Abstract： BACKGROUND: Traditional Chinese medicine (TCM) believes that the treatment for stroke at exacerbation should emphasize on reducing fever,calming the wind, resolving phlegm and removing blood stasis, and should pay more attention to inducing resuscitation.OBJECTIVE: To observe the protective effect on neurons by the TCM methods for dissolving the turbid with aromatics and eliminating the phlegm for resuscitation in patients with acute ischemic stroke.DESIGN: A comparative observation.SETTING: Department of Traditional Chinese Medicine, People's Hospital affiliated to Peking University Health Science Center.PARTICIPANTS: Sixty-seven inpatients diagnosed to have cerebral infarction within 72 hours after the attack were selected from the Emergency Department and Department of Traditional Chinese Medicine, Peking University Health Science Center between July 2000 and August 2001. They were randomly divided into treatment group (odd number, n=33, 19 males and 14 females) and control group (even number, n=34, 22 males and 12 females).METHODS: ①The patients were selected according to the diagnostic standard about cerebral infarction and the results of cerebral CT. ② TCM typing: In the treatment group, there were 13 cases of internal block due to phlegm and heat, 9 of internal excess due to stagnation of phlegm, 7 of internal block due to blood stasis and 4 of deficiency of qi due to blood stasis. In the control gToup, there were 12 cases of internal block due to phlegm and heat, 13 of internal excess due to stagnation of phlegm, 8 of internal block due to blood stasis and 1 of deficiency of qi due to blood stasis. The standards for TCM syndrome differentiation and integral referred to the Standards for the Differentiation of Stroke Syndrome set by the scientific research group of State Administration of Traditional Chinese Medicine of China. ③ Patients in the treatment group and control group were treated with Xingnaojing injection and Danshen injection respectively.The levels of endothelin, tumor necrosis factor (TNF-α) and nitric oxide in plasma were detected before treatment and at 2 weeks after treatment, and the results were compared.MAIN OUTCOME MEASURES: The levels of endothelin, tumor necrosis factor (TNF-α) and nitric oxide in plasma, the liver and renal functions were detected before treatment and at 2 weeks after treatment.RESULTS: All the 67 patients with cerebral infarction were involved in the analysis of results. ①The integrals of syndromes of internal block due to phlegm and heat and internal excess due to stagnation of phlegm and the neurologic deficit score in the treatment group after treatment were very significantly decreasedas compared with those before treatment[(17.94±5.22), (25.66±6.39); (17.12±4.98), (23.89±5.31) ,P ＜ 0.01], also significantly different from those in the control group after treatment[(17.94 ±5.22), (22.37 ±5.24); ( 17.12 ±4.98 ), (23.49 ±4.96),P ＜ 0.05],suggesting that the effects of Xingnaojing on the two syndromes and nerve function were better than those of Danshen. ② The concentrations of endothelin, TNF-α and nitric oxide in the treatment group after treatment were markedly decreased as compared with those before treatment, and TNF-α decreased more significantly.CONCLUSION: TCM methods for dissolving the turbid with aromatics and eliminating the phlegm for resuscitation in treating patients with acute ischemic stroke has various protections on the neurons of patients with ischemic stroke, which has provided new thoughts for TCM in preventing and treating the neural apoptosis induced by ischemia/reperfusion in the future.