本文選題：化痰解郁方 + 后循環(huán)短暫性腦缺血發(fā)作��； 參考：《成都中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的：評價化痰解郁方治療后循環(huán)短暫性腦缺血發(fā)作(痰熱上擾證)眩暈癥狀的療效與安全性,為其臨床應(yīng)用提供科學(xué)依據(jù)。方法：采用隨機數(shù)字表法,將60例符合后循環(huán)短暫性腦缺血發(fā)作(痰熱上擾證)的患者,隨機分為2組,試驗組和對照組比例為1：1,兩組各30例。治療方案為試驗組：在基礎(chǔ)用藥上,使用化痰解郁方,每日1劑,每次1袋(200m1),每日3次,口服,同時合用敏使朗(甲磺酸倍他司汀片),每次1片,每日3次,口服；對照組：在基礎(chǔ)用藥上,使用敏使朗(甲磺酸倍他司汀片),每次1片,每日3次,口服。療程共2周。治療前及治療2周后分別進行中醫(yī)證候量表、眩暈殘障程度評定量表(DHI)及歐洲眩暈評價量表評分,進行經(jīng)顱多普勒(TCD)超聲檢查,記錄雙側(cè)椎動脈(VA)及基底動脈(BA)的平均血流速度(Vm)及動脈搏動指數(shù)(PI),試驗期間觀察患者的生命體征及不良反應(yīng),進行安全性評價。結(jié)果：(1)中醫(yī)證候量表評分比較：治療2周后試驗組及對照組評分較前均有下降,兩組內(nèi)比較差異均有統(tǒng)計學(xué)意義(P0.05),治療后兩組間比較差異有統(tǒng)計學(xué)意義(P0.05),試驗組總有效率為93.10%,對照組為60.71%,經(jīng)比較后差異有統(tǒng)計學(xué)意義(P0.05),試驗組的療效優(yōu)于對照組。(2)眩暈殘障程度評定量表(DHI)評分比較：治療2周后試驗組及對照組評分較前均有下降,兩組內(nèi)比較差異均有統(tǒng)計學(xué)意義(P0.05),治療后兩組間比較差異有統(tǒng)計學(xué)意義(P0.05)；DHI各因子評分較前均有下降,兩組內(nèi)比較差異均有統(tǒng)計學(xué)意義(P0.05),治療后兩組間比較差異均有統(tǒng)計學(xué)意義(P0.05)；試驗組總有效率為79.31%,對照組為53.57%,經(jīng)比較后差異有統(tǒng)計學(xué)意義(P0.05)試驗組療效優(yōu)于對照組。(3)歐洲眩暈評價量表評分比較：治療2周后試驗組及對照組評分較前均有下降,兩組內(nèi)比較差異均有統(tǒng)計學(xué)意義(P0.05),治療后兩組間比較差異有統(tǒng)計學(xué)意義(P0.05),試驗組總有效率為89.66%,對照組為60.71%,差異有統(tǒng)計學(xué)意義(P0.05),試驗組療效優(yōu)于對照組。(4)經(jīng)顱多普勒(TCD)超聲檢查比較：治療2周后試驗組及對照組左側(cè)椎動脈的平均血流速度(Vm)及搏動指數(shù)(PI)較前均改善,組內(nèi)比較差異均有統(tǒng)計學(xué)意義(P0.05),治療后兩組間比較差異無統(tǒng)計學(xué)意義(P0.05),在左側(cè)椎動脈的Vm及PI的改善上兩組間療效相當(dāng)：治療2周后試驗組及對照組右側(cè)椎動脈、基底動脈的Vm及PI較前均改善,組內(nèi)比較差異均有統(tǒng)計學(xué)意義(P0.05),治療后兩組間比較差異有統(tǒng)計學(xué)意義(P0.05),在右側(cè)椎動脈、基底動脈Vm及PI的改善上試驗組優(yōu)于對照組。(5)試驗期間兩組患者的生命體征未發(fā)生異常變化,未見明顯不良反應(yīng)。結(jié)論：化痰解郁方可以明顯改善后循環(huán)短暫性腦缺血發(fā)作(痰熱上擾證)患者的中醫(yī)證候量表、眩暈殘障程度評定量表(DHI)及歐洲眩暈評價量表評分,可以改善患者經(jīng)顱多普勒(TCD)超聲檢查相關(guān)指標,并且安全無明顯不良反應(yīng)出現(xiàn)。
[Abstract]:Objective: to evaluate the efficacy and safety of Huatan Jieyu prescription (Huatan Jieyu recipe) in treating vertigo symptoms of transient ischemic attack (phlegm heat disturbance syndrome) after circulation, so as to provide scientific basis for its clinical application. Methods: 60 patients with transient ischemic attack of posterior circulation (phlegm heat disturbance) were randomly divided into two groups. The ratio of experimental group and control group was 1: 1, 30 cases in each group. The treatment group was treated with Huatan Jieyu prescription, one dose of Huatan Jieyu prescription, 3 times a day, 3 times a day, combined with benazepam (Betastine mesylate, 1 tablet per day, 3 times a day, oral); Control group: on the basis of medication, use Minzheng (betastatin mesylate tablet, 1 tablet per time, 3 times a day, oral. The course of treatment was 2 weeks. Before treatment and 2 weeks after treatment, TCM syndrome scale, dizziness degree assessment scale (DHI) and European vertigo evaluation scale were scored, and transcranial Doppler TCD ultrasound examination was performed. The mean blood flow velocity (Vm) and arterial pulsatility index (PIV) of bilateral vertebral artery (VA) and basilar artery (BA) were recorded. The vital signs and adverse reactions were observed during the trial, and the safety was evaluated. Results (1) comparison of TCM syndrome scale scores: after 2 weeks of treatment, the scores of the experimental group and the control group were all lower than before. After treatment, the difference between the two groups was statistically significant (P 0.05). The total effective rate of the experimental group was 93.10% and the control group was 60.71%. After comparison, the difference was statistically significant. The curative effect of the experimental group was better than that of the control group. Comparison of dizziness assessment scale (DHI): after 2 weeks of treatment, the scores of both the experimental group and the control group were lower than before. The difference between the two groups was statistically significant (P 0.05). After treatment, there was a significant difference between the two groups (P 0.05) and the DHI scores of the two groups were all lower than those before treatment. The total effective rate of the trial group was 79.31 and that of the control group was 53.57. After comparison, the curative effect of the test group was better than that of the control group. Comparison of the European Vertigo Evaluation scale: after 2 weeks of treatment, the scores of the experimental group and the control group were lower than before. After treatment, the difference between the two groups was statistically significant (P 0.05). The total effective rate was 89.66 in the experimental group and 60.71 in the control group (P 0.05). The curative effect of the test group was better than that of the control group. Comparison of left vertebral artery flow velocity (Vm) and pulsatile index (PII) of left vertebral artery in the experimental group and the control group after 2 weeks of treatment. There was no significant difference between the two groups after treatment. The improvement of VM and Pi in the left vertebral artery was similar between the two groups: after 2 weeks of treatment, the right vertebral artery in the experimental group and the control group were improved. The VM and Pi of basilar artery were improved compared with the former, and the differences were statistically significant in both groups. After treatment, there was a significant difference between the two groups in the right vertebral artery, and the right vertebral artery. The improvement of VM and Pi in the basilar artery was better in the experimental group than in the control group. Conclusion: Huatan Jieyu prescription can obviously improve the scores of TCM syndrome scale, dizziness assessment scale and European vertigo evaluation scale in patients with transient cerebral ischemic attack (phlegm-heat disturbance syndrome) after circulation. It can improve the relevant indexes of transcranial Doppler TCD, and there is no significant adverse reaction.
【學(xué)位授予單位】：成都中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R277.7

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