Xuanbai-Chengqi Decoction combined with conventional western medicine therapy for coma patients with acute cerebral infarction the influence of arousal / 国际中医中药杂志

ABSTRACT

Objective:To explore the effect of Xuanbai-Chengqi Decoction combined with conventional western medicine therapy for the coma patients with acute cerebral infarction. Methods:A total of 72 patients with acute cerebral infarction in Huaibei Hospital of Traditional Chinese Medicine from March 2019 to January 2020 were randomly divided into two groups with 36 in each group. The control group was treated with conventional western medicine therapy, and the treatment group was given Xuanbai-Chengqi Decoction by nasal feeding on the basis of the control group. Both groups were treated for 7 days. The National Institutes of Health Stroke Scale (NIHSS) was used to evaluate the degree of neurological deficit, and the Full Outline of Unresponsiveness Scale (FOUR) was used to evaluate the degree of consciousness disorder of patients. Three-dimensional reconstruction of head CT was performed to identify and mark the edema area. The levels of serum high-sensitivity C-reactive protein (hs-CRP), homocysteine (Hcy) and vascular endothelin-1 (ET-1) were measured by double antibody sandwich enzyme-linked immunosorbent assay. The adverse events during treatment were observed and the clinical effective rate was evaluated. Results:The total effective rate was 100% (36/36) in the treatment group and 86.1% (35/36) in the control group, and the difference between the two groups was statistically significant ( Z=-0.242, P=0.015). On the 3rd and 7th day after treatment, the NIHSS scores of the treatment group were significantly lower than those in the control group ( t values were 26.567 and 17.982, all Ps<0.01). On the 3rd and 7th day after treatment, the eye opening response, motor response, brainstem response, brain stem response and total scores (3 days after treatment, t=15.235 , 14.892, 18.452, 11.232, 16.235; 7 days after treatment, t=19.5 68, 16.232, 10.356, 9.546, 11.098) of the treatment group were significantly lower than those in the control group. The levels of serum hs-CRP, Hcy, ET-1 and CT threshold of brain edema in the treatment group were significantly lower than those in the control group after treatment ( t=22.352, 17.789, 11.908 and 19.652, all Ps<0.01). There were no adverse drug reactions, no abnormal changes in blood routine tests, liver function and electrocardiogram in both groups. Conclusion:The Xuanbai-Chengqi Decoction combined with conventional western medicine therapy can improve the neurological function and promote awakening of coma patients with acute cerebral infarction, which may be related to reducing the levels of inflammatory cytokines related to hs-CRP, Hcy and ET-1, improving microcirculation and relieving brain edema.