| Objective: Using Self-made Recipe of Cleaning Away Heat-evil and Eliminating Aputum(platycodon grandiflorum,unibract fritillary bulb,menthol and borneol)combined with Vinpocetine Injection is to treat the true bulbar paralysis after ischemic stroke and verify the heat phlegm fu-organ syndrome.Observing the clinical curative effect is to provide a new kind of combining traditional Chinese and western medicine treatment for the true bulbar paralysis after cerebral infarction.Methods: Eighty-four hospitalized patients who suffer from cerebral arterial thrombosis and true bulbar paralysis and meet with inclusion criteria of the heat phlegm fu-organ syndrome have been divided into the treatment group 1(28cases),the treatment group 2(28cases)and control group(28cases)at random according to the order of admission.All the hospitalized patients are provided the foundation treatment in accordance with the Guide of Diagnosis and Treatment of Acute Ischemic Stroke in China(2010)"stroke unit model",including oxygen,respiratory support,control of blood pressure,blood glucose,blood lipids,nutrition support,dehydration of intracraninal pressure,platelet aggregation,clear the free radicals,etc.At the same time,stroke risk factors and secondary prevention of stroke are intervened and managed;complication is treated positively and prevented by strengthening health missionary.The control group is provided swallowing rehabilitation meanwhile basic treatment.Treatment group 1 has been given 30 mg vinpocetine injection(Manufacturer: henan hong pharmaceutical co.,LTD.,approval number:approved by H20041792,2 ml: 20 mg/branch)which adding 0.9%sodium chloride injection 250 ml on the basis of constrsting the control group.The treatment schedule is 14 days,one time per day.Treatment group 2 has been given 30 mg vinpocetine injection(Manufacturer: henan hong pharmaceutical co.,LTD.,approval number:approved by H20041792,2 ml: 20 mg/branch)which adding 0.9%sodium chloride injection 250 ml on the basis of constrsting the control group.The treatment schedule is 14 days,one time per day and is verified phlegm pyretic and FU-Organ sthenia syndrome.The treatment group 2 accept the Chinese medicine treatment at the same time.The method is clearing heat transforming phlegm and eliminating turbidity by purgation.Self-made recipe: Characteristics of 10 g,unibract fritillary bulb,borneol of 10 g,mint of 10 g,One dose per day.One dose of this recipe is decocted to 100 ml.The patients who can’t swallow should aceept nasal feeding.In two days after treatment schedule,the patients will accept standard evaluation of swallow funtion,Kubota drinking water test for swallowing function evaluation and clinical efficacy evaluation.Results: 1.This study is randomized controlled trial,including 84 patients which were randomly divided into 28 cases in treatment group 1,treatment group and control group respectively according to the order of the hospital.During the study,there are 1 patients falling off,without excluding cases.Among that treatment group 1,there are a total of 28 cases including male(15 cases)and female(13 cases)which aged 40 to80,an average of 60.82 + /-8.05 years.In the treatment group 2,there are a total of 27 cases including male(16cases)and female(11cases)which aged 40 to 80,an average of 63.22 + /-7.65 years of age.In the control group a total of 28 cases,(12 male and female in 16 cases,aged 40 to 80,an average of 62.54 + /-7.18 years old).After statistics analysis,the age,sex,course of diseases of three groups of patients are no statistical significance.P > 0.05,it is comparable.Under the condition of Standard treatment on patients,the comparison among three groups of standardized swallowing assessment score and water swallow test score,P > 0.05,it is comparable between groups.2.After 30 days’ treatment,three groups were compared between groups.Through standardized swallowing assessment and water swallow test score in three group patients,by T-test and Rank-sum test analysis,P<0.05,it shows that the difference is statistically significant.Treatment group 2 is better than the control group and treatment group 1,and the treatment group 1 is better than the control group.From the clinical curative effect analysis,the water swallow test assesses the swallowing function of two groups of patients before and after treatment.After 30 days treatment,in the treatment group 2,20 caseswere markedly effective;5 cases were effective and 2 cases were ineffective;no case became exacerbation.In the treatment group 1,12 cases were markedly effective;7 cases were effective;7 cases were invalid;1 case became exacerbation.In the control group,5 cases had marked effect;6 cases were effective;14 cases were no effect;3 cases became exacerbation.In treatment group 2,the total effective rate was 92.59%.In treatment group1,total effective rate was 67.86%.In the control group total effective rate was 39.29%.The treatment group 2 were higher than the treatment group1 and control group.Treatment group2 is higher than the control group.By the rank-sum test analysis,P < 0.05,the difference is statistically significant.The curative effect in treatment group 2 is superior to the control group and treatment group 1.The treatment group 1 is better than the control group.3.No significant adverse reactions in the two groups of patients during treatmentConclusion : Using Self-made Recipe of Cleaning Away Heat-evil and Eliminating Aputum combined with Vinpocetine Injection to treat phlegm pyretic and FU-Organ sthenia syndrome of ischemic cerebral apoplexy swallowing disorder has an exact effect.And it is obviously superior to control group and using vinpocetine group,and using vinpocetine is better than the control group. |
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