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Objective To observe the clinical efficacy of Dachaihu decoction in treatment of stroke-associated pneumonia (SAP) in the elderly patients with excess-heat syndrome and acute ischemic stroke (AIS). Methods One hundred elderly patients with excess-heat syndrome and SAP admitted to the Department of Neurology of Tianjin Nankai Hospital from August 2015 to September 2016 were enrolled, and they were divided into a control group and an observation group according to the random number table, 50 cases in each group. Both groups were given conventional neurological treatment, while the observation group additionally received Dachaihu decoction (the ingredients of the decoction: bupleurum 15 g, scutellariae 10 g, pinellia 10 g, fructus aurantii immaturus 15 g, radix paeoniae alba 10 g, rhubarb 5 g, ginger 10 g, jujube 2), and according to the individual's symptoms and signs, the above ingredients can be added and/or subtracted, 1 dose per day, divided into two parts, 1 part taken in the morning and 1 part in the evening orally, 14 days as a therapeutic course. The body temperature recovery time, the duration of antibiotic treatment, the changes of Clinical Pulmonary Infection Score (CPIS) and National Institutes of Health Stroke Scale (NIHSS) score before and after treatment of the two groups were observed and the therapeutic effects in the two groups were evaluated. Results The body temperature recovery time (days: 6.56±2.70 vs. 8.08±3.23) and the duration of antibiotic treatment (days: 8.78±2.80 vs. 10.02±2.90) in the observation group were significantly shorter than those in the control group (both P ＜ 0.05); with the prolongation of treatment, after treatment, the CPIS and NIHSS score were decreased significantly in both groups, reaching the lowest levels on the 14th day, and the degrees of score descent in observation group were more significant than those of the control group (CPIS score: 0.68±0.59 vs. 1.12±0.96, NIHSS score: 6.38±2.31 vs. 7.44±2.74, both P ＜ 0.05); the total effective rate in the observation group was significantly higher than that in the control group [92% (46/50) vs. 76% (38/50), P ＜ 0.05]. Conclusion The therapeutic effect of Dachaihu decoction used for treatment of SAP in elderly patients with excess-heat syndrome is favorably effective and safe.
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Objective To explore the effect of patients with acute cerebral infarction and complication of acute gastric mucosal lesions (AGML) on their short-term prognoses.Methods Two hundred and sixteen patients with acute cerebral infarction admitted to the Department of Neurology in Tianjin Nankai Hospital from January to December 2014 were enrolled, and they were divided into the control group without AGML (167 cases) and observation group with AGML (49 cases) according to whether AGML occurred or not. The digestive tract was monitored in the two groups, and the relationships between the incidence of AGML and the location of infarction, stroke classification, as well as the anti-thrombosis treatments like thrombolysis, anti-coagulation and anti-platelet, etc. were analyzed; the changes in scores of the National Institutes of Health Stroke Scale (NIHSS) on admission, 7 days and 14 days after onset and 14-day mortality of two groups were compared.Results AGML occurred in 49 of 216 patients (22.69%); the 14-day mortality of the observation group was obviously higher than that of the control group [6.12% (3/48) vs. 1.80% (3/167),P 1/3 hemispheres) in the observation group was higher than that in the control group [cerebellum: 18.37% (9/49) vs. 4.19% (7/167); brainstem: 24.49% (12/49) vs. 8.98% (15/167), multiple lobes: 16.33% (8/49) vs. 2.99% (5/167), all P < 0.05]; the incidence of cardiac cerebral embolism (CE) was significantly higher than that in the control group [55.10% (27/49) vs. 12.57% (21/167),P < 0.05]. With the extension of disease course, the NIHSS score of the observation group was increased, while the score of the control group was gradually reduced, and the NIHSS scores of the observation group were obviously higher than those of control group on the 7th and 14th day after onset (7 days: 18.12±4.20 vs. 10.93±6.73, 14 days: 19.33±3.11 vs. 9.66±9.15, bothP < 0.05). The thrombolysis, argatroban anti-coagulation and anti-platelet incidence between the two groups after treatments was of no statistically significant difference (the incidence in control group was 4.79%, 47.31%, 47.90%, and it was 4.08%, 44.90%, and 48.98% in observation group, allP < 0.05). Conclusion The occurrence of AGML complication in patients with acute cerebral infarction is closely related to their short-term prognoses, and when the cerebral embolus is cardiac in origin or the infarction is located at multiple cerebral lobes, brain stem or cerebellum, the probability of the occurrence of AGML is relatively high, suggesting a poor outcome.
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Objective To study the effects of Buyang Huangwu decoction(BHD) on serum matrix metalloproteinase-9(MMP-9),high sensitivity C-reactive protein(hs-CRP)levels and inflammatory reaction of patients with ischemic stroke accompanied by Qi deficiency and blood stasis syndrome. Methods Thirty-nine patients with acute ischemic stroke onset for 24-48 hours accompanied by Qi deficiency and blood stasis syndrome were admitted into Nankai Hospital of Tianjin City,and in accordance with the random number table,they were divided into BHD treatment group(21 cases)and conventional western treatment control group(18 cases). The patients in both groups were given conventional western medicine,such as anti-platelet,descent of blood lipid and protection of brain. In the BDH group,the patients were additionally given BHD oral administration. Before and after treatment for 72 hours and 7 days,the changes of serum levels of MMP-9 and hs-CRP were observed in both groups. In the mean time,20 subjects having taken physical healthy examinations in outpatient clinics were assigned in the healthy control group. Results Compared to the healthy control group,before treatment the levels of MMP-9 and hs-CRP in western treatment control and BHD groups were significantly higher than those in the healthy control group〔MMP-9 (μg/L):403.3±32.9,417.9±45.3 vs. 86.5±6.1;hs-CRP(mg/L):7.4±0.7,6.9±0.6 vs. 2.2±0.4,all P<0.05〕. After treatment for 72 hours,the levels of MMP-9 and hs-CRP achieved their peaks,after treatment for 7 days, the levels of MMP-9 and hs-CRP were significantly lower than those at 72 hours in both groups〔the control group:MMP-9(μg/L):190.4±58.0 vs. 528.9±65.1,hs-CRP(mg/L):5.8±0.7 vs. 11.1±0.8;the BDH group:MMP-9 (μg/L):89.5±11.4 vs. 437.6±55.2,hs-CRP(mg/L):3.1±0.9 vs. 7.3±0.6,all P<0.05〕. Conclusions In patients with acute cerebral infarction,the serum levels of MMP-9 and hs-CRP are significantly increased. After conventional treatment,the levels gradually decline,and the descent in the group with addition of BHD is more remarkable,suggesting that BHD have prominent effect for treatment of patients with acute cerebral infarction accompanied by Qi deficiency and blood stasis syndrome.