Observation On The Curative Effect Of Xinglouchengqi Decoction Combined With Mannitol In The Treatment Of Massive Cerebral Infarction

Objective: To observe the clinical efficacy and safety of Xinglouchengqi decoction combined with mannitol in the treatment of large area cerebral infarction,and to explore the combination of traditional Chinese and Western medicine to broaden the thinking and provide clinical basis for the treatment of large-area cerebral infarction.Methods: Sixty-four patients with massive cerebral infarction who met the inclusion criteria were selected as the subjects.They were divided into treatment group and control group by random number table method,32 cases in each group.All patients in the group were treated with basic treatment according to the "stroke unit model" of the Chinese Guidelines for the Treatment of Acute Ischemic Stroke(2014),and with the guidance of the "Guidelines for Supratentorial Large Area Cerebral Infarction(2015)issued jointly by the American Neurological Intensive Care Association and the German Neurological Intensive Care and Emergency Medical Association.For the control of brain edema after massive cerebral infarction,the control group was treated with mannitol,while the treatment group was treated with Xingpin Chengqi Decoction plus mannitol.During the first,third and seventh days of treatment,the symptoms of phlegm-heat-fu syndrome,the changes of NIHSS score,the volume of brain edema,the DTABR ratio of quantitative electroencephalogram and the changes of hs-CRP in blood were observed.Statistical analysis was made to evaluate the effect of combined treatment of traditional Chinese and Western Medicine on brain edema after massive cerebral infarction.Results:1.Comparisons of brain edema volume,DTABR and hs-CRP levels between the two groups: 1 day after treatment,there was no significant difference in brain edema volume,DTABR and hs-CRP levels between the two groups(P > 0.05).The brain edema volume,DTABR and hs-CRP levels of the treatment group at 3 and 7 days after treatment were significantly lower than those of the control group at 1 day after treatment,and the difference was statistically significant(P < 0.05).2.Total clinical effective rate of cerebral edema: 19 cases were markedly effective in the treatment group,9 cases were effective,4 cases were ineffective,the total clinical effective rate was 87.5%;11 cases were markedly effective in the control group,10 cases were effective,11 cases were ineffective,and the total clinical effective rate was 65.63%.From the data analysis,it can be found that the total clinical effective rate of the treatment group was significantly higher than that of the control group,and the difference was statistically significant(P < 0.05).3.The changes of NIHSS score and phlegm-heat-fu syndrome score before and after treatment in the two groups: There was no significant difference in the score level between the two groups on the 1st day after treatment(P > 0.05).The NIHSS score and phlegm-heat-fu syndrome score of the treatment group at 3 and 7 days after treatment were significantly lower than those of the control group at 1 day after treatment,and the difference was statistically significant(P < 0.05).The scores of TCM symptoms and neurological function were significantly higher than those of the control group(P < 0.05),and the difference was statistically significant(P < 0.05).Conclusions:1.The curative effect of Xinglouchengqi Decoction combined with mannitol in the treatment of massive cerebral infarction is better than that of the control group with mannitol alone.2.The treatment of large-area cerebral infarction with modified Xinglou Chengqi Decoction combined with mannitol can rapidly improve the severity of large-area cerebral infarction and the syndrome changes of phlegm-heat-fu syndrome.3.Xinglouchengqi Decoction combined with mannitol in the treatment of massive cerebral infarction can quickly control the volume of brain edema and reduce the levels of DTABR and hs-CRP.4.Xinglouchengqi Decoction combined with mannitol in the treatment of massive cerebral infarction has no obvious toxic and side effects,which is safe and effective,and deserves further promotion and research.