本文關(guān)鍵詞：益氣活血方預防寒潮促發(fā)高血壓性腦卒中的臨床研究　出處：《廣州中醫(yī)藥大學》2016年碩士論文　論文類型：學位論文

  更多相關(guān)文章： 益氣活血方 寒潮 腦卒中 TCD

【摘要】：目的觀察益氣活血方對寒潮來臨時高血壓患者的預防作用,旨在建立中風的一級預防體系,采用隨機對照的實驗方法,探討益氣活血方對寒潮促發(fā)腦卒中的預防作用,探明其作用機理,豐富中風"正虛邪中"理論,具有重要臨床價值和巨大的社會效益與經(jīng)濟效益。方法1.收集2013年6月30日—2015年6月31日期間廣州中醫(yī)藥大學第三附屬醫(yī)院內(nèi)科符合選例標準的中風患者的病例資料共計124例,隨機分為治療組62例和對照組62例,兩組基礎(chǔ)療法相同,治療組加用益氣活血方治療,每個月至少服用湯藥2周,療程6個月,之后經(jīng)歷一次寒潮打擊。2.治療組與對照組在寒潮及強冷空氣來臨時終點事件發(fā)病率的對比分析,終點事件以發(fā)病時癥狀體征為參考,以頭顱CT或MRI確診腦卒中(包括腔隙性腦梗死、腦梗死、腦出血)的為準。3.入選時兩組分別行TCD檢查,經(jīng)歷寒潮后兩組再次行TCD檢查,最終在未出現(xiàn)終點事件的兩組病人中各隨機選取35例,兩組經(jīng)過年齡、性別的統(tǒng)計學分析對比無差異性。分別觀察兩組寒潮前后的大腦中動脈(MCA)收縮期峰值血流速度、臥位—立位MCA腦血流差值(CBFV)。收集病例完成后,采用SPSS20.0統(tǒng)計軟件進行分析對比兩組結(jié)果。成果1.經(jīng)統(tǒng)計分析,治療組62例患者在寒潮或強冷空氣來臨后出現(xiàn)腔隙性腦梗死2例,腦梗死3例,腦出血0例,發(fā)病率8.06%,對照組62例在寒潮或強冷空氣來臨后出現(xiàn)腔隙性腦梗死4例,腦梗死10例,腦出血1例,發(fā)病率24.19%。治療組較對照組在寒潮來臨時腦卒中發(fā)生率顯著降低,差異有統(tǒng)計學意義(P0.05)。2.排除發(fā)生終點事件的患者后,分別從兩組剩余患者中各隨機抽取30例患者,經(jīng)統(tǒng)計學分析,經(jīng)過危險因素對比分析,確定入選時無統(tǒng)計學差異,入選時兩組臥位—立位MCA腦血流差值(CBFV)比較無統(tǒng)計學差異(P0.05)。兩組患者雙側(cè)MCA峰值流速降低,雙側(cè)對比、兩組間比較無統(tǒng)計學差異(P0.05),兩組流速均低于正常值,有統(tǒng)計學差異(P0.05)。3.經(jīng)歷寒潮后治療組患者MCA峰值流速較對照組增快(P0.05),較正常值比較無統(tǒng)計學差異(P0.05),寒潮后治療組患者臥、立位CBFV均較對照組速度增快,差異有統(tǒng)計學意義(P0.05);治療組寒潮后與入選時相比,患者MCA峰值流速增快,差異有統(tǒng)計學意義(P0.05),治療組患者臥、立位CBFV血流均較前寒潮前增快,差異有統(tǒng)計學意義(P0.05),CBFV差值較寒潮前小,差異有統(tǒng)計學意義(P0.01)。結(jié)論1.豐富中風"正虛邪中"的理論,明確扶助正氣、避免感受外邪是預防中風的主要方法;2.益氣活血方能顯著降低寒潮促發(fā)的高血壓性腦卒中的發(fā)病率。3.益氣活血方預防卒中的可能機制是,提高血管的彈性,增加腦灌注,改善腦血流自動調(diào)節(jié)功能,有效抵御寒潮來臨時血管痙攣帶來的危害,從而降低寒潮所促發(fā)的腦卒中。
[Abstract]:Objective to observe the preventive effect of Yiqi Huoxue recipe (YQHXF) on patients with hypertension during cold wave, and to establish a primary prevention system for stroke, and to adopt a randomized controlled experimental method. To explore the preventive effect of Yiqi Huoxue recipe on stroke induced by cold wave, to find out its mechanism, and to enrich the theory of apoplexy. It has important clinical value and great social and economic benefits. Methods 1. Collect the cases of Internal Medicine of the third affiliated Hospital of Guangzhou University of traditional Chinese Medicine from June 30th 2013 to June 31st 2015. There were 124 standard stroke cases. Randomly divided into the treatment group of 62 cases and the control group of 62 cases, the two groups of basic therapy the same, treatment group plus Yiqi Huoxue prescription, at least 2 weeks each month, the course of treatment for 6 months. Treatment group and control group in the cold wave and the arrival of strong cold air incident incidence of the end point of the comparative analysis, the endpoint events in the onset of symptoms and signs as a reference. Ct or MRI was used to diagnose stroke (including lacunar infarction, cerebral infarction, cerebral hemorrhage). 3. TCD was performed in the two groups, and TCD was performed again in the two groups after cold wave. Finally, 35 patients were randomly selected from each group of patients who did not have an endpoint event, and the two groups passed through age. The peak systolic blood flow velocity of MCA in the middle cerebral artery before and after cold wave was observed in two groups. The cerebral blood flow difference of MCA in supine position and standing position was analyzed and compared with the two groups by SPSS20.0 software after collecting the cases. The results were analyzed and compared by statistical analysis. 1. In the treatment group, there were 2 cases of lacunar cerebral infarction, 3 cases of cerebral infarction and 0 cases of cerebral hemorrhage after cold surge or strong cold air. The incidence rate was 8.06%. In the control group, there were 4 cases of lacunar cerebral infarction, 10 cases of cerebral infarction and 1 case of cerebral hemorrhage after cold surge or strong cold air. The incidence of stroke in the treatment group was significantly lower than that in the control group at the onset of the cold wave, and the difference was statistically significant (P0.05. 2). After excluding the patients who had the terminal event, the incidence of stroke in the treatment group was significantly lower than that in the control group. 30 patients were randomly selected from each of the remaining patients in the two groups. After statistical analysis and comparative analysis of risk factors, it was confirmed that there was no statistical difference at the time of selection. There was no significant difference in cerebral blood flow difference (CBFV) between the two groups (P < 0.05). The peak flow velocity of bilateral MCA was decreased and the bilateral contrast was observed in the two groups. There was no statistical difference between the two groups (P 0.05), and the velocity of the two groups was lower than the normal value. The peak velocity of MCA in the treatment group was faster than that in the control group (P 0.05), but there was no significant difference compared with the normal value (P 0.05). In the treatment group after cold wave, the CBFV in supine and standing position increased faster than that in the control group, and the difference was statistically significant (P 0.05). In the treatment group, the peak velocity of MCA increased after cold wave, the difference was statistically significant (P 0.05). The blood flow of CBFV in the treatment group was faster than that before the cold wave. The difference of CBFV was significantly lower than that before cold wave. Conclusion 1.Conclusion 1. Enrich the theory of apoplexy, and clearly support the vital energy. 2. Avoiding external evil is the main method to prevent apoplexy. 2.Yiqi Huoxue prescription can significantly reduce the incidence of hypertensive stroke induced by cold wave .3.The possible mechanism of Yiqi Huoxue prescription to prevent stroke is to improve the elasticity of blood vessels and increase cerebral perfusion. To improve the automatic regulation of cerebral blood flow, effectively resist the harm of vasospasm in cold wave, and reduce the stroke caused by cold wave.
【學位授予單位】：廣州中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R277.7

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