發(fā)布時(shí)間：2018-04-29 15:13

  本文選題：進(jìn)展性腦卒中 + 益氣活血法�。� 參考：《河北醫(yī)科大學(xué)》2016年碩士論文

【摘要】：目的:本研究通過對(duì)168例急性早期缺血腦卒中患者的臨床研究,觀察治療前與益氣活血藥治療至發(fā)病第8天的NIHSS評(píng)分及中醫(yī)證候量化評(píng)分,評(píng)價(jià)益氣活血法在預(yù)防進(jìn)展性腦卒中的療效。方法:符合納入標(biāo)準(zhǔn)的患者168例,隨機(jī)分為對(duì)照組86例給予西醫(yī)常規(guī)治療;治療組82例在西醫(yī)常規(guī)治療的基礎(chǔ)上給予參芪扶正注射液聯(lián)合丹紅注射液干預(yù),連續(xù)用藥至發(fā)病第7天。統(tǒng)計(jì)分析兩組美國國立衛(wèi)生研究院卒中量表(NIHSS)和中醫(yī)證候量化評(píng)分,對(duì)治療組與對(duì)照組評(píng)分變化進(jìn)行組內(nèi)前后比較,以及兩組治療前后評(píng)分進(jìn)行比較,并觀察兩組治療前后證型分布特征。結(jié)果:治療組1例發(fā)生進(jìn)展性腦卒中,對(duì)照組7例;益氣活血組發(fā)生進(jìn)展性腦卒中的患者明顯少于對(duì)照組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05);治療組治療前后NIHSS評(píng)分比較(P0.05),表明差異無統(tǒng)計(jì)學(xué)意義;對(duì)照組治療前后NIHSS評(píng)分比較,治療后明顯高于治療前評(píng)分(P0.05),治療前后差異有統(tǒng)計(jì)學(xué)意義。治療組治療前后中醫(yī)證候量化評(píng)分比較(P0.05),表明治療組中醫(yī)證候量化評(píng)分差異無顯著統(tǒng)計(jì)學(xué)意義;對(duì)照組治療前后中醫(yī)證候量化評(píng)分比較,對(duì)照組治療后評(píng)分高于治療前,(P0.05),表明對(duì)照組治療前后中醫(yī)證候量化評(píng)分差異具有統(tǒng)計(jì)學(xué)意義。兩組治療前NIHSS評(píng)分比較(P0.05),差異無統(tǒng)計(jì)學(xué)意義;兩組治療前中醫(yī)證候量化評(píng)分比較(P0.05),差異無統(tǒng)計(jì)學(xué)意義。兩組治療后NIHSS評(píng)分比較(P0.05),差異具有統(tǒng)計(jì)學(xué)意義,表明治療組神經(jīng)缺損程度改善明顯優(yōu)于對(duì)照組;兩組治療后中醫(yī)證候量化評(píng)分比較(P0.05),差異無統(tǒng)計(jì)學(xué)意義。治療組各證素治療前后(P0.05),無統(tǒng)計(jì)學(xué)意義。表明火熱證候未見明顯變化。證素之間比較未見明顯變化(P0.05);對(duì)照組各證候治療前后(P0.05),無統(tǒng)計(jì)學(xué)意義。各證素之間比較,風(fēng)證與瘀證有明顯變化,具有統(tǒng)計(jì)學(xué)意義(P0.05),其余證素之間未見明顯變化,無統(tǒng)計(jì)學(xué)意義(P0.05)。表明對(duì)照組治療前后火熱證未見明顯變化。兩組血壓比較治療組第一天143.94±19.18,第二天141.21±17.04,第三天138.15±15.41;對(duì)照組第一天145.44±15.18,第二天141.51±14.71第三天138.24±12.92,無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:1氣虛血瘀是影響缺血性腦卒中病理進(jìn)程的主要機(jī)制,尤其決定著進(jìn)展性腦卒中的預(yù)后轉(zhuǎn)歸;2益氣活血法可有效控制進(jìn)展性腦卒中發(fā)生,能減少并發(fā)癥的出現(xiàn),未發(fā)現(xiàn)改藥有明顯的不良反應(yīng);3益氣活血法可有效改善急性腦卒中患者神經(jīng)功能缺損。
[Abstract]:Objective: through the clinical study of 168 patients with acute early ischemic stroke, the NIHSS score and the quantitative score of TCM syndromes were observed before treatment and 8 days after treatment with Yiqi Huoxue medicine. Objective: to evaluate the efficacy of Yiqi Huoxue method in the prevention of progressive stroke. Methods: 168 patients who met the inclusion criteria were randomly divided into control group (86 cases) and treatment group (82 cases) treated with Shenqi Fuzheng injection combined with Danhong injection. The patients were treated continuously until the 7th day. The stroke scale NIHSS (National Institutes of Health) and the quantitative score of TCM syndromes in the two groups were statistically analyzed. The scores of the treatment group and the control group were compared before and after treatment, and the scores before and after treatment were compared between the two groups. The distribution characteristics of syndromes before and after treatment were observed. Results: one case of progressive stroke occurred in the treatment group and 7 cases in the control group, and the number of patients with progressive stroke in the Yiqi and Huoxue group was significantly lower than that in the control group. The difference was statistically significant (P 0.05); the comparison of NIHSS scores before and after treatment in the treatment group showed no statistical significance; in the control group, the comparison of NIHSS score before and after treatment was significantly higher than that before and after treatment (P 0.05), and the difference before and after treatment was statistically significant. Comparison of quantitative scores of TCM Syndromes before and after treatment in the treatment Group (P0.05), which indicated that there was no significant difference in the quantitative scores of TCM syndromes in the treatment group, while in the control group, the quantitative scores of TCM syndromes were compared before and after treatment. The scores after treatment in the control group were higher than those in the control group before and after treatment, indicating that the quantitative score of TCM syndrome in the control group had statistical significance before and after treatment. There was no significant difference in NIHSS score before treatment between the two groups, and there was no significant difference between the two groups in the quantitative score of TCM syndromes before treatment. After treatment, the NIHSS score of the two groups was significantly higher than that of the control group, and the difference was statistically significant, indicating that the improvement of the degree of nerve defect in the treatment group was significantly better than that in the control group, while the quantitative score of TCM syndrome after treatment in the two groups had no statistical significance. In the treatment group, there was no statistical significance before and after treatment. The results showed that there was no obvious change in the syndrome of hot fever. There was no significant change in the syndromes between the two syndromes, but there was no significant difference between the control group and the control group before and after treatment. Compared with other syndromes, wind syndrome and blood stasis syndrome had significant changes (P 0.05), while the other syndromes had no significant change (P 0.05). The results showed that the control group had no obvious change before and after treatment. The blood pressure of the two groups was 143.94 鹵19.18 on the first day, 141.21 鹵17.04on the second day, 138.15 鹵15.41 on the third day, and 145.44 鹵15.18 on the first day and 138.24 鹵12.92 on the second day in the control group. Conclusion 1 qi deficiency and blood stasis is the main mechanism that affects the pathological process of ischemic stroke, especially the prognosis of progressive stroke can be controlled effectively and the complications can be reduced by the method of promoting Qi and activating Blood Circulation, which can effectively control the occurrence of progressive stroke. It was not found that the modified drug had obvious adverse reactions. The method of supplementing qi and activating blood circulation could effectively improve the nerve function defect in patients with acute stroke.
【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)】：R277.7

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