本文選題：祛瘀化痰 + 晚期血吸蟲(chóng)病　； 參考：《湖北中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的以“痰瘀阻絡(luò)”為晚期血吸蟲(chóng)病(巨脾型)核心病機(jī),突出“痰瘀互結(jié)”這一關(guān)鍵病理改變,將祛瘀化痰法的治則應(yīng)用于晚期血吸蟲(chóng)病患者,觀察其臨床療效,為從痰瘀阻絡(luò)辯證論治晚期血吸蟲(chóng)病(巨脾型)患者提供臨床依據(jù)。方法研究對(duì)象為2014年3月至2016年2月至荊州市區(qū)血吸蟲(chóng)防治所就診的晚期血吸蟲(chóng)病(巨脾型)患者,以納入和排除標(biāo)準(zhǔn)篩選后,共納入64例。按隨機(jī)數(shù)字方式分為對(duì)照組和治療組,各32例。將兩組患者治療前的肝功能、中醫(yī)癥候積分等相關(guān)指標(biāo)進(jìn)行統(tǒng)計(jì)學(xué)對(duì)比,證明兩組患者各項(xiàng)指標(biāo)無(wú)統(tǒng)計(jì)學(xué)差異后開(kāi)始臨床觀察。對(duì)照組采用晚期血吸蟲(chóng)病(巨脾型)臨床路徑給予患者治療:消除病因及誘因治療、保肝治療(如還原型谷胱甘肽、復(fù)方甘草酸單銨)及對(duì)癥支持治療。治療組在對(duì)照組治療方案基礎(chǔ)之上給予以浙貝、漏蘆、郁金、丹參為主方的中藥顆粒劑口服治療,隨證加減。治療三個(gè)月后記錄兩組患者的肝纖維化、肝功能、B超、中醫(yī)癥候積分等相關(guān)指標(biāo),并將治療前后及兩組之間的數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)分析,觀察藥物的療效和毒副反應(yīng)。結(jié)果兩組患者治療前后總體療效對(duì)比及總體中醫(yī)癥候積分對(duì)比無(wú)顯著差異;在脾厚、肝門靜脈直徑、ALT的改善上兩組患者之間沒(méi)有顯著差異。治療組在中醫(yī)癥候積分上對(duì)嘔吐、腹脹、尿黃的改善明顯優(yōu)于對(duì)照組;對(duì)AST、TBil、白蛋白(A)、LN的改善明顯優(yōu)于對(duì)照組;治療組的起效速度明顯快于對(duì)照組。結(jié)論祛瘀化痰法能有效改善晚期血吸蟲(chóng)病(巨脾型)患者的AST、TBil、白蛋白(A)、LN指標(biāo),并能有效緩解嘔吐、腹脹、尿黃癥狀。
[Abstract]:Objective to take "phlegm and stasis blocking collaterals" as the core pathogenesis of advanced schistosomiasis (giant spleen type), to highlight the key pathological change of "phlegm and blood stasis mutual knot", and to apply the method of removing blood stasis and removing phlegm to patients with advanced schistosomiasis, and to observe its clinical effect. To provide clinical basis for the treatment of advanced schistosomiasis (giant spleen type) from phlegm and blood stasis obstruction of collaterals. Methods from March 2014 to February 2016, 64 patients with advanced schistosomiasis (giant spleen type) were included in the study. The patients were randomly divided into control group (32 cases) and treatment group (32 cases). The two groups of patients before treatment of liver function, TCM symptom score and other related indicators were statistically compared, it was proved that the two groups of patients after no statistical differences in each index began to clinical observation. The patients in the control group were treated with advanced schistosomiasis (giant spleen type) by clinical pathway: eliminating the etiology and inducement, protecting liver (such as reduced glutathione, compound ammonium glycyrrhizinate) and symptomatic support therapy. Treatment group on the basis of the control group on the basis of the treatment of Zhejiang shellfish, leaky Reed, Tujin, Danshen prescription of traditional Chinese medicine granules oral treatment, plus or minus with the syndrome. After three months of treatment, the liver fibrosis, liver function, B-ultrasound, TCM symptom score and other related indexes were recorded, and the data before and after treatment and between the two groups were statistically analyzed to observe the curative effect and side effects of drugs. Results there was no significant difference in total curative effect and total TCM symptom score between the two groups before and after treatment, but there was no significant difference between the two groups in spleen thickness, hepatic portal vein diameter and alt improvement. The improvement of TCM symptom score on vomiting, abdominal distension and urine yellow in the treatment group was significantly better than that in the control group, and the improvement of ASTT TBiland Albumin in the treatment group was significantly better than that in the control group; the onset rate of the treatment group was obviously faster than that of the control group. Conclusion the method of removing blood stasis and removing phlegm can effectively improve ASTTBiland Albumin AtroLN in patients with advanced schistosomiasis (giant spleen type), and can effectively relieve the symptoms of vomiting, abdominal distension and urine yellow.
【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R259

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