Clinical study of modified Tianma-Gouteng Decoction combined with conventional western medicine in the treatment of cerebral hemorrhage with syndrome of hyperactive liver yang causing wind / 国际中医中药杂志

ABSTRACT

Objective:To evaluate the effect of modified Tianma-Gouteng Decoction combined with conventional western medicine in the treatment of cerebral hemorrhage with syndrome of hyperactive liver yang causing wind. Methods:From May 2017 to December 2019, 120 patients of cerebral hemorrhage with syndrome of hyperactive liver yang causing wind were randomly divided into two groups, 60 in each group. The control group was treated with conventional western medicine treatment, and the observation group was with modified Tianma-Gouteng Decoction on the basis of the control group. Before and after treatment, the TCM symptom scores were evaluated. Serum norepinephrine (NE), epinephrine (E), dopamine (DA) were detected by ELISA. Serum MDA was detected by ELISA. Serum homocysteine (Hcy), endothelin (ET) were detected by fluorescence polarization immunoassay, the National Institutes of Health Stroke Scale (NIHSS) was used to assess the degree of neurological impairment, and Barthel index was used to assess activities of daily living. The rebleeding during the treatment was observed and recorded to evaluate the clinical efficacy. Results:The total effective rate was 90.0% (54/60) in the observation group and 70.0% (42/60) in the control group, with significant difference between the two groups ( χ2=7.500, P=0.006). After 3 and 6 weeks of treatment, the TCM syndrome score of the observation group were significantly lower than those in the control group ( t=10.670, 14.022, P<0.001). After treatment, NIHSS score of treatment group was significantly lower than that of control group ( t=5.736, P<0.01), Barthel index score of treatment group was significantly higher than that of control group ( t=10.559, P<0.01). After treatment, serum NE [(2 897.51 ± 241.65) pmol/L vs. (6 309.25±394.16) pmol/L, t=57.160], E [(1 352.45 ± 234.15) pmol/L vs. (4 131.20 ± 431.55) pmol/L, t=43.839] and DA [(623.59 ± 45.61) pmol/L vs. (950.61 ± 51.39) pmol/L, t=36.866] levels, serum SOD [(4.08 ± 1.05) C/μg·mgHb vs. (3.16 ± 1.02) C/μg·mgHb, t=4.868], MDA [(3.15 ± 1.41) μmol/L vs. (5.86 ± 1.31) μmol/L, t=10.907] levels, serum Hcy [(12.98 ± 2.41) μmol/L vs. (17.68 ± 2.26) μmol/L, t=11.019], ET [(51.36 ± 5.29) ng/L vs. (79.58±7.65) ng/L, t=23.502] in treatment group were significantly lower than those in the control group ( P<0.01); NO [(63.19 ± 3.87) μmol/L vs. (51.26 ± 3.59) μmol/L, t=17.506] in treatment group was significantly higher than that of the control group ( P<0.01). The incidence of rebleeding was 1.7% (1/60) in the observation group and 15.0% (9/60) in the control group, where the difference was statistically significant ( χ2=6.982, P=0.008). Conclusion:Modified Tianma-Gouteng Decoction combined with conventional western medicine therapy can protect the cerebral nerve function of patients with cerebral hemorrhage with syndrome of hyperactive liver yang causing wind, prevent the secondary ischemic brain injury after cerebral hemorrhage, and improve the clinical curative effect.