Clinical Study Of Buyanghuanwu Decoction On Acute Ischemic Stroke Early Neurological Deterioration

Objective:In patients with acute ischemic stroke as the research object, to observe the effect of Buyang Buyanghuanwu decoction intervention can prevent early neurological deterioration,and to explore early neurological deterioration mechanism, so as to provide the basis for prevention and treatment of early neurological deterioration.Methods:The inclusion and exclusion criteria were divided into two groups, 31 cases in the treatment group and 30 cases in the control group, 61 cases in the control group, two groups were given aspirin 200 mg(orally, 1 time / day); edaravone injection 30 mg + 0.9% sodium chloride injection 250ml(intravenous infusion, 2 times / day); Salvia miltiorrhiza injection20ml+5% Glucose Injection 250ml(intravenous infusion, 1 times / day); atorvastatin of atorvastatin 20mg(orally, 1 time / day); folic acid tablets 5mg(orally, 3 times / day), 10 days for treatment of Danshen injection and aspirin 100 mg(orally, 1 time / day). Before treatment,record the patients basic information, measurement of D-dimer and blood homocysteine,plasma fibrinogen, C-reactive protein, tumor necrosis factor and neuron specific enolase levels and brain CT check, record TCM symptoms score, neural function score, activity of daily living score;After treatment, the second day time measuring C-reactive protein, serum homocysteine,neuron specific enolase, recording the neurological function score; After treatment 3 days a time measuring D-dimer body, plasma fibrinogen, tumor necrosis factor,recording of neural function score, activities of daily living score, and on the basis of neural function defect score evaluation two groups occurred early neurological deterioration; The above all indexes and scores were measured after fourteenth days of treatment.Results:Basic information between the two groups(P> 0.05) difference was not statistically significant, indicating that the two groups before treatment were comparable.(1)After second days of treatment,the difference of C-reactive protein and homocysteine(P<0.05) was statistically significant between the two groups.The third groups of two days after treatment D-dimer, plasma fibrinogen,tumor necrosis factor comparison(P<0.05), the difference was statistically significant. After fourteenth days of treatment, C-reactive protein, tumor necrosis factor, plasma fibrinogen, D-dimer, blood homocysteine,(P<0.05) were statistically significant;(2)There was significant difference in CT value between the two groups after treatment(P<0.05);(3)After third days and fourteenth days after treatment, the difference of neurological function score between the two groups was statistically significant(P<0.05);(4)After fourteenth days of treatment, the two groups of Chinese medicine syndrome score(P<0.05) was statistically significant;(5)The incidence rate of early neurological deterioration in the treatment group was 12.9%, the incidence rate of early neurological deterioration was36.67% in the control group, the difference was statistically significant between the two groups by chi square test(x2=4.643, p=0.031<0.05);(6)There was significant difference between the two groups in the treatment of fourteenth days(t=2.037, p=0.046<0.05);(7)The total effective rate of Efficacy evaluation of traditional Chinese Medicine symptoms of the two groups were 87.1% and 66.67%, respectively(z=-2.059,p=0.039<0.05),the difference was statistically significant;(8) Treatment group significantly efficiency of 22.58%, effective rate was 93.55%, control group markedly effective rate of 13.33%, efficiency 70%(z=-2.130,P=0.033<0.05) the difference was significant.Conclusion:1.In the acute stage of using western medicine combined with Buyanghuanwu decoction than the pure western medicine treatment can reduce the incidence of acute ischemic stroke early neurological deterioration;2.D-dimer body,blood homocysteine,plasma fibrinogen,C-reactive protein,tumor necrosis factor,neuron specific enolase,acute ischemic stroke risk factors,the use of Yang Buyanghuanwu decoction can reduce the above clinical indexes;3.Early neurological deterioration may be related to the occurrence of inflammatory reaction and coagulation mechanism;4.There may be a correlation between inflammatory reaction and the occurrence of coagulation mechanism.