發(fā)布時(shí)間：2018-02-13 11:51

  本文關(guān)鍵詞： 神經(jīng)病理性疼痛 血液流變學(xué) 右美托咪定　出處：《西南醫(yī)科大學(xué)》2017年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：目的:本課題旨在觀察神經(jīng)病理性疼痛患者血液流變學(xué)的變化,探討右美托咪定對(duì)神經(jīng)病理性疼痛患者血液流變學(xué)的影響及其可能機(jī)制,從血液流變學(xué)角度為治療神經(jīng)病理性疼痛提供臨床參考。方法:選擇西南醫(yī)科大學(xué)附屬中醫(yī)醫(yī)院疼痛科2015年8月-2016年8月期間符合納入標(biāo)準(zhǔn)的神經(jīng)病理性疼痛患者共60例以及同期西南醫(yī)科大學(xué)附屬中醫(yī)院體檢中心符合要求的健康人30例。將健康人分為健康對(duì)照組(C組,n=30),將60例神經(jīng)病理性疼痛患者分為右美托咪定組(D組,n=30)和生理鹽水組(NS組,n=30)。右美托咪定組(D組):右美托咪定+神經(jīng)病理性疼痛常規(guī)治療;生理鹽水組(NS組):生理鹽水+神經(jīng)病理性疼痛常規(guī)治療。D組和NS組分別于治療前、治療3天、治療7天三個(gè)時(shí)間點(diǎn)檢測(cè)血液粘度和紅細(xì)胞流變學(xué)指標(biāo),檢測(cè)血清SOD活力、MDA和Cor含量,并制作血涂片觀察紅細(xì)胞形態(tài)變化;同時(shí)記錄VAS評(píng)分、SDS評(píng)分。C組檢測(cè)一次血液粘度和紅細(xì)胞流變學(xué)指標(biāo)、血清SOD活力、MDA和Cor含量及制作血涂片觀察紅細(xì)胞形態(tài)。結(jié)果:1、三組研究對(duì)象一般情況的比較均無(wú)統(tǒng)計(jì)學(xué)意義(P㧐0.05)。2、T0時(shí)刻:與C組比較D組和NS組患者Hηb、Lηb、ηp、EAI、MDA、ERI、Cor、紅細(xì)胞畸變率均增加,EDI和SOD下降,差異均有統(tǒng)計(jì)學(xué)意義(P㩳0.05);D組和NS組各指標(biāo)比較無(wú)統(tǒng)計(jì)學(xué)意義(P㧐0.05)。3、T1和T2時(shí)刻D組和NS組組間比較:D組各指標(biāo)(Hηb、Lηb、ηp、EAI、MDA)在T1和T2時(shí)刻均較NS組明顯降低(P㩳0.05);D組EDI在T1和T2時(shí)刻均較NS組明顯升高(P㩳0.05);D組各指標(biāo)(Cor、VAS評(píng)分、紅細(xì)胞畸變率)在T1時(shí)刻低于NS組,但無(wú)統(tǒng)計(jì)學(xué)意義(P㧐0.05),在T2時(shí)刻低于NS組(P㩳0.05);D組ERI在T1時(shí)刻高于NS組,但無(wú)統(tǒng)計(jì)學(xué)意義(P㧐0.05),在T2時(shí)刻低于NS組(P㩳0.05);D組SOD在T1時(shí)刻高于NS組,但無(wú)統(tǒng)計(jì)學(xué)意義(P㧐0.05),在T2時(shí)刻高于NS組(P㩳0.05);D組SDS評(píng)分在T2時(shí)刻低于NS組(P㩳0.05)。4、D組和NS組組內(nèi)比較:(1)D組各指標(biāo)變化趨勢(shì):Hηb、Lηb、ηp、EAI、MDA、Cor、VAS評(píng)分、紅細(xì)胞畸變率與T0比較,T1顯著降低(P㩳0.05),至T2繼續(xù)降低(P㩳0.05);ERI在T1時(shí)刻低于T0,但差異無(wú)統(tǒng)計(jì)學(xué)意義(P㧐0.05),T2時(shí)刻低于T1(P㩳0.05);SOD在T1時(shí)刻高于T0(P㩳0.05),至T2繼續(xù)升高至(P㩳0.05);EDI在T1時(shí)刻高于T0(P㩳0.05),但T1與T2比較無(wú)差異(P㧐0.05);MDA在T1時(shí)刻低于T0(P㩳0.05),在T2時(shí)刻低于T1,但差異無(wú)統(tǒng)計(jì)學(xué)意義(P㧐0.05)。(2)NS組各指標(biāo)變化趨勢(shì):Hηb、ηp、EAI、Cor、VAS評(píng)分與T0比較,T1指標(biāo)顯著降低(P㩳0.05),至T2繼續(xù)降低(P㩳0.05);NS組各指標(biāo)(Lηb、ηp、紅細(xì)胞畸變率)在T1時(shí)刻低于T0,但差異無(wú)統(tǒng)計(jì)學(xué)意義(P㧐0.05),在T2時(shí)刻低于T1(P㩳0.05);SOD和EDI在T1時(shí)刻高于T0,但差異無(wú)統(tǒng)計(jì)學(xué)意義(P㧐0.05),在T2時(shí)刻高于T1(P㩳0.05);MDA在T1時(shí)刻低于T0,至T2繼續(xù)降低,但差異均無(wú)統(tǒng)計(jì)學(xué)意義(P㧐0.05)。(3)SDS評(píng)分的組內(nèi)比較:兩組均T2低于T0,差異具有統(tǒng)計(jì)學(xué)意義(P㩳0.05)。結(jié)論:1、神經(jīng)病理性疼痛患者血液粘度增加,紅細(xì)胞變形能力減弱,紅細(xì)胞聚集性和紅細(xì)胞畸變率增加,且機(jī)體處于氧化應(yīng)激狀態(tài);2、右美托咪定可有效減輕神經(jīng)病理性疼痛患者的疼痛和抑郁程度;3、右美托咪定可有效改善神經(jīng)病理性疼痛患者血液流變性。
[Abstract]:Objective: the purpose of this study is to observe the change of blood rheology in patients with neuropathic pain, to investigate the effect of dexmedetomidine on Hemorheology of patients with neuropathic pain and its possible mechanism, to provide clinical reference for the treatment of neuropathic pain from the point of view of hemorheology. Methods: Southwest Medical University Affiliated Hospital of traditional Chinese Medicine Department of pain during August August 2015 -2016 inclusion the standard of neuropathic pain in patients with a total of 60 cases of the same period and the Southwest Medical University Affiliated Hospital of traditional Chinese medicine medical center to meet the health requirements of the 30 cases of healthy people. Will be divided into healthy control group (group C, n=30), 60 patients with neuropathic pain were randomly divided into dexmedetomidine group (group D, n=30) and physiological saline group (group NS, n=30). Dexmedetomidine group (D group): Dexmedetomidine + conventional treatment of neuropathic pain; saline group (NS group): saline + neuropathic 鐤肩棝甯歌娌葷枟.D緇勫拰NS緇勫垎鍒簬娌葷枟鍓，

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