本文選題：通腦飲 + 急性缺血性腦梗死��； 參考：《南京中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的：探討中藥方劑通腦飲對(duì)于氯吡格雷慢代謝基因型的急性缺血性腦卒中患者在促進(jìn)神經(jīng)功能恢復(fù)和改善血管狹窄等方面的臨床療效。方法：基于氯吡格雷CYP2C19的基因類型,可以將人群分為快代謝(EM)、中代謝(IM)、慢代謝(PM)三類,本次研究對(duì)象主要為慢代謝型及快代謝型,各選入40例患者。其中,慢代謝(PM組)為治療組,快代謝(EM組)為對(duì)照組。快代謝組以氯吡格雷75mg qd單抗治療為主,慢代謝組以阿司匹林100mg qd加用通腦飲250ml bid為主,余治療均給以同樣的西醫(yī)基礎(chǔ)藥物,口服藥物療程均為3個(gè)月,分別于首診日,治療第7日、14日及90日觀察中醫(yī)癥狀、神經(jīng)功能缺損評(píng)分、生活能力狀態(tài)、中風(fēng)復(fù)發(fā)率狀況,研究其對(duì)中慢代謝患者神經(jīng)功能恢復(fù)的臨床療效；觀察首診日及治療第90天大腦中動(dòng)脈流速變化。結(jié)果：治療后,兩組大腦中動(dòng)脈流速較前均有下降(P0.05),神經(jīng)功能缺損評(píng)分和改良Rankin評(píng)分較治療前均有顯著下降(P0.05),同時(shí)改良Barthel指數(shù)較前均顯著升高(P0.05)；通腦飲組神經(jīng)功能缺損評(píng)分、改良Rankin評(píng)分等較氯吡格雷單抗對(duì)照組組差異具有統(tǒng)計(jì)學(xué)意義(均P0.05),并且在改善大腦中動(dòng)脈狹窄方面的療效不亞于氯吡格雷組。結(jié)論：通腦飲可以明顯改善氯吡格雷慢代謝基因型急性缺血性腦梗死患者神經(jīng)功能缺損癥狀、提高患者生活質(zhì)量、改善顱內(nèi)動(dòng)脈狹窄,與阿司匹林單抗聯(lián)用療效顯著。
[Abstract]:Objective: to investigate the clinical efficacy of Tongnao decoction (TNY) in promoting the recovery of nerve function and improving vascular stenosis in patients with acute ischemic stroke with clopidogrel slow metabolic genotype. Methods: based on the gene types of clopidogrel CYP2C19, the population could be divided into three groups: fast metabolic CYP2C19, middle metabolic CYP2C19 and slow metabolic CYP2C19. The subjects of this study were mainly slow metabolic type and fast metabolic type, each of which was selected from 40 patients. The slow metabolism group (PM group) and the fast metabolism group (EM group) were used as the control group. The fast metabolism group was treated with clopidogrel 75mg QD monoclonal antibody, the slow metabolism group was treated with aspirin 100mg QD plus Tongnaoyin 250ml bid, and the rest of the treatment was given the same western medicine. The course of oral treatment was 3 months, respectively, on the first day of diagnosis. On the 7th, 14th and 90th day of treatment, the symptoms of traditional Chinese medicine (TCM), the score of neurological deficit, the state of living ability and the recurrence rate of apoplexy were observed, and the clinical curative effect on the recovery of nerve function in patients with moderate and slow metabolism was studied. The velocity of middle cerebral artery (MCA) was observed on the first day of diagnosis and 90 days after treatment. Results: after treatment, the flow velocity of the middle cerebral artery in both groups was lower than that before treatment (P 0.05), the neurological deficit score and the modified Rankin score were significantly lower than those before treatment, and the modified Barthel index was significantly higher than that before treatment, and the nerve function defect score of Tongnaoyin group was significantly higher than that of the control group. The modified Rankin score was significantly higher than that of clopidogrel monoclonal antibody control group (all P 0.05), and the effect on improving middle cerebral artery stenosis was no less effective than that in clopidogrel group. Conclusion: Tongnaoyin can obviously improve the symptoms of neurological deficit, improve the quality of life and improve the stenosis of intracranial artery in patients with clopidogrel slow metabolic genotype acute ischemic cerebral infarction.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R277.7

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

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本文編號(hào)：1930731