發(fā)布時(shí)間：2018-01-21 19:52

  本文關(guān)鍵詞： 腦梗死 化痰通絡(luò)湯 針灸 血脂 血液流變學(xué)　出處：《廣西中醫(yī)藥大學(xué)》2016年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：目的:觀察以化痰通絡(luò)湯為主方加減聯(lián)合頭皮針治療急性腦梗死(風(fēng)痰瘀阻證)的臨床療效,為中醫(yī)藥治療急性腦梗死提供中醫(yī)理論基礎(chǔ)。方法:選擇2014年6月~2015年6月廣西中醫(yī)藥大學(xué)附屬欽州市中醫(yī)醫(yī)院收治的80例腦梗死急性期患者,中醫(yī)符合風(fēng)痰瘀阻證,并均經(jīng)頭部CT或MRI檢查確診。采用隨機(jī)數(shù)字標(biāo)法隨機(jī)分為觀察組和對(duì)照組,每組各40例。對(duì)照組予阿司匹林腸溶片、阿托伐他汀鈣片等常規(guī)西醫(yī)治療,觀察組在對(duì)照組西醫(yī)常規(guī)治療基礎(chǔ)上予化痰通絡(luò)湯加減聯(lián)合頭皮針治療,治療15d后觀察比較兩組的臨床療效,兩組治療前后神經(jīng)功能缺損評(píng)分及中醫(yī)癥候積分的變化情況,同時(shí)檢測(cè)兩組患者治療前后的血脂各項(xiàng)指標(biāo)包括總膽固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、低密度脂蛋白(low density lipoprotein,LDL)、高密度脂蛋白(high density lipoprotein,HDL)水平,血液流變學(xué)各項(xiàng)指標(biāo)包括全血黏度(高切、低切)、血漿黏度,并計(jì)算紅細(xì)胞聚集指數(shù)、紅細(xì)胞變形指數(shù),并進(jìn)行對(duì)比分析。結(jié)果:(1)臨床療效:觀察組治療后的總有效率92.5%,顯著高于對(duì)照組的總有效率70.0%,差異有統(tǒng)計(jì)學(xué)意義(P0.05),提示觀察組的臨床療效顯著優(yōu)于對(duì)照組。(2)神經(jīng)功能缺損評(píng)分(NDS):治療后兩組患者的神經(jīng)功能缺損評(píng)分均顯著下降,觀察組治療前后差值顯著高于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05),提示觀察組的神經(jīng)功能缺損改善情況顯著優(yōu)于對(duì)照組。(3)中醫(yī)癥候積分:治療后兩組患者的中醫(yī)癥候積分與治療前比較顯著降低,且觀察組治療前后差值顯著高于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05),提示觀察組的中醫(yī)臨床癥狀改善優(yōu)于對(duì)照組。(4)各項(xiàng)血脂指標(biāo):治療后觀察組各項(xiàng)血脂指標(biāo)TC、TG、LDL、HDL水平分別較對(duì)照組變化更顯著,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(5)各項(xiàng)血液流變學(xué)指標(biāo):觀察組各項(xiàng)血液流變學(xué)指標(biāo)全血黏度(高切、低切)、血漿黏度,紅細(xì)胞聚集指數(shù)、紅細(xì)胞變形指數(shù)分別較對(duì)照組變化更顯著,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:以化痰通絡(luò)湯為主方加減聯(lián)合頭皮針治療急性腦梗死(風(fēng)痰瘀阻證)療效顯著,可有效改善風(fēng)痰瘀阻證急性腦梗死患者的臨床癥狀體征,改善患者的神經(jīng)功能,降低血脂及改善血液流變學(xué)各項(xiàng)指標(biāo),值得臨床推廣應(yīng)用。
[Abstract]:Objective: to observe the clinical effect of Huatan Tongluo decoction (Huatan Tongluo decoction) combined with scalp acupuncture in the treatment of acute cerebral infarction (wind-phlegm stasis syndrome). To provide the theoretical basis of Chinese medicine for the treatment of acute cerebral infarction. Methods:. From June 2014 to June 2015, 80 patients with acute cerebral infarction were selected from Qinzhou Hospital of traditional Chinese Medicine, affiliated to Guangxi University of traditional Chinese Medicine. Chinese medicine accord with the syndrome of wind and phlegm stasis and were diagnosed by CT or MRI. The patients were randomly divided into observation group and control group with 40 cases in each group. The control group was treated with aspirin enteric-coated tablets. The observation group was treated with Huatan Tongluo decoction combined with scalp acupuncture on the basis of routine western medicine treatment in the control group. After 15 days of treatment, the clinical effects of the two groups were observed and compared. Changes of neurological deficit score and TCM symptom score before and after treatment in both groups. Serum lipids were measured before and after treatment in both groups, including total cholesterol cholesterol (TC) and triglyceride triglyceride (TG). Low density lipoprotein, high density lipoprotein, high density lipoprotein. HDL, hemorheology, including whole blood viscosity (high shear, low shear, plasma viscosity, erythrocyte aggregation index, erythrocyte deformability index). Results: the total effective rate of the observation group after treatment was 92.5, significantly higher than that of the control group, the total effective rate was significantly higher than that of the control group, the difference was statistically significant (P 0.05). The results suggest that the clinical efficacy of the observation group is significantly better than that of the control group. The difference before and after treatment in the observation group was significantly higher than that in the control group (P 0.05). It is suggested that the improvement of nerve function defect in the observation group is significantly better than that in the control group. 3) the TCM symptom score of the two groups after treatment is significantly lower than that before treatment. The difference before and after treatment in the observation group was significantly higher than that in the control group (P 0.05). It is suggested that the improvement of TCM clinical symptoms in the observation group is better than that in the control group. (4) the changes of serum lipids in the observation group are more significant than those in the control group after treatment. The difference was statistically significant (P 0.05. 0. 05. 5) the hemorheological indexes of the observation group were the whole blood viscosity (high shear, low shear, plasma viscosity, erythrocyte aggregation index). The erythrocyte deformability index was more significant than that of the control group. Conclusion: Huatan Tongluo decoction plus or minus scalp acupuncture treatment of acute cerebral infarction (wind and phlegm stasis syndrome) has a significant effect. It can effectively improve the clinical symptoms and signs of patients with acute cerebral infarction of wind-phlegm and stasis syndrome, improve the neurological function of patients, reduce blood lipid and improve the indexes of hemorheology, which is worthy of clinical popularization and application.
【學(xué)位授予單位】：廣西中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R277.7

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