本文選題：病毒性腦炎　切入點：痰熱壅盛型　出處：《河南中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:通過實用性隨機(jī)對照試驗,評價在基于指南的規(guī)范治療基礎(chǔ)上加用加味清瘟敗毒飲治療病毒性腦炎(痰熱壅盛型)的臨床療效,為進(jìn)一步探討病毒性腦炎的中醫(yī)規(guī)范化治療,提供可靠的臨床證據(jù)。方法:(1)將符合納入標(biāo)準(zhǔn)的70例病例,參照隨機(jī)數(shù)表,以1:1的比例隨機(jī)分為治療組和對照組,每組各35例。治療組予加味清瘟敗毒飲+基于指南的規(guī)范化西醫(yī)治療,對照組予基于指南的規(guī)范化西醫(yī)治療,兩組均觀察14天。(2)分別于治療前、治療7天、治療14天三個時點采集血液及腦脊液標(biāo)本,通過比較血白細(xì)胞數(shù)、中性粒細(xì)胞比值、腦脊液壓力、腦脊液蛋白定量及白細(xì)胞數(shù)的變化,觀察評價加味清瘟敗毒飲對患者理化常規(guī)指標(biāo)的影響。(3)分別于治療前、治療7天、治療14天統(tǒng)計臨床癥狀、體征積分,通過積分變化,評價加味清瘟敗毒飲對患者臨床癥狀、體征的影響。(4)分別于治療前、治療14天兩個時點統(tǒng)計腦電圖及頭顱MRI分級,評價加味清瘟敗毒飲對患者腦電圖波形及頭顱影像學(xué)改變的影響。結(jié)果:(1)病毒性腦炎療效評價:治療組總有效率97.14%,對照組總有效率88.57%,兩組療效差異具有統(tǒng)計學(xué)意義(P0.05),說明加味清瘟敗毒飲治療痰熱壅盛型病毒性腦炎的臨床療效顯著。(2)治療7天:治療組與對照組組內(nèi)比較:臨床癥狀、體征積分,血常規(guī)(白細(xì)胞數(shù)、中性粒細(xì)胞比值)及腦脊液(壓力、蛋白定量、白細(xì)胞數(shù))均較治療前下降(P0.05);組間比較:治療組下降程度較對照組顯著(P0.05)。(3)治療14天:兩組組內(nèi)比較:臨床癥狀、體征積分,血常規(guī)(白細(xì)胞數(shù)、中性粒細(xì)胞比值)及腦脊液(壓力、蛋白定量、白細(xì)胞數(shù))均較治療7天時下降(P0.05),腦電圖分級、頭顱磁共振分級較治療前改善(P0.05);組間比較:治療組改善程度較對照組顯著,差異具有統(tǒng)計學(xué)意義(P0.05)。結(jié)論:加味清瘟敗毒飲能夠明顯改善痰熱壅盛型病毒性腦炎患者的理化常規(guī)指標(biāo)、臨床癥狀、體征積分,降低腦電圖、頭顱MRI分級。尤其能夠降低患者發(fā)熱程度、縮短發(fā)熱周期,促進(jìn)昏迷患者蘇醒,改善疾病預(yù)后�？傊�,加味清瘟敗毒飲治療病毒性腦炎(痰熱壅盛型)臨床療效顯著,無明顯毒副作用,值得臨床推廣使用。
[Abstract]:Objective: to evaluate the clinical efficacy of Jiawei Qingwen Baidu decoction in the treatment of viral encephalitis (phlegm and heat obstruction type) on the basis of the standard treatment based on the guidelines through a practical randomized controlled trial. In order to further explore the standardized treatment of viral encephalitis in TCM and provide reliable clinical evidence, 70 cases that met the inclusion criteria were randomly divided into treatment group and control group with the proportion of 1: 1 according to the random number table. There were 35 cases in each group. The treatment group was treated with standardized western medicine with modified Qingwen Baidu Yin, and the control group with standardized western medicine treatment based on guidelines. The two groups were observed for 14 days and treated for 7 days, respectively. Blood and cerebrospinal fluid (CSF) samples were collected at three time points after treatment for 14 days. The changes of white blood cell count, neutrophil ratio, cerebrospinal fluid pressure, cerebrospinal fluid protein quantification and white blood cell count were compared. Observe and evaluate the effect of Jiawei Qingwen Baidu decoction on the physical and chemical routine indexes of patients. Before treatment, 7 days of treatment, 14 days of treatment, statistics of clinical symptoms and signs integral, through integral changes, evaluate the clinical symptoms of Jiawei Qingwen Baiduyin on patients' clinical symptoms. The effects of physical signs on EEG and MRI grade of the skull were recorded at two time points before treatment and 14 days after treatment, respectively. To evaluate the effect of Jiawei Qingwen Baidu decoction on EEG waveform and cranial imaging changes in patients. Results: the curative effect of viral encephalitis in the treatment group was 97.14. The total effective rate in the treatment group was 97.14. The total effective rate in the control group was 88.57. The difference between the two groups was statistically significant. The clinical curative effect of modified Qingwen Baidu decoction on phlegm and heat accumulation type viral encephalitis was remarkable for 7 days: comparison between the treatment group and the control group: clinical symptoms, Physical sign score, blood routine (leukocyte count, neutrophil ratio) and cerebrospinal fluid (pressure, protein quantification), The number of white blood cells in the treatment group was significantly lower than that in the control group for 14 days. The comparison between the two groups: clinical symptoms, signs score, blood routine examination (white blood cell count, white blood cell count, white blood cell count, WBC count, WBC count, WBC count, WBC count, WBC count, WBC count, WBC count, WBC count, WBC count). The ratio of neutrophil to neutrophil and cerebrospinal fluid (pressure, protein quantification, white blood cell count) decreased P0.05, EEG grade and cranial magnetic resonance grade improved P0.05 compared with that of control group after 7 days of treatment, and the improvement degree of treatment group was significantly higher than that of control group. Conclusion: Jiawei Qingwen Baidu decoction can significantly improve the physical and chemical indexes, clinical symptoms and signs of viral encephalitis patients with phlegm-heat blockage, and reduce EEG. Cranial MRI grade. In particular, it can reduce the degree of fever, shorten the period of fever, promote the recovery of coma patients, and improve the prognosis of disease. In short, the clinical effect of Jiawei Qingwen Baidu decoction on viral encephalitis (phlegm and heat accumulation type) is remarkable. There are no obvious side effects, so it is worth popularizing in clinic.
【學(xué)位授予單位】：河南中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R259

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1 李莉;加味清瘟敗毒飲治療病毒性腦炎（痰熱壅盛型）的臨床療效觀察[D];河南中醫(yī)藥大學(xué);2016年

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本文編號：1560070