摘要
目的探讨辨证与非辨证使用中药注射剂治疗急性期脑梗死的临床疗效及不良反应发生率。方法将符合研究标准的急性期脑梗死患者85例随机分为辨证用药组(45例)和非辨证用药组(40例)。辨证用药组兼热象者29例,给予丹参注射液治疗,无热象者16例给予川芎嗪注射液治疗;非辨证用药组随机抽签分别给予丹参注射液或川芎嗪注射液。疗程为2周,于治疗后3个月进行随访并分析比较。用美国国立卫生研究院卒中量表(NIHSS)、简明精神状态量表(MMSE)、日常生活活动能力量表(MBI)及中医证候学综合评价两组疗效。结果与治疗当日比较,两组患者治疗后NIHSS评分显著降低,MMSE、MBI评分显著升高,差异有统计学意义(P均<0.01),但组间评分比较差异无统计学意义(P均>0.05)。辨证用药组患者在神经功能好转的同时中医证候一并好转,而非辨证用药组虽然神经功能好转,但出现不良反应者较多。结论辨证与非辨证使用中药注射剂治疗急性期脑梗死虽在神经功能缺损程度评分上无显著差异,但辨证用药对中医证候改善具有良性趋势,提示中药注射剂的使用要遵循辨证施治的原则。
Objective To compare the clinical effects and side-effects of traditional Chinese medicine （TCM） injection for treatment of patients with acute cerebral infarction with differentiation method and nondifferentiation method. Methods Eighty-five patients with cerebral infarction at acute seizure phase targeted to the inclusion criteria were randomly divided into two groups： differentiation group （45 cases） and nondifferentiation group （40 cases）. In the differentiation group, Danshen injection （丹参注射液） was given to 29 patients with heat syndrome （热象） and Chuanxiongqin injection （川芎嗪注射液） was given to 16 patients without heat syndrome. In the non-differentiation group, Danshen injection and Chuanxiongqin injection were randomly given to the patients. The course of treatment was 2 weeks. After treatment for 3 months, the clinical effects were comprehensively measured in both groups by National Institutes of Health Stroke Scale （NIHSS）, Mini Mental State Examination（MMSE）, Maslach Burnout Inventory （MBI） and TCM syndrome evaluation. Results At the end of the 14th day and the 3rd month after treatment , NIHSS was significantly lower, while MMSE and MBI were markedly higher than those before the treatment in both the differentiation group and non-differentiation group （all P〈0. 01）, but no differences being found between the two groups （all P〉0. 05）. In the differentiation group, there was improvement in neurological functions, and simultaneously also the improvement of the manifestations of the TCM syndrome. Furthermore, although the non-differentiation group showed improvement in neurological function, it experienced more side-effects. Conclusion There was significant difference in TCM syndrome improvement between the two groups, although similar trend appeared in the neurological dysfunction improvement. This clinical test indicates that we should obey syndrome differentiation principle in using TCM injection.
出处
《中国中西医结合急救杂志》
CAS
2008年第2期78-80,共3页
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
基金
北京市中医管理局科研基金资助项目(2003I-17)
关键词
辨证
治疗
中药注射剂
脑梗死
急性
differential diagnosis
treatment
traditional Chinese medicine injection
acute cerebral infarction
