica10g, Chuanxiong10g, earthworm15g, silkworm of10g, red sage root15g turmeric10g, Shichangpu10g,10g of bile Southern Starof Gastrodia15g, the Uncaria10g, etc.), One a day, each dose of dextrose400ml,2times a day, each200ml, morning and evening hours service,14days for a course. Treatment group and control group were given the same basic treatment, during treatment, In addition, according to the disease given appropriate adjustment of blood pressure, blood sugar, symptomatic and supportive treatment. Not use any drugs that may interfere with the observation of the clinical efficacy or impact on clinical observation indicators. The standard group without any intervention.3.Outcome measures3.1Endpoint Score before and after treatment of clinical manifestations of stroke, blood stasis score, serum VEGF, neurological deficit score (NIHSS), etc.3.2Safety index Before and after treatment of blood, urine, feces, three conventional, fecal occult blood test, ECG, renal function (BUN, Cr), liver function (ALT and AST), blood clotting, etc.And adverse drug reactions. A course of treatment after the review of the CT or MRI to observe the lesions before and after treatment with or without expansion, and bleeding. Statistically.The measured data are mean±standard deviation (x±s). Count data were analyzed by chi-square (χ2)test, Grade information Wilcoxon test was used. Various indicators using SPSS13.0for Windows statistical analysis software processing; P<0.05as statistically significant.Result1. Treatment group, the clinical efficacy in the control group after treatment:Clinical treatment group cured cases the two cases, effective in cases of nine cases of effective cases of14cases, the total efficiency of83.33%; Clinical recovery of the control group the number of cases to0cases, effective in cases of the eight cases, the number of valid cases of10cases, the total efficiency of60.00%; After treatment, the clinical efficacy of the difference was significant, statistically significant (χ2=4.02, P<0.05). Among them, the clinical efficacy assessment of the treatment group than the control group.2. Treatment group and control group before and after treatment of blood stasis points and nerve function deficit score: Statistically significant differences (P<0.05), to the improvement of the treatment group patients with blood stasis points and neurological deficit scores.3. Treatment group and control group and standard group serum levels of VEGF in comparison:Statistically, the treatment group and control group, serum levels of VEGF in the standard group after treatment, there are statistically significant (P<0.01); Treatment and control groups in serum levels of VEGF after treatment than before treatment improved significantly (P<0.01), but the treatment group, the serum levels of VEGF than the control group increased (P<0.01) more pronounced.4. Safety testing:All patients before and after treatment of blood, urine, fecal three conventional fecal occult blood test, ECG, renal function (BUN, Cr), and liver function (ALT and AST), blood clotting, brain CT or MRI showed no abnormality change.ConelusionThe results of this study show that the circulation HuayuTongluo side of the treatment group compared with conventional Western treatment control group, the clinical efficacy of collaterals in patients with ACI blood stasis and blood stasis points and neurological deficit scores were significantly improved (P<0.05), after treatment, the serum levels of VEGF than the control group increased (P<0.01) more pronounced.In this study, the problems:VEGF mainly in animal models still lack sufficient clinical evidence to support, and this clinical study less the number of cases pending further observational study. In addition, effective prescription needed clinical study of the clinical multi-center, a large sample, multi-program, to improve the repeatability of Traditional Chinese Medicine for the majority of patients in the treatment of ACI. |
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