Effects Reaserch Of Tongnaokang On Index Of Fibrinolytic And Coagulative System And Serum Thyroid Hormones Level In Acute Ischemic Stroke Patients

Objectives: To observe the changes of coagulant,blood rheology,and thyroid hormone levels in patients with acute cerebral infarction?phlegm and blood stasis resistance?.To study Tongnaokang on acute cerebral infarction patients with phlegm and blood stasis resistance winding type thyroid hormone level,coagulation fibrinolytic indexes and indexes of blood rheology,and observe its clinical efficacy,and safety evaluation,to provide trial evidence for clinical use.Methods: Selected by random number table method in May 2014 to January 2016 in anhui taihe county hospital's intensive medicine and encephalopathy in acute cerebral infarction patients hospitalized with a total of 60 patients,randomly divided into treatment group and control group,30 cases in each group.The random digital table method was used to select the health group of 20 healthy people who were given a physical examination in our hospital.Patients in the control group were treated with conventional western medicine,and the treatment group was based on a control group called tongnaokang with phlegm.To observe the changes of the coagulation index,blood rheology index and serum thyroid hormone level of the acute cerebral infarction group and the healthy group.Comparing the control group and treatment group in the treatment of patients before and after coagulation fibrinolytic indexes,blood rheology indexes and the change of serum thyroid hormone level,the ability to assess the patient's daily life and poor nerve function damage status and TCM syndrome integral value and the clinical curative effect,overall and comparison analysis,all data by SPSS 17.0 for Windows statistical software for statistical analysis.Results:1)Acute cerebral infarction patients blood coagulation fibrinolytic indexes,degree of abnormal blood rheology indexes,serum thyroid hormone levels and can reflect the patient's illness weight NIHSS score.Acute cerebral infarction patients' serum FT₃ and TT₃,TSH level of high and low negative correlation with NIHSS score,with statistical significance?P < 0.01?;And serum FT₄,TT₄ level changes there was no statistically significant correlation with NIHSS score?P > 0.05?.Cerebral infarction group serum FIB,D-D,t-PA and PAI-1 levels were very significant differences?P < 0.01?,while differences in serum levels of PT,APTT,INR,no statistical significance?P > 0.05?.Cerebral infarction groups before treatment serum than whole blood viscosity?low shear?,whole blood viscosity?high shear?,erythrocyte aggregation index,plasma viscosity were higher,the difference was statistically significant?P < 0.05?.2)Acute cerebral infarction blood coagulation fibrinolytic indexes,degree of abnormal blood rheology indexes patients,serum thyroid hormone levels and can reflect the patient's illness weight NIHSS score.FIB serum of acute cerebral infarction patients,D-D,t-PA and PAI-1 level correlation with NIHSS score was statistically significant?P < 0.05 or P < 0.01?,of which the FIB,D-D,and NIHSS score was positively related to the level of PAI-1?t-PA level and negatively correlated with NIHSS score;And serum PT,APTT,INR levels,there was no statistically significant correlation with NIHSS score?P > 0.05?.Serum in patients with acute cerebral infarction than the whole blood viscosity?low shear?,whole blood viscosity?high shear?,plasma viscosity and erythrocyte aggregation index,NIHSS score levels were positively correlated,and there is statistical significance?P < 0.05?.Acute cerebral infarction patients' serum FT₃ and TT₃,TSH levels are positively related with NIHSS score,with statistical significance?P < 0.01?;And serum FT₄,TT₄ level changes there was no statistically significant correlation with NIHSS score?P > 0.05?.3)The treatment group compared with control group before and after treatment efficacy indicators.Total effective rate in treatment group patients significantly increased than the control group,2 groups of cases the total curative effect more significant difference?P < 0.05?,indicating that the clinical total efficacy of treatment group is better than the control group.Treatment group and control group after treatment of TCM syndrome integral values were lower,in treatment group decreased more significantly?P < 0.01?;Compare two groups after treatment,the treatment group of TCM syndrome integral value improvement is more apparent?P < 0.05?.NIHSS scores were lower group and the control group after treatment,the treatment group decreased very significantly?P < 0.01?;Compare two groups after treatment,the treatment group NIHSS score improved more significantly?P < 0.05?.Barthel index score group and the control group after treatment,the treatment group increased very significant difference?P < 0.01?;Compared two groups after treatment,the treatment group Barthel index score higher than the control group significant difference?P < 0.05?.Compared with before treatment group,two groups after treatment in patients with serum PT,APTT,INR had no significant difference?P > 0.05?,and serum FIB,D-D,t-PA and PAI-1 level change is very significant difference?P < 0.01?;Compared two groups after treatment,the treatment group of serum FIB,D-D,t-the improvement of the PA and PAI 1 is better than that of control group?P < 0.05?.Compared with group before treatment,treatment group was lower than whole blood viscosity?low shear?serum,whole blood viscosity?high shear?,erythrocyte aggregation index,plasma viscosity is significant?P < 0.01?;Compared two groups after treatment,treatment group was lower than whole blood viscosity?low shear?serum,whole blood viscosity?high shear?,erythrocyte aggregation index,plasma viscosity is better than that in control group?P < 0.05?.Compared with the same group before treatment,2 groups of patients with serum FT₃ and TT₃,TSH levels are changed,the treatment group FT₃ and TT₃ and TSH three indicators were very significant differences?P < 0.01?,while serum FT₄,TT₄ level differences had no statistical significance?P > 0.05?;Compared two groups after treatment,the treatment group on the improvement of FT₃ and TT₃,TSH index is better than that of control group?P < 0.05?.4)Treatment group in the treatment of stages of blood routine,urine routine,stool routine,occult blood,liver and kidney function,blood glucose,electrocardiogram,transformation of hemorrhagic cerebral infarction,and chest radiograph indicators have no abnormal phenomenon,no adverse reactions such as dizziness,diarrhea and nausea.Conclusion:1)Acute cerebral infarction patients blood coagulation fibrinolytic indexes,abnormal blood rheology indexes,serum thyroid hormone levels,and the abnormal degree and reflect the NIHSS illness weight show correlation.2)Tongnaokang with eliminating phlegm and freeing channels,can improve the acute cerebral infarction patients with thyroid hormone levels,reduce blood viscosity and fibrinogen concentration,improve the state of platelet aggregation,restore normal function of blood coagulation and fibrinolysis system.3)Tongnaokang can improve nerve function defect in patients with acute cerebral infarction,improve the level of the patient's daily life,improve the patients' TCM syndrome integral,the overall curative effect significantly better than that of conventional western medicine combined with western medicine treatment of clinical treatment.4)Tongnaokang during treatment without any obvious adverse reaction,good security,worthy of clinical promotion application.