本文選題：刺血　切入點(diǎn)：中醫(yī)療法　出處：《廣州中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:觀察刺血療法對高血壓腦出血急性期的中短期降壓效果,為刺血降壓提供依據(jù),明確刺血降壓對高血壓腦出血急性期患者血壓控制的可行性,進(jìn)一步探討刺血對高血壓腦出血患者預(yù)后的影響。方法:本課題將2016年5月至2017年3月期間廣東省中醫(yī)院高血壓腦出血急性期住院患者為研究對象,并根據(jù)病例納入、排除及剔除標(biāo)準(zhǔn)納入患者,患者隨機(jī)分為治療組及對照組,每組各30例患者。治療組:在使用西藥降壓的基礎(chǔ)治療上,對腦出血部位對側(cè)肢體十宣穴及耳尖穴進(jìn)行刺血治療;對照組:常規(guī)使用西藥降壓治療。研究人員通過觀察兩組患者血壓波動情況、腦血腫是否進(jìn)展、意識、肢體功能恢復(fù)情況等,如實(shí)填寫臨床病例觀察表,保存原始臨床資料。將各患者的臨床病例觀察表錄入Excel建立數(shù)據(jù)庫,運(yùn)用統(tǒng)計(jì)學(xué)軟件SPSS21.0對兩組數(shù)據(jù)進(jìn)行重復(fù)測量方差分析進(jìn)行數(shù)據(jù)統(tǒng)計(jì)。結(jié)果:本課題共計(jì)收集患者62名高血壓腦出血患者,剔除2名,因兩名患者提前出院而終止,最后共計(jì)納入60名高血壓腦出血患者。其中治療組和對照組分別有16、13例行手術(shù)治療,兩組患者均未出現(xiàn)死亡同時治療組患者經(jīng)刺血治療后均未出現(xiàn)不良反應(yīng)。經(jīng)統(tǒng)計(jì)學(xué)處理可知治療組與對照組的患者一般情況無統(tǒng)計(jì)學(xué)差異,治療前兩組患者來源于同一個總體。我們通過對兩組患者血壓進(jìn)行組間對比,發(fā)現(xiàn)刺血組患者血壓在刺血后短時間內(nèi)下降,血壓下降后血壓相對平穩(wěn),血壓控制效果優(yōu)于對照組;其他觀察指標(biāo)方面,經(jīng)統(tǒng)計(jì)學(xué)處理,結(jié)果提示兩組間GOS評分、GCS評分、腦血腫大小、肌力未見明顯統(tǒng)計(jì)學(xué)差異,但是組內(nèi)患者治療前后自身對照,發(fā)現(xiàn)組內(nèi)患者后的GOS評分、GCS評分、腦血腫大小、肌力與治療前對比有統(tǒng)計(jì)學(xué)差異。兩組患者中僅對照組發(fā)生1例腦血腫擴(kuò)大。此外初步統(tǒng)計(jì)治療組聯(lián)合使用的降壓藥物更少且血壓更平穩(wěn)。結(jié)論:高血壓腦出血急性期患者可采用刺血療法,該療法可在短時間內(nèi)降低血壓,同時使高血壓腦出血患者中短期血壓更加穩(wěn)定,血壓控制效果更佳。刺血療法具有祛邪扶正、清熱解毒、醒神開竅等功效,其可在一定程度上促進(jìn)患者的意識恢復(fù)、改善神經(jīng)功能缺損、維持腦血腫穩(wěn)定同時減少降壓藥使用。刺血療法為高血壓腦出血早期積極降壓提供迅速有效的治療方法,此療法讓傳統(tǒng)醫(yī)學(xué)與現(xiàn)代醫(yī)學(xué)優(yōu)勢互相結(jié)合,讓中西醫(yī)的更好的為人類健康服務(wù),也為傳統(tǒng)醫(yī)學(xué)的現(xiàn)代化應(yīng)用研究提供新方向。概而言之,該療法操作簡便,安全有效,值得在廣大基層推廣,讓更多患者受益。
[Abstract]:Objective: to observe the effect of blood pricking therapy on blood pressure reduction in the acute stage of hypertensive intracerebral hemorrhage, to provide basis for blood pricking and lowering blood pressure, and to determine the feasibility of blood pressure control in patients with hypertensive intracerebral hemorrhage at the acute stage of hypertensive intracerebral hemorrhage. Methods: from May 2016 to March 2017, the inpatients with hypertensive intracerebral hemorrhage in Guangdong Provincial Hospital of traditional Chinese Medicine were included in the study. The patients were randomly divided into treatment group (n = 30) and control group (n = 30). Control group: routine use of western medicine to reduce blood pressure. By observing the fluctuation of blood pressure, progress of cerebral hematoma, consciousness, recovery of limb function, and so on, the researchers truthfully filled out the observation form of clinical cases. Save the original clinical data. Input the clinical observation form of each patient into the Excel to establish the database. Results: 62 patients with hypertensive intracerebral hemorrhage were collected, 2 patients were excluded, and 2 patients were terminated because two patients were discharged early. Finally, a total of 60 patients with hypertensive intracerebral hemorrhage were included. Among them, 1613 patients in the treatment group and the control group received surgical treatment respectively. There was no death in the two groups and there was no adverse reaction in the treatment group after blood prick treatment. There was no statistical difference between the treatment group and the control group. Before treatment, the two groups came from the same population. By comparing the blood pressure between the two groups, we found that the blood pressure of the patients in the blood pricking group decreased in a short period of time after the prick, and the blood pressure after the blood pressure drop was relatively stable. The effect of blood pressure control was better than that of the control group. The results showed that there was no significant difference in GOS score, hematoma size and muscle strength between the two groups, but there was no significant difference between the two groups before and after treatment, but there was no significant difference between the two groups before and after treatment. The GOS score, the size of cerebral hematoma, and the size of cerebral hematoma were found in the patients of the group. There was statistical difference between muscle strength and pre-treatment. In the two groups, only one case of cerebral hematoma was enlarged in the control group. In addition, the combined use of antihypertensive drugs and blood pressure in the preliminary statistical treatment group was less and the blood pressure was more stable. Conclusion: hypertensive intracerebral hemorrhage is more stable. Patients in acute stage can be treated with blood pricking therapy. This therapy can lower blood pressure in a short time, at the same time make the blood pressure of patients with hypertensive intracerebral hemorrhage more stable, blood pressure control effect is better. Pricking blood therapy has the functions of dispelling evil and strengthening, clearing away heat and detoxifying, waking up the spirit and opening the orifices, etc. To a certain extent, it can promote the recovery of consciousness, improve the nerve function defect, maintain the stability of cerebral hematoma and reduce the use of antihypertensive drugs. Blood pricking therapy can provide a rapid and effective treatment for the early stage of hypertensive intracerebral hemorrhage. This therapy combines the advantages of traditional medicine and modern medicine, so that traditional Chinese and western medicine can better serve human health, and also provide a new direction for the modern application of traditional medicine. In summary, the treatment is simple, safe and effective. Worth popularizing in broad grass-roots, let more patient benefit.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R743.34

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