| 引用本文: |
丁雪霏, 肖阳春.大续命汤加减治疗急性缺血性卒中（中风-中经络）的临床疗效观察[J].湖南中医药大学学报,2026,46(6):1233-1238[点击复制] |
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| 大续命汤加减治疗急性缺血性卒中（中风-中经络）的临床疗效观察 |
| 丁雪霏,肖阳春 |
| (北京中医医院顺义医院, 北京 101300) |
| 摘要: |
| 目的 观察大续命汤加减治疗急性缺血性卒中（AIS）（中风-中经络）风痰瘀阻证的临床疗效。方法 前瞻性选取2023年1月至2024年12月北京中医医院顺义医院收治的76例AIS（中风-中经络）风痰瘀阻证患者，采用随机数字表法分为观察组与对照组，各38例。对照组予常规西医治疗，观察组在对照组基础上加用大续命汤加减治疗，每日1剂，疗程14 d。比较两组治疗后的总有效率及治疗后1、6个月随访的美国国立卫生研究院卒中量表（NIHSS）评分、Barthel指数（BI）评分；比较两组治疗前及治疗14 d后经颅多普勒超声检测的大脑前动脉、大脑中动脉、大脑后动脉平均血流速度（Vm）值以及血液流变学指标（全血低切黏度、血浆黏度、纤维蛋白原）、超敏C反应蛋白（hs-CRP）水平、中医证候积分和不良反应发生率。结果 治疗后，观察组总有效率为97.37%，高于对照组的76.32%（P<0.05）。观察组NIHSS评分均低于对照组（P<0.05），BI评分均高于对照组（P<0.05）。治疗后，与对照组比较，观察组大脑前动脉、大脑中动脉、大脑后动脉Vm值升高（P<0.05），血液流变学指标（全血低切黏度、血浆黏度、纤维蛋白原）及hs-CRP水平下降（P<0.05）；中医证候总积分、主症（半身不遂、口舌歪斜、言语不利）及次症（倦怠乏力、食欲不振、痰多）积分均下降（P<0.05）。两组不良反应发生率比较，差异无统计学意义（P>0.05）。结论 在常规西医治疗基础上联合大续命汤加减，可有效改善AIS（中风-中经络）风痰瘀阻证患者的神经功能、日常生活能力、脑血流灌注及中医证候，且安全性良好。 |
| 关键词: 急性缺血性卒中 大续命汤 中经络 风痰瘀阻证 神经功能 血液流变学 |
| DOI：10.3969/j.issn.1674-070X.2026.06.020 |
| 投稿时间：2026-03-29 |
| 基金项目:北京市医管局培育计划项目（PZ2023023）；北京中医医院顺义医院院级课题项目（SYYJ-201810）。 |
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| Clinical efficacy observation of modified Daxuming Decoction in treating acute ischemic stroke (stroke involving the meridians) |
| DING Xuefei, XIAO Yangchun |
| (Beijing Shunyi Hospital of Traditional Chinese Medicine, Beijing 101300, China) |
| Abstract: |
| Objective To observe the clinical efficacy of modified Daxuming Decoction in treating acute ischemic stroke (AIS) (stroke involving the meridians) with wind-phlegm and blood stasis obstruction pattern. Methods A prospective study was conducted on 76 patients with AIS (stroke involving the meridians) of wind-phlegm and blood stasis obstruction pattern admitted to Beijing Shunyi Hospital of Traditional Chinese Medicine from January 2023 to December 2024. They were divided into observation group and control group using a random number table method, with 38 cases in each group. The control group received conventional Western medicine treatment, while the observation group received modified Daxuming Decoction (one dose per day for 14 days) in addition to the conventional treatment. The total effective rate after treatment, as well as the National Institutes of Health Stroke Scale (NIHSS) score and Barthel Index (BI) score at 1-month and 6-month follow-up visits, was compared between the two groups. Additionally, the mean blood flow velocity (Vm) values of the anterior cerebral artery, middle cerebral artery, and posterior cerebral artery measured by transcranial Doppler, hemorheological parameters (whole blood low-shear viscosity, plasma viscosity, fibrinogen), high-sensitivity C-reactive protein (hs-CRP), TCM pattern score, and the incidence of adverse reactions were compared before and 14 days after treatment. Results After treatment, the total effective rate in the observation group was 97.37%, which was significantly higher than 76.32% in the control group (P<0.05). The NIHSS scores in the observation group were lower than those in the control group (P<0.05), while the BI scores were higher (P<0.05). After treatment, compared with the control group, the observation group showed increased Vm values in the anterior, middle, and posterior cerebral arteries (P<0.05), decreased hemorheological parameters (whole blood low-shear viscosity, plasma viscosity, fibrinogen) and hs-CRP levels (P<0.05), and reduced total TCM pattern scores as well as scores for primary symptoms (hemiplegia, facial deviation, dysphasia), and secondary symptoms (fatigue, loss of appetite, excessive phlegm) (P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion Modified Daxuming Decoction combined with conventional Western medicine can effectively improve neurological function, daily living ability, and cerebral blood flow perfusion, and reduce TCM pattern scores in patients with AIS (stroke involving the meridians) and wind-phlegm and blood stasis obstruction pattern, with good safety. |
| Key words: acute ischemic stroke Daxuming Decoction stroke involving the meridians wind-phlegm and blood stasis pattern neurological function hemorheology |
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