| Purpose: To observe the ischemic stroke phlegm and Qi Deficiency Syndrome inrecovery period. TCM and Western medicine treatment options in order to enhancethe efficacy of Integrative Medicine comprehensive intervention of theSyndrome.(Phlegm knot and Chief Qi Deficiency Syndrome)Content:(1) TCM and Western medicine treatment options for ischemic strokerecovery of nerve function efficacy observed;(2) TCM and Western medicinetreatment options to improve the recovery period of ischemic stroke (phlegm andChairman Qi Deficiency Syndrome) Clinical observation of the quality of life;each end and Chief Qi Deficiency Syndrome Evaluation (3) TCM and Western medicinetreatment options for ischemic stroke recovery Phlegm;(4) TCM and Westernmedicine treatment program interventions lack of hemorrhagic stroke is asecurity inspection.Methods: This research was a multi-centered, single-blinded, block randomized,parallel controlled trial. Researchers for each sub-centers engaged in weretraditional Chinese medicine physicians or Chinese and Western medicineneurology physician, the randomization software DAS for IWRS was used, enrolledorder the patients were randomly assigned based on the ratio of1:1. Theexperimental group received the treatment of the Chinese medicine injectiontherapy, acupuncture, massage therapy, basic treatment of Western medicine,modern rehabilitation and routine care; the control group received the basictreatment of Western medicine, modern rehabilitation, routine care, treatmentweeks. The selected clinical efficacy index questionnaires included the ischemicstroke patients with phlegm blood stasis and Qi deficiency questionnaire, theU.S. National Institutes of the researcher of Health Stroke Scale (NIHSS),activities of daily living scale (ADL), Barthel Index, modified Rankin Scale(MRS) as efficacy evaluation.To observe the score changes for the first,2weeks,4weeks, follow-up period (follow-up90days,180days) at different time points in the experimental group and the control group, the effectiveness ofinterventions and safety evaluation. Using SAS statistical software, thedescriptive statistics, chi-square test, independent sample paired t-teststatistical methods, repeated measures ANOVA statistical analysis was also used.Results:1. This study included239cases of patients, male138, female101cases.225patients met the standard programme, the experimental group enrolled116patients,the control group119cases. All the patients were done by thecomparability analysis, the P values of gender, age, ethnicity, marital status,nature of work, height and weight of the two groups were0.1,0.847,0.211,0.994,0.417,0.159,0.339respectively and were comparable.2. The Mean±SD of the total score of the the ischemic stroke patients withphlegm blood stasis and Qi deficiency syndrome integration questionnaire of thefirst week for the experimental group was42.53±6.12vs the control group43.21±6.69,there was no significant difference (P=0.424)>0.05. The Mean±SD of of the experimental group score for the second week was39.30±5.88vs the control group40.48±6.46,and there was no significant difference (P=0.151)>0.05. The Mean±SD of the fourth week total score experimental group35.40±6.00vs the control group37.56±7.23,and the difference wasstatistically significant (P=0.015)<0.05and90days of follow-up the Mean±SD of the total score experimental group34.57±6.99vs the control group37.78±9.07, the difference was statistically significant (P=0.018)<the0.05,180days follow up the Mean±SD of the total score for the experimentalgroup33.60±7.08vs the control group35.83±8.17, the difference wasstatistically significant (P=0.030)<0.05. The diachronic changes of theexperimental group and control group for the ischemic stroke patients with phlegmblood stasis and Qi deficiency in the0-2w was0.316，2-4w was0.047,4w-90dayswas0.016,90days-180days was0.097, and the P value <0.05in the2-4w and4w-90,the result had statistical significance.The experimental group and the control group P value of the major syndrome score for the ischemic stroke patientswith phlegm blood stasis and Qi deficiency of2weeks,4weeks,90days,180days,0.795,0.919,0.347,0.251,0.173,were all greater than0.05, the differencewas not statistically significant. P value of Phlegm dimension score of the twogroups for2weeks,4weeks,90days,180days, P=0.201,0.055,0.003,0.031,0.020>0.05, P value of the blood stasis score of0,2weeks,4weeks,90days,180days were0.478,0.760,0.212,0.152,0.261，greaterthan0.05，no statistically significance was found.The diachronic changes ofthe experimental group and control group for the blood stasis dimension in the0-2w was0.52，2-4w was0.449,4w-90days was0.225,90days-180days was0.433,Pvalue>0.05, no statistically significance was found.The P value of theQidificiency dimension was0.497,0.069,0.013,0.002,0.019respectively，showedthe result of2weeks,4weeks,90days,180days was statistically significant（P<0.05）。The P value of the diachronic changes of the experimental group andcontrol group of the Qi deficiency dimension0-2w was0.1，2-4w was0.048,4w-90was0.004,90days-180was0.143,<0.05,statiscal significance was found。3. P values of the NIHSS score for the experimental group and the control groupof2weeks,4weeks,90days180days were0.360,0.372,0.239,0.092,0.432>0.05,the difference was not statistically significant. P value of the ADL scoreexperimental group and control group of2weeks,4weeks,90days180days were0.549,0.856,0.887,0.394,0.398>0.05, the difference was not statisticallysignificant. P values of the MRS total score experimental group and controlgroup of the2weeks,4weeks,90days180days were0.448,0.379,0.084,0.158,0.066>0.05, the difference was not statisticallysignificant. The P values of the BATHEL index2weeks,4weeks,90days180dayswere0.727,0.888,0.434,0.432,0.199>0.05, the difference was not statisticallysignificant. The safety test group had no adverse events occurred;2cases ofadverse events in the control group, the incidence of adverse events was1.7%,no adverse reactions. Conclusions:1. The ischemic stroke with phlegm blood stasis and Qi deficiency scale forintegration of the Traditional Chinese Medicine Research and Western medicinetreatment treatments for the patients was feasible and the scale can be usedto reflect the TCM and Western medicine treatment program interventions,the mostobvious dimension was phlegm dimension and the Qi deficiency dimension.Whilethe U.S. National Institutes of the researcher of Health Stroke Scale (NIHSS),activities of daily living scale (ADL), Barthel Index, modified Rankin Scale(MRS) as efficacy index could not reflect the TCM syndrome changes.2. The integral of the TCM and Western medicine treatment can not only improvethe western evaluation index, but also can improve the TCM syndromes obviously,onset time of treatment the fourth week,and could also be continued to thefollow-up periods of90days,180days. The most obvious onset tiom was4w-90days,90days-180days. |
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