本文選題：中西醫(yī)結(jié)合　切入點(diǎn)：缺血性　出處：《河北醫(yī)科大學(xué)》2016年碩士論文

【摘要】：目的:通過(guò)選擇我院康復(fù)科缺血性中風(fēng)病病人,按照中風(fēng)病診療規(guī)范,給予常規(guī)藥物以及康復(fù)訓(xùn)練等綜合治療的基礎(chǔ)上,同時(shí)配合音樂(lè)、針灸、中藥、熏蒸等個(gè)性化方案,觀察中西醫(yī)結(jié)合個(gè)性化康復(fù)方案對(duì)缺血性中風(fēng)病運(yùn)動(dòng)功能障礙的影響,評(píng)價(jià)中西醫(yī)個(gè)性化康復(fù)方案對(duì)缺血性中風(fēng)病病人的治療效果,評(píng)價(jià)其治療作用及安全性。方法:根據(jù)選取標(biāo)準(zhǔn),選擇2014年9月-2015年9月邢臺(tái)市人民醫(yī)院康復(fù)科缺血性中風(fēng)病伴有運(yùn)動(dòng)功能障礙的病人60例,按照單純隨機(jī)抽樣分組的原則分為對(duì)照組和治療組,兩個(gè)組均給予常規(guī)內(nèi)科治療,治療組再給予中西醫(yī)結(jié)合個(gè)性化康復(fù)方案(中醫(yī)治療方法+西醫(yī)治療方法),對(duì)照組給予西醫(yī)康復(fù)治療方案。西醫(yī)康復(fù)方案:基礎(chǔ)康復(fù)治療。中醫(yī)康復(fù)方案包括:中醫(yī)音樂(lè)療法:根據(jù)中醫(yī)“五型人”分類方法,對(duì)病人給予不同類型的音樂(lè)治療,每日2小時(shí),分為早:8:00-9:00;下午15:00-16:00。中藥內(nèi)服:每天一劑,一次100毫升,早晚各一次。針灸:選取肩井穴、肩隅穴、曲池穴、合谷穴、伏兔穴、昆侖穴、太沖穴、足三里穴、陽(yáng)陵泉穴、委中穴。病人姿勢(shì):囑咐病人盡量采取仰臥位,對(duì)病人采納常規(guī)針灸手法(提插捻轉(zhuǎn)),得氣后留針30分鐘,注意避免暈針、斷針等反應(yīng)。中藥熏蒸:獨(dú)活15克,桑寄生15克,羌活15克,秦艽15克,薄荷10克,藏紅花10克,檀香15克,五味子10克,細(xì)辛6克。將上述藥物煎液后用于治療有功能障礙的一側(cè),在藥液溫度較高時(shí)利用蒸汽熏蒸患側(cè),待中藥藥液溫度降低之45℃左右時(shí),用藥液將患側(cè)熱擦25分鐘,每日進(jìn)行1-2次。每組的治療與訓(xùn)練時(shí)間為周一至周五(不包括藥物治療),療程為1個(gè)月。病人入院時(shí)予康復(fù)評(píng)定一次,治療一個(gè)月后進(jìn)行第二次評(píng)定。評(píng)定結(jié)果納入統(tǒng)計(jì)分析�？祻�(fù)訓(xùn)練期間,觀察病人的訓(xùn)練態(tài)度,生活習(xí)慣,盡量減少干擾。根據(jù)治療前后兩組FMA評(píng)定法、美國(guó)國(guó)立衛(wèi)生院腦卒中評(píng)定表(NIHSS)和日常生活能力評(píng)定(BI)結(jié)果的統(tǒng)計(jì)分析,來(lái)觀察中西醫(yī)結(jié)合個(gè)性化康復(fù)方案對(duì)缺血性中風(fēng)病運(yùn)動(dòng)功能障礙的療效及實(shí)用性。結(jié)果:1兩組病人,在經(jīng)過(guò)中西醫(yī)結(jié)合個(gè)性化方案和單純西醫(yī)治療方案的治療后,肢體運(yùn)動(dòng)功能(FMA)均有顯著的改善,治療組優(yōu)于對(duì)照組,組間差異有統(tǒng)計(jì)學(xué)意義(P0.01)。2兩組病人,在經(jīng)過(guò)中西醫(yī)結(jié)合個(gè)性化方案和單純西醫(yī)治療方案的治療后,日常生活能力評(píng)定(BI)均有顯著的改善,治療組優(yōu)于對(duì)照組,組間差異有統(tǒng)計(jì)學(xué)意義(P0.01)。3兩組病人,在經(jīng)過(guò)中西醫(yī)結(jié)合個(gè)性化方案和單純西醫(yī)治療方案的治療后,腦卒中評(píng)定(NIHSS)均有顯著的改善,治療組優(yōu)于對(duì)照組,組間差異有統(tǒng)計(jì)學(xué)意義(P0.01)�？祻�(fù)治療過(guò)程中未見病人不良反應(yīng),此項(xiàng)治療具有相對(duì)的安全性。結(jié)論:1缺血性中風(fēng)病偏癱病人,在給予常規(guī)康復(fù)訓(xùn)練基礎(chǔ)上,配合中西醫(yī)結(jié)合個(gè)性化康復(fù)治療方案,增強(qiáng)病人訓(xùn)練積極性,可有效提高病人康復(fù)效率。2與單獨(dú)的使用西醫(yī)康復(fù)手段相比,中西醫(yī)結(jié)合個(gè)性化康復(fù)方案治療缺血性中風(fēng)病偏癱病人,康復(fù)效果更加明顯,可以有效縮短病人康復(fù)治療時(shí)間,提升康復(fù)治療水平。3中西醫(yī)結(jié)合個(gè)性化康復(fù)方案安全性較高,無(wú)明顯不良反應(yīng),是一種安全可靠的康復(fù)手段。這為臨床康復(fù)提供了新的手段和方法,適合一般病人的康復(fù)需求,有利于病人回歸社會(huì),具有一定的臨床發(fā)展前景,符合我國(guó)醫(yī)療發(fā)展的趨勢(shì)。4中醫(yī)傳統(tǒng)康復(fù)手段結(jié)合西醫(yī)康復(fù)方法,能夠更好的提高康復(fù)效果,發(fā)揮各自的優(yōu)勢(shì),減少病人及家屬的家庭和社會(huì)負(fù)擔(dān)。中西醫(yī)結(jié)合個(gè)性化康復(fù)方案,能夠推動(dòng)康復(fù)醫(yī)療技術(shù)的進(jìn)步,進(jìn)而推動(dòng)傳統(tǒng)中醫(yī)走向世界,與世界先進(jìn)的康復(fù)技術(shù)相接軌。這不僅使我國(guó)的康復(fù)醫(yī)療水平得到提高,也減少了國(guó)家的經(jīng)濟(jì)損失,促進(jìn)了社會(huì)的和諧發(fā)展。
[Abstract]:Objective: through the selection of our hospital rehabilitation of ischemic stroke patients, according to the standard of diagnosis and treatment of stroke, given routine medicine and rehabilitation training on the comprehensive treatment, at the same time with the music, acupuncture, Chinese medicine fumigation, personalized programs, combined with individualized rehabilitation program observation effect on ischemic stroke movement dysfunction of traditional Chinese medicine and Western medicine treatment effect evaluation Chinese and Western medicine individualized rehabilitation scheme on ischemic stroke patients, to evaluate the curative effect and safety. Methods: according to the selection criteria, 60 cases of September 2014 -2015 year in September the rehabilitation department of Xingtai People's Hospital with motor dysfunction of ischemic stroke patients, according to the principle of random sampling in the group divided into treatment group and control group, two groups the treatment group received routine medical treatment and individualized rehabilitation program combining traditional Chinese and Western Medicine (TCM treatment plus Western medicine treatment Method), the control group received rehabilitation treatment. Western medicine Western medicine: basic rehabilitation. Including the rehabilitation scheme of traditional Chinese medicine: Chinese music therapy: according to the classification of traditional Chinese medicine "five type" method, given different types of music therapy for patients, 2 hours a day, divided into early: 8: 00-9:00; 15:00-16:00. p.m. every day: Chinese medicine an agent, a 100 ml, sooner or later each time. Acupuncture: select Jianjing, shoulder corner point, Quchi, Hegu, down the rabbit hole, Kunlun cave, Taichong, Zusanli, Yanglingquan, Weizhong. Patient posture: patient supine position to take charge of the patient, adopt routine acupuncture (lifting thrusting twirling), have left 30 minutes, avoid fainting, breakage and other reactions. Traditional Chinese medicine fumigation: Angelica 15 grams, 15 grams of 15 grams Loranthaceae, notopterygium, Gentiana 15 grams, 10 grams of mint, saffron 10 grams, 15 grams of sandalwood, Schisandra 10 grams, 6 grams of Asarum. The medicine decoction after use In the treatment of dysfunctional side, the use of steam fumigation affected side in the liquid when the temperature is higher, the traditional Chinese medicine liquid temperature decreased 45 degrees Celsius, liquid medicine will ipsilateral hot rub for 25 minutes, 1-2 times a day. The treatment and training time each Monday to Friday (not including drug therapy, treatment for 1) months. Patients on admission to rehabilitation evaluation once a month after treatment. Results the second evaluation included in the statistical analysis. The patients were observed during rehabilitation training, training attitude, habits, try to reduce interference. According to the two groups before and after treatment FMA assessment method, National Institutes of Health Stroke scale (NIHSS) and ADL (BI) the results of the statistical analysis, to observe the curative effect and practicability of combining traditional Chinese and Western medicine individualized rehabilitation scheme on ischemic stroke movement dysfunction. Results: 1 patients in the two groups, through the combination of traditional Chinese and Western medicine personality The treatment scheme and pure western medicine treatment, limb motor function (FMA) were significantly improved in treatment group than the control group, there was significant difference between the groups (P0.01.2) two groups of patients, after treatment of traditional Chinese and Western medicine and simple western medicine personalized program scheme, ADL (BI) were significantly improved in treatment group than the control group, there was significant difference between the groups (P0.01.3) two groups of patients, after treatment of traditional Chinese and Western medicine and simple western medicine treatment individualized after stroke assessment (NIHSS) were significantly improved in treatment group than the control group, there was statistical significance between the groups the difference (P0.01). No adverse reactions during the treatment of rehabilitation of patients, is relatively safe in the treatment. Conclusion: 1 ischemic stroke hemiplegia patients received routine rehabilitation training, on the basis, combined with the character of traditional Chinese medicine and Western Medicine Rehabilitation treatment, strengthen the patient training initiative, can effectively improve the efficiency of rehabilitation of patients with.2 compared with the use of Western medicine rehabilitation therapy alone, individualized rehabilitation regimen in the treatment of ischemic stroke patients with hemiplegia rehabilitation of traditional Chinese and Western medicine, the effect is more obvious, can effectively shorten the time of rehabilitation patients, enhance the combination of personalized rehabilitation scheme with high security level of rehabilitation the.3 of traditional Chinese medicine and Western medicine, no obvious adverse reactions, is a safe and reliable means of rehabilitation. This provides new means and methods for clinical rehabilitation, rehabilitation needs for patients, help patients return to society, has certain clinical development prospects, in line with the trend of.4 Chinese traditional Chinese medical development means of rehabilitation combined with western medicine rehabilitation methods, can improve the rehabilitation effect better, play their respective advantages, reduce patient and family burden of family and society in traditional Chinese and Western medicine. With personalized rehabilitation, rehabilitation can promote the progress of medical technology, and promote the traditional Chinese medicine to the world, combined with the rehabilitation of the world advanced technology. It not only improve the rehabilitation level of our country, but also to reduce the economic loss, and promote the harmonious development of the society.

【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R743

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