Clinical Observation On Acute Stage Of Hemorrhagic Apoplexy Treated By Xingnaoning Mixture

Purpose:Through clinical observation and study of two groups of patients in intracranial pressure,hematoma volume,NIHSS score,TCM syndrome product,BI index changes,to evaluate the effectiveness and safety of Xingnaoning Mixture objectively,in order to study a new and efficient preparation of traditional Chinese medicine for clinical application,to provide more effective treatment for patients with acute hemorrhagic stroke.Improve their ability to live,so as to effectively save valuable medical resources.Method:This study carefully collected 69 cases of acute hemorrhagic stroke in Xiangyang Hospital of Traditional Chinese Medicine from November 2016 to November 2018,which met the requirements of this study.69 Cases were randomly divided into control group(34 cases)and treatment group(35cases).In the control group,2 cases fell off during the treatment,and 32 cases completed the experiment;In the treatment group,3 cases dropped out and 32 cases finished the experiment.The control group was given basic treatment:(1)keep the ward quiet and turn over regularly;(2)Keep the airway unobstructed;(3)Intermittent high flow oxygen inhalation;(4)symptomatic treatment;(5)In patients with cranial hypertension,20%mannitol 125 ml intravenous drip is given according to the condition,whichcan be repeated every 6 to 12 hours as appropriate.It is generally used for3-5 days,up to a week;(6)managing the patient's blood pressure;(7)To protect the brain,nutrition,such as symptomatic treatment,timely treatment of complications.In addition to the above basic treatment,the treatment group was also given oral,nasal feeding or retention enema Xingnaoning Mixture(Batch No E Yao Zi No.Z2008/1753,composition:Rhubarb,Hirudo,Rhizoma Acori Tatarinowii,Herba Leonuri,Radix Notoginseng,Rhizoma Alismatis,in addition to containing 0.8g/ml crude drug,which is the preparation of our hospital),usage: Oral or nasal feeding100ml/time,twice a day for 30 days.Such as coma patients,patients with severe vomiting and gastrointestinal bleeding,the method of retention enema,200ml/time,twice a day,for 30 consecutive days.Intracranial Pressure and hematoma volume were measured on the 0th day,7th day and30 th day after treatment,and 90 days after the follow-up NIHSS score,BI index,TCM symptomatology observation to evaluate the scale changes in the evaluation of its effectiveness.Two groups of patients before and after treatment were basic vital signs,blood routine,stool routine,urine routine,liver and kidney function.The safety of Xingnaoning Mixture was evaluated by electrocardiogram(ECG)and head CT scan,and the adverse reactions were observed.Detailed records should be made and symptomatic treatment should be given in time.Observation indicators:Indexes of curative effect: ICP and hematoma volume change before treatment,7 days and 30 days after treatment,and NIHSS score,BI index and TCM symptom score after 90 days follow-up;Safety indicators: the basic level of vital signs,blood,urine and stool routine,liver and kidney function and electrocardiogram,head CT.Statistical analysis:Statistical analysis using SPSS 21.0 processing,statistical results are based on the obtained P value judgment: P < 0.05 is statistically significant,P > 0.05 is not statistically significant.Consequence:This clinical observation included 69 cases,64 cases of the actual completion of the experiment,off 5 cases.The results are as follows:(1)comparability analysis: The effects of age,sex,blood pressure,blood sugar level,bleeding site and underlying disease on the results were excluded by statistical analysis,Before treatment,NIHSS score,BI index,Western medicine curative effect index,Chinese medicine curative effect index,Hematoma volume and intracranial pressure had no statistical significance after statistical analysis,indicating that the two groups were comparable.(2)Analysis of curative effect: 1)Intracranial Pressure was measured before treatment,7 days after treatment and 30 days after treatment in both groups.After monitoring and comparing before and after treatment,it was found that the effect of the treatment group was better.That is,Xingnaoning Mixture can reduce intracranial hypertension in patients with acute cerebral hemorrhage;2)The Hematoma volume of patients in different periods was statistically analyzed.It was found that Xingnaoning Mixture could significantly reduce the volume of hematoma,that is,Xingnaoning Mixture could significantly promote the absorption of intracranial hematoma in patients,so as to reduce the volume of hematoma;3)Xingnaoning Mixture can obviously improve the NIHSS score,the nerve defect and the quality of life of the patients;4)The curative effect of the treatment group is better in improving the living ability of patients,which suggests that the curativeeffect of Xingnaoning Mixture is worth popularizing and can obviously improve the independent living ability of patients;5)The curative effect index of western medicine in the treatment group was better than that in the control group,suggesting that Xingnaoning had an advantage in reducing the NIHSS score of patients,that is,it could significantly improve the neurological impairment of patients;6)Evaluate the curative effect by comparing the TCM syndrome scores of the two groups of patients.The therapeutic effect of the treatment group is significantly better,suggesting that Xingnaoning Mixture is very effective in improving the symptoms and signs of stroke in patients with stroke.It can significantly improve the patient's limb function and language function;7)According to the comprehensive curative effect evaluation,the total effective rate of Xingnaoning mixture is 93.8%,suggesting that the comprehensive effect of Xingnaoning mixture on patients with acute cerebral hemorrhage deserves recognition.(3)Safety analysis: The adverse reaction of Xingnaoning Mixture in treating hemorrhagic apoplexy was less,mainly diarrhea,no obvious abnormality was found in routine examination of stool and electrolyte analysis,and the patient cured spontaneously without treatment;Before and after treatment,the patients underwent relevant safety examinations such as blood biochemistry and head CT,and no abnormal changes related to the use of Xingnaoning Mixture and evidence of toxic and side effects were found.It is concluded that Xingnaoning mixture is safe for clinical use.Conclusion: In the treatment of acute hemorrhagic apoplexy,the combination of routine therapy and Xingnaoning Mixture is more effective.Xingnaoning Mixture can improve ICP,hematoma volume,NIHSS score,BI index,the Chinese and Western medical efficacy indexes have significanteffects.By examining blood routine,routine urine,liver and kidney function,electrocardiogram,and head CT,there are no obvious side effects,fewer adverse reactions,mild symptoms,and high safety,and is worthy of clinical promotion.