| Background:The four major characteristics of stroke are acute onset,rapid change,serious illness,and recurrence. Stroke patients will have different degrees of sequelae, severe disturbance of consciousness,and even life-threatening. The etiology and pathogenesis of stroke are complex, difficult to treat and time-consuming to recover. Therefore, it is very important to prevent and cure stroke. Xinglouchengqi Decoction is widely used in the treatment of stroke,and has achieved good results, it was proposed by academician Wang Yongyan for the treatment of stroke by characteristic therapy of the resolving phlegm and relaxing bowels.Objective:Take the phlegm-heat and bowel-qi-obstructed syndrome of acute cerebral infarction as the object of study,to explore the changes of TCM related scales, NIHSS scores and Hcy changes before and after treatment with of resolving phlegm and relaxing bowels therapy.Hcy is one of the independent risk factors of acute cerebral infarction, it is also one of the prognostic indicators of acute cerebral infarction. According to the change of correlation scale before and after treatment, to analyzed the therapeutic effect from the angle of Hcy.Method:60 patients with acute cerebral infarction and syndrome of the phlegm-heat and bowel-qi-obstructed who met the inclusion criteria were enrolled and randomly divided into treatment and control group with the ratio of 2:1, 40 cases in the treatment group and 20 cases in the control group. The treatment group was prescribed with Xinglouchengqi Decoction while the other with routine laxative medication (Lactulose or Glycerine Enema).The course of treatment was limited between 3 to 7 days and it can be adjusted flexibly according to specific bowel movement of each patient. Before and after the treatment, 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 the level of Hcy were also recorded on the evaluation points, and the relevant safety indicators were detected. The efficacy of the two groups was evaluated by comparing the scores of the scales and the changes in the Hcy values.Result:1 The two groups were compared before and after treatment, the improvement of NIHSS score and score of scale for phlegm-heat and bowel-qi-obstructed syndrome was statistically significant in both groups (P < 0.05), additionally,the improvement of TCM Stroke Scale score was statistically significant in treatment group (P <0.05). There was no significant difference between the standard of diagnosis and curative effect evaluation of acute cerebral infarction and the NIHSS score (P>0.05). According to the "ischemic stroke syndromes diagnosis scale" to evaluate the patients with the syndrome factors, the treatment group of inner wind, inner fire, phlegm dampness, blood stasis score after treatment was decreased compared with that before treatment (P<0.05), The control group of inner wind, inner fire,phlegm dampness score after treatment than before treatment decreased (P<0.05); the inner wind and inner fire, phlegm dampness improvement were compared between two groups showed no significant difference (P>0.05).2 According to the diagnostic criteria of acute cerebral infarction and the standard of curative effect evaluation, the curative effect of the treatment group was 75%, and the effective rate of the control group was 65%, there was no statistical difference between the two groups(P>0.05).The levels of Hcy in the treatment group and the control group were compared within the group after treatment. The difference between the two groups was statistically significant(P<0.05),but there was no significant difference between the control group and the control group (P>0.05).3 The two group after treatment Hcy levels were compared between the two groups, the difference was not statistically significant (P>0.05). Combined with the trend of Hcy levels before and after treatment, we can see that the two groups are significantly lower than before treatment.Conclusion:1 The therapy of resolving phlegm and relaxing bowels on the TCM scale score of the phlegm-heat and bowel-qi-obstructed syndrome in acute cerebral infarction patients,deficiency of vital energy syndrome elements except no difference (P>0.05), the rest were improved (P<0.05), visible removing phlegm to relax bowels therapy as a purgative agent,besides the effect of resolving phlegm and clearing the bowels,both diarrhea is not hurt effect.2 The NIHSS score of the phlegm-heat and bowel-qi-obstructed syndrome of acute cerebral infarction patients was improved (P<0.05),but there was no difference between groups (P>0.05). It suggested that the therapy of resolving phlegm and relaxing bowels can improve the neurologic impairment.3 The therapy of the removing phlegm to relax bowels has a significant decrease in the Hey levels of the phlegm-heat and bowel-qi-obstructed syndrome in acute cerebral infarction patients patients. In order to improve the gastrointestinal function and improve the whole body state, the method of the removing phlegm to relax bowels therapy can lower the level of Hey and improve the prognosis of patients with acute cerebral infarction. |
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