| Background:Ischemic stroke is also named cerebral infarction in western medicine.The high mortality,morbidity,disability rate and recurrence rate all year round,brings great distress and heavy burden to patients themselves,their families,as well as the society.Chinese medicine has an advantage in stroke treatment,and after long observation and practice,the systemic theories and treatment strategies were summed up,which provide a clear way for clinical treatment.After absorbing and summarizing the traditional theories,and considering the "toxin" and "collateral disease" as a starting point,Professor Wang Yongyan brought forward the hypothesis of "toxic brain collateral damage" for pathogenesis of stroke.He concluded the main clinical manifestation of phlegm-heat and bowel-qi-obstructed syndrome.Based on the therapy of resolving phlegm and relaxing bowels,Professor Wang's Xinglouchengqi Decoction has a good therapeutic effect on stroke patients at acute phase,and as a result,the decoction has been widely used in clinical practices and studies.Objective:This research chose acute ischemic stroke patients with phlegm-heat and bowel-qi-obstructed as main subjects,Xinglouchengqi Decoction as the treatment prescription,whose efficacy was then compared with conventional treatment program of western medicine.The evaluation of the correlation scale and the detection of the TEG were performed before and after the treatment,and the changes of the patients' symptoms during the treatment were observed and recorded.The effect of Xinglouchengqi Decoction on the thrombus elasticity of patients with phlegm-heat and bowel-qi-obstructed were evaluated by comparing the changes of the scale indexes before and after treatment and the statistical changes of TEG indexes.Methods:47 acute ischemic stroke patients with phlegm-heat and bowel-qi-obstructed syndrome were enrolled in this study.According to the random number table,the patients were divided into two groups in the ratio of 2:1,with 30 cases in the treatment group and 17 cases in the control group.The treatment group was prescribed with Xinglouchengqi Decoction,while the control group with routine laxative medication,Duphlac or(and)Glycerine Enema.The evaluation points were the first day and the time after 5 ± 2 days when bowel-qi-obstructed syndrome was relieved.During the treatment,patients were given conventional therapy such as anti-platelet aggregation,blood lipid stabilization,nerve-protection,improvement of blood circulation and other conventional treatment measures and the standardization of basic diseases.During the treatment period,the patient's condition changes were observed,and the daily changes of symptoms,and signs were recorded.The TCM Stroke Scale,stroke syndrome factors scales,the phlegm-heat and bowel-qi-obstructed syndrome scale,American National Institutes of Health Stroke Scale(NIHSS)and signs of TEG were also recorded on the evaluation points.The scores of the recorded and tested values were analyzed with SPSS software(version 20.0)to evaluate the clinical efficacy of the two groups.Results:The scores of the two groups after treatment were compared with those before treatment.The TCM Stroke Scale had a decreasing tendency,but the difference did not reach significance.The phlegm-heat and bowel-qi-obstructed syndrome scale and NIHSS scale were significantly lower than those before treatment(P<0.05).There was no significant difference in the improvement rate between the three groups(P>0.05).The appearance rate of the six syndromes were significantly lower than those before treatment(P<0.05),and the scores of the internal wind,the internal fire and the phlegm-dampness were significantly lower than those before treatment(P<0.05).However,there was no significant difference between the two groups as to the change of six syndromes(P>0.05).Before treatment,the values of TEG signs in the two groups were within the normal range.After treatment,in the treatment group,the indexes were still within the normal range,but R,K and LY30 values were lower,and values of ?,MA and Cl were higher,but statistical difference was not found.After treatment,in the control group,the LY30 value was lower than the normal range,and the values of the other indexes were within the normal range.The values of R and MA were higher than that before treatment,K value,a angle,LY30,Cl values were lower than before treatment,but with no statistically significant difference before and after treatment.There was no statistically significant difference in TEG between the two groups before and after treatment(except for Angle and CI values).There were significant correlations between part of the six syndromes before the treatment of the case and the partial index of TEG signs.Among them,the internal fire syndromes were negatively correlated with R(P<0.05),and positively correlated with Angle(P<0.05).The qi deficiency syndromes were negatively correlated with R(P<0.05),and positively correlated with CI(P<0.05),the yin deficiency syndromes were negatively correlated with K(P<0.05).There was no correlation between NIHSS score and the TEG signs.The overall effective rates of the two groups were 60.00%and 52.94%respectively,and there was no significant difference between the two groups.Conclusion:(1)Xinglouchengqi Decoction plays a good role in alleviating the symptoms and improving neurological deficits caused by phlegm-heat and bowel-qi-obstructed syndrome in AIS patients.(2)It has a significant effect on the improvement of the three syndromes of the internal wind,internal fire,phlegm-dampness elements.(3)The blood clotting mechanism and the balance of anticoagulant mechanism of AIS patients with phlegm-heat and bowel-qi-obstructed syndrome can be maintained by Xinglouchengqi decoction.(4)Some indexes of TEG are highly correlated with internal fire,qi deficiency syndromes and yin deficiency syndromes.With the increase of three syndromes,the coagulation mechanism of the body also enhances. |
PDF Full Text Request