CAJ | 학술논문

目的：观察安脑丸对心肝火旺型中风先兆证患者继发中风的预防效果。方法选择我院中医门诊2008年1月-2012年10月收治的心肝火旺型中风先兆证患者61例，随机分为预防组31例和对照组30例。两组患者均给予血脂康胶囊口服，2粒/次，2次/ d，预防组患者加用安脑丸，3 g/次，2次/ d；两组患者均连续治疗8周，之后均单纯口服血脂康胶囊40个月。观察两组患者继发中风发病情况，治疗前后颈总动脉内膜中层厚度（IMT）、易损斑块横截面积（VPA），中医症状积分（SS），血清三酰甘油（TG）、总胆固醇（TC）水平。结果对两组患者随访42个月，预防组继发中风发生率为9.7%，低于对照组的26.7%（P ﹤0.05）。两组患者治疗前颈总动脉 IMT、VPA，SS，血清TG、TC 水平及治疗后血清 TG、TC 水平比较，差异均无统计学意义（P ﹥0.05）；预防组患者治疗后颈总动脉 IMT、VPA，SS 均小于对照组（P ﹤0.05）。结论安脑丸可有效降低心肝火旺型中风先兆证患者继发中风发生率，减少颈总动脉 IMT，缩小颈总动脉 VPA，改善患者临床症状，但其无降脂效果，在应用时需配合使用降脂药物。
목적：관찰안뇌환대심간화왕형중풍선조증환자계발중풍적예방효과。방법선택아원중의문진2008년1월-2012년10월수치적심간화왕형중풍선조증환자61례，수궤분위예방조31례화대조조30례。량조환자균급여혈지강효낭구복，2립/차，2차/ d，예방조환자가용안뇌환，3 g/차，2차/ d；량조환자균련속치료8주，지후균단순구복혈지강효낭40개월。관찰량조환자계발중풍발병정황，치료전후경총동맥내막중층후도（IMT）、역손반괴횡절면적（VPA），중의증상적분（SS），혈청삼선감유（TG）、총담고순（TC）수평。결과대량조환자수방42개월，예방조계발중풍발생솔위9.7%，저우대조조적26.7%（P ﹤0.05）。량조환자치료전경총동맥 IMT、VPA，SS，혈청TG、TC 수평급치료후혈청 TG、TC 수평비교，차이균무통계학의의（P ﹥0.05）；예방조환자치료후경총동맥 IMT、VPA，SS 균소우대조조（P ﹤0.05）。결론안뇌환가유효강저심간화왕형중풍선조증환자계발중풍발생솔，감소경총동맥 IMT，축소경총동맥 VPA，개선환자림상증상，단기무강지효과，재응용시수배합사용강지약물。
Objective To observe the preventive effect to secondary stroke of Annao wan in patients with premonitory stroke diagnosed as hyperactivity of heart - fire and liver - fire in TCM. Methods A total of 61 patients with premonitory stroke diagnosed as hyperactivity of heart - fire and liver - fire in TCM were chosen,and then they were randomly divided into preven-tion group(n = 31)and control group( n = 30). Both groups given Xuezhikang capsule,two capsules per time,twice per day,and prevention group given extra Annao wan;both groups treated for 8 weeks,and then given Xuezhikang capsule on-ly. The incidence of secondary stroke,IMT and VPA of common carotid artery,symptoms scores(SS),TG,TC before and af-ter treatment were observed. Results The fellow - up lasted for 42 month of the two groups,the incidence of secondary stroke of prevention group was 9. 7% ,was lower than that of control group of 26. 7% (P ﹤ 0. 05). There was no significant differences of IMT and VPA of common carotid artery,SS,TG,TC before treatment between the two groups;after treatment,IMT and VPA of common carotid artery,SS of prevention group were less than those of control group(P ﹤ 0. 05),while there was no signifi-cant differences of TG,TC between the two groups. Conclusion Annao wan can effectively reduce the incidence of secondary stroke in patients with premonitory stroke diagnosed as hyperactivity of heart - fire and liver - fire in TCM,reduce IMT and VPA of common carotid artery,improve the clinical symptoms;but it is invalid in reducing lipid,that should combine with lipid -lower drugs.