ABSTRACT
ObjectiveTo explore the clinical efficacy and safety of the combination of Erchentang and Bixie Fenqingyin in the treatment of patients with acute cerebral infarction accompanied by hyperuricemia of phlegm and blood stasis blocking collaterals syndrome to provide a new method and evidence for the treatment of acute cerebral infarction with hyperuricemia. MethodA total of 132 eligible patients with acute cerebral infarction accompanied by hyperuricemia of phlegm and blood stasis blocking collaterals syndrome admitted to the Putuo Hospital of Shanghai University of Traditional Chinese Medicine（TCM） from May 2021 to May 2022 were randomly divided into a Chinese medicine group， a western medicine group， and a control group， with 44 cases in each group. All three groups received routine western medical treatment for acute cerebral infarction. Additionally， the Chinese medicine group received Erchentang combined with Bixie Fenqingyin， the western medicine group received Benzbromarone tablets， and the control group did not receive any uric acid-lowering treatment. The treatment duration was four weeks. The modified Rankin Scale （mRS） score after three months of onset， as well as the National Institutes of Health Stroke Scale （NIHSS） scores， TCM syndrome scores， serum uric acid （SUA） levels， serum C-reactive protein （CRP） and interleukin-6 （IL-6） levels， serum superoxide dismutase （SOD） and malondialdehyde （MDA） levels， and other safety indicators were observed before and after treatment. ResultA total of 129 cases completed the trial observation， with 43 cases in the Chinese medicine group， 42 cases in the western medicine group， and 44 cases in the control group. The rate of good prognosis in the Chinese medicine group （83.7%，36/43） was higher than that in the western medicine group （64.3%，27/42） and the control group （40.9%，18/44） （χ2=4.184，16.930，P<0.05）， and the western medicine group was superior to the control group （χ2=4.707，P<0.05）. After treatment， the NIHSS scores， TCM syndrome scores， SUA， CRP， IL-6， and MDA levels of the patients in all three groups decreased， while the SOD levels increased compared with those before treatment （P<0.05）. Among them， the improvement in NIHSS score was better in the Chinese medicine group and the western medicine group than in the control group （P<0.05）. The Chinese medicine group showed the greatest improvement in TCM syndrome （P<0.05）， while the western medicine group showed the greatest reduction in uric acid levels （P<0.05）. No significant abnormalities in safety indicators were observed before and after treatment in the three groups， and no serious adverse reactions were reported. ConclusionThe combination of Erchentang and Bixie Fenqingyin can significantly improve the prognosis， early neurological deficits， and TCM syndromes of patients acute cerebral infarction accompanied by hyperuricemia of phlegm and blood stasis blocking collaterals syndrome. It can also lower uric acid levels and inhibit inflammatory and oxidative stress reactions.
ABSTRACT
Objective:To discuss clinical effect of addition and subtraction therapy of Ditantang combined with Taohong Siwutang to cerebral infarction and syndrome of phlegm and blood stasis blocking collaterals during early recovery， and to study protection to brain nerve. Method:One hundred and fifty-two patients were randomly divided into control group （76 cases） and observation group （76 cases） by random number table， 71 patients in control group completed the therapy （5 patients were falling off， missing visit or eliminated）， and 70 patients in observation group completed the therapy. Both groups' patients got comprehensive rehabilitation measures. Patients in control group got Zhongfeng Huichun pills， 1.5 g/time， 3 times/day. Patients in observation group got addition and subtraction therapy of Ditantang combined with Taohong Siwutang in the morning and at night， 1 dose/day. The treatment was continued for 12 weeks. Before and after treatment， scores of degree of neurological deficit， Barthel （BI） index， Fugl-Meyer scale （FMA）， modified Rankin scale （MRS） and syndrome of phlegm and blood stasis blocking collaterals were graded. And levels of malondialdehyde （MDA）， glutathione peroxidase （GSH-Px）， superoxide dismutase （SOD）， advanced oxidation protein products （AOPP）， vascular endothelial growth factor （VEGF）， brain-derived neurotrophic factor （BDNF） and neuron specific enolase （NSE）. And cerebral hemodynamics were detected， and peak flow velocity （VS）， vascular resistance index （RI）， pulsatility index （PI） and cerebrovascular reserve function （CVR） were recorded. Safety was evaluated. Result:After the 6th week and 12th week of treatment， scores of degree of neurological deficit， BI， FMA， MRS， syndrome of phlegm and blood stasis blocking collaterals， AOPP， MDA， NSE， RI and PI were lower than those in control group （P<0.01）， levels of SOD， GSH-Px， BDNF， VEGF， Vs and CVR were higher than those in control group （P<0.01）. The clinical effect was better than which in control group （Z=2.109， P<0.05）. Besides， there was no adverse reaction caused by Ditantang combined with Taohong Siwutang. Conclusion:Ditantang combined with Taohong Siwutang can ameliarate the hemodynamics， reduce the lipid peroxidation damage， regulate the neurovascular repair factor， so it can promote the repair of nerve tissue and function， clinically reduce the degree of nerve function defect， improve the ability of daily life and exercise when it used to cerebral infarction and syndrome of phlegm and blood stasis blocking collaterals during early recovery， and it is good for clinical effect and safe using.
ABSTRACT
Objective:To explore the clinical efficacy of modified Ditantang combined with acupuncture in the treatment of dysphagia after apoplexy （DAS） syndrome of phlegm and blood stasis blocking collaterals. Method:One hundred and eight patients were randomly divided into control group （54 cases） and observation group （54 cases） by number table. Both groups underwent nutritional management，rehabilitation training and acupuncture. Patients in control group additionally took Tongluo Huatan capsules， 3 granules/time， 3 times/day， while patients in observation received modified Ditantang. Both groups had two weeks of treatment. The Kubota's drinking water test， swallowing contrast examination （VFSS）， and standard swallowing function assessment （SSA） were conducted. Swallowing disorder specific quality of life scale （SWAL-QOL） and sputum collateral stasis syndrome were scored before and after treatment. The levels of brain-derived neurotrophic factor （BDNF）， nerve growth factor （NGF） and neuron-specific enolase （NSE） before and after treatment. The occurrence of pneumonia， malnutrition， dehydration and aspiration were then recorded. Result:The clinical effective rate was （47/49） 95.92%in the observation group， higher than （41/50） 82.00% in the control group's （<italic>χ</italic><sup>2</sup>=4.854，<italic>P</italic><0.05）. The grade of Kubota's drinking water test in observation group was lower than that in the control group（<italic>Z</italic>=2.211，<italic>P</italic><0.05）. VFSS swallowing dysfunction in observation group was lighter than that in control group（Z=1.969，<italic>P</italic><0.05）. The scores of Kubota's drinking water test， SSA and phlegm and blood stasis blocking collateral syndrome in the observation group were all lower than those in the control group（<italic>P</italic><0.01）， while the VFSS score was higher than that in control group （<italic>P</italic><0.01）. The swallowing symptom score， other symptom scores and total SWAL-QOL scores of the observation group were higher than those of the control group（<italic>P</italic><0.01）. The levels of BDNF and NGF in the observation group were higher than those in the control group （<italic>P</italic><0.01）， but the NSE level was lower than that in the control group（<italic>P</italic><0.01）. The complication rate in the observation group was （6/49）12.24%， which was lower than （15/50）30.00% in the control group（<italic>χ</italic><sup>2</sup>=4.668，<italic>P</italic><0.05）. Conclusion:On the basis of nutrition management and rehabilitation training， modified Ditantang combined with acupuncture can reduce the risk of dysphagia and aspiration， improve the degree of neurological deficits， improve the quality of life， and reduce complications in treatment of DAS syndrome of phlegm and blood stasis， with significant clinical efficacy.
ABSTRACT
Objective@#To investigate the effectiveness and safety of Huatan-Quzhuo decoction in combination with western medicine for the treatment of carotid atherosclerotic plaques.@*Methods@#A total of 194 patients with carotid atherosclerosis were selected were randomly divided into two groups, 97 in each group. The control group was treated with simvastatin. The observation group was treated with Huatan-Quzhuo decoction on the basis of the control group. The serum levels of interleukin-1 (IL-1), tumor necrosis factor α (TNF-α), malondialdehyde (MDA), and superoxide dismutase (SOD) were observed before and after treatment in the two groups. The Sod, IMT, number of plaques, number of vulnerable plaques and area of plaques, carotid artery intima-media thickness (IMT), number of plaques, number of vulnerable plaques, and area of plaques were detected.@*Results@#After treatment, the levels of TC, TG, and LDL-C in the observation group were significantly lower than those in the control group (t were 4.546, 6.712, 4.872, P<0.01). After treatment, the IMT (0.85 ± 0.11 mm vs. 1.08 ± 0.13 mm, t=13.302), number of plaques (0.74 ± 0.36 vs. 1.02 ± 0.42, t=4.985), number of vulnerable plaques (0.24 ± 0.25 vs. 0.41 ± 0.27, t=4.550), and plaque area (50.06 ± 9.73 mm2 vs. 68.52 ± 11.24 mm2, t=12.230) in the observation group were significantly lower than those in the control group (P<0.01). The levels of IL-1, TNF-α and MDA in the observation group were significantly lower than the control group (t were 13.089, 4.769, 10.442, P<0.01). The level of SOD was observation group was significantly higher than the control group (t=11.636, P<0.01).@*Conclusions@#The combination of Huatan-Quzhuo decoction and western medicine in the treatment of carotid artery atherosclerosis can regulate the level of blood lipids, improve the degree of atherosclerosis, reduce the degree of inflammation and oxidative stress.
ABSTRACT
Objective To investigate the effectiveness and safety of Huatan-Quzhuo decoction in combination with western medicine for the treatment of carotid atherosclerotic plaques. Methods A total of 194 patients with carotid atherosclerosis were selected were randomly divided into two groups, 97 in each group. The control group was treated with simvastatin. The observation group was treated with Huatan-Quzhuo decoction on the basis of the control group. The serum levels of interleukin-1 (IL-1), tumor necrosis factor α (TNF-α), malondialdehyde (MDA), and superoxide dismutase (SOD) were observed before and after treatment in the two groups. The Sod, IMT, number of plaques, number of vulnerable plaques and area of plaques, carotid artery intima-media thickness (IMT), number of plaques, number of vulnerable plaques, and area of plaques were detected. Results After treatment, the levels of TC, TG, and LDL-C in the observation group were significantly lower than those in the control group (t were 4.546, 6.712, 4.872, P<0.01). After treatment, the IMT (0.85 ± 0.11 mm vs. 1.08 ± 0.13 mm, t=13.302), number of plaques (0.74 ± 0.36 vs. 1.02 ± 0.42, t=4.985), number of vulnerable plaques (0.24 ± 0.25 vs. 0.41 ± 0.27, t=4.550), and plaque area (50.06 ± 9.73 mm2 vs. 68.52 ± 11.24 mm2, t=12.230) in the observation group were significantly lower than those in the control group (P<0.01). The levels of IL-1, TNF-α and MDA in the observation group were significantly lower than the control group (t were 13.089, 4.769, 10.442, P<0.01). The level of SOD was observation group was significantly higher than the control group ( t=11.636, P<0.01). Conclusions The combination of Huatan-Quzhuo decoction and western medicine in the treatment of carotid artery atherosclerosis can regulate the level of blood lipids, improve the degree of atherosclerosis, reduce the degree of inflammation and oxidative stress.