【摘要】：目的：通過臨床觀察臭氧（O3）治療對急性期腦梗塞患者血清中谷氨酸（GLU）水平的影響，探討其對急性期腦梗塞的療效及對預(yù)后的影響，為臭氧（O3）治療在腦血管疾病上的臨床應(yīng)用提供理論依據(jù)，并驗證興奮性氨基酸是與臨床療效一致的化驗指標(biāo)，且其數(shù)值可反映急性期腦梗塞的患者病情的緩急輕重，并對其作以分析探討。 方法：將于2012.8-2013.1期間沈陽市第二中醫(yī)院救治的急性腦梗塞的患者，根據(jù)患者的腦梗塞部位，面積，發(fā)病時間等篩選60例并分組。治療組（應(yīng)用臭氧自體血回輸治療30例）和對照組（常規(guī)藥物治療30例),兩組均于發(fā)病72h內(nèi)接受治療。對照組采用脫水降顱壓，控制血壓，應(yīng)用腦細胞保護劑等常規(guī)藥物治療,治療組在常規(guī)療法基礎(chǔ)上加用臭氧自體血回輸治療，用專用采血袋，取患者肘正中靜脈，采血100毫升，與濃度為47μg/ml的醫(yī)用臭氧100ml，按1：1比例混合，經(jīng)過5-10分鐘，，與血液充分混合后，15分鐘內(nèi)回輸至患者體內(nèi)，每日一次，14天為一個療程。入組后1天，3天，7天，14天檢測采用分光光度法測定血漿谷氨酸水平，以及進行相關(guān)療效評判，并對記錄之結(jié)果行統(tǒng)計學(xué)分析。 結(jié)果： 1.臨床表現(xiàn) 應(yīng)用臭氧自體血回輸治療14天后，治療組與對照組比，神經(jīng)功能缺損評分明顯降低，差異有顯著性意義(P0.05)；證實治療組神經(jīng)功能恢復(fù)良好，優(yōu)于對照組。另外，患者經(jīng)治后，半身不遂、口眼歪斜、舌強言蹇或不語等臨床癥狀好轉(zhuǎn)情況，治療組更為明顯。 2.理化檢查 應(yīng)用臭氧自體血回輸治療14天后，治療組與對照組對比，治療組血漿谷氨酸明顯低于對照組，差異有顯著性意義(P0.05或P0.01)。 3.整體療效 治療后，采用《中國神經(jīng)功能缺損評定標(biāo)準》[2]進行評分，行療效評判。其中，對照組基本治愈1例，顯著進步7例，進步13例，無效9例，總有效率70.00%，治療組基本治愈4例，顯著進步12例，進步9例，無效5例，總有效率83.33%，經(jīng)統(tǒng)計分析證實，治療組療效明顯優(yōu)于對照組，差異有統(tǒng)計學(xué)意義(P＜0.05)。 結(jié)論：采用臭氧自體血回輸治療同時檢測血清興奮性氨基酸水平，對急性期腦梗塞的臨床療效確實，既可促進神經(jīng)功能盡快恢復(fù)，又可提示預(yù)后水平。興奮性氨基酸是與腦梗塞的臨床療效一致的化驗指標(biāo)，且其數(shù)值標(biāo)志著患者病情緩急輕重。臭氧治療其機制之一可能與降低血漿興奮性氨基酸水平有關(guān)。
[Abstract]:Objective: to observe the effect of ozone (O3) treatment on serum glutamate (GLU) level in patients with acute cerebral infarction, and to explore its effect on acute cerebral infarction and its influence on prognosis. To provide a theoretical basis for the clinical application of ozone (O3) in the treatment of cerebrovascular diseases, and to verify that the excitatory amino acid is the same as the clinical efficacy, and its value can reflect the severity of the patients with acute cerebral infarction. It is analyzed and discussed. Methods: 60 patients with acute cerebral infarction who were treated in Shenyang second traditional Chinese Medicine Hospital from 2018 to 2013.1 were selected and divided according to the location, area and time of onset of cerebral infarction. The treatment group (30 cases were treated with ozone autologous blood transfusion) and the control group (30 cases with routine drug therapy) were treated within 72 hours after the onset of the disease. The control group was treated with dehydration, blood pressure control, brain cell protectant and other routine drugs. The treatment group was treated with ozone autologous blood transfusion on the basis of routine therapy. 100 ml of medical ozone was mixed with 47 渭 g/ml of medical ozone at 1:1. After 5 to 10 minutes of mixing with blood, it was infused to the patients within 15 minutes, once a day, 14 days as a course of treatment. The plasma glutamate levels were measured by spectrophotometry on day 1, day 3, day 7 and day 14 after admission, and the results were analyzed statistically. Results: 1. After 14 days of ozone autologous blood transfusion, the neurological deficit score in the treatment group was significantly lower than that in the control group (P0.05). It was proved that the nerve function of the treatment group was better than that of the control group. In addition, the patients after treatment, hemiplegia, mouth and eye skew, tongue-strong or silent and other clinical symptoms improved, the treatment group was more obvious. 2. After 14 days of ozone autologous blood transfusion, compared with the control group, the plasma glutamate in the treatment group was significantly lower than that in the control group (P0.05 or P0.01). 3. After the whole treatment, the evaluation standard of Chinese nerve function defect [2] was used to evaluate the curative effect. In the control group, 1 case was basically cured, 7 cases were improved significantly, 13 cases were improved, 9 cases were ineffective, and the total effective rate was 70.000.In the treatment group, 4 cases were cured, 12 cases were improved significantly, 9 cases were improved, 5 cases were ineffective, and the total effective rate was 83.33%. Statistical analysis showed that the curative effect of the treatment group was significantly better than that of the control group, and the difference was statistically significant (P < 0.05). Conclusion: the level of serum excitatory amino acids in patients with acute cerebral infarction treated by ozone autologous blood transfusion can not only promote the recovery of nerve function, but also indicate the level of prognosis. Excitatory amino acid is the same as the clinical efficacy of cerebral infarction, and its value indicates the patient's disease priority. One of the mechanisms of ozone therapy may be related to the reduction of plasma excitatory amino acid levels.
【學(xué)位授予單位】：遼寧中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R743.33

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