本文選題：辛溫開竅法 + 急性缺血性腦卒中��； 參考：《山東中醫(yī)藥大學》2016年碩士論文

【摘要】：目的:觀察運用辛溫開竅法治療痰濁瘀阻型急性缺血性腦卒中(AIS)的臨床療效,及對缺血性腦卒中急性期炎性因子的影響,進一步探討辛溫開竅法在AIS治療中的臨床意義,并運用中醫(yī)理論探討AIS痰濁瘀阻證的病因病機,以豐富中醫(yī)診療方法,完善中醫(yī)理論。方法:將符合納入標準的60例痰濁瘀阻型AIS患者按入院時間2014年9月-2016年2月先后順序,隨機分為治療組和對照組,各30例。按照《中國急性缺血性腦卒中診治指南2010》,給予對照組規(guī)范的二級預防和卒中治療,治療組在對照組治療基礎上,另給予導師自創(chuàng)辛溫開竅方治療,14天為一個療程,一日一劑,于早晚餐后半小時后溫服(麝香末1g二等份隨方?jīng)_服),入院后于治療前的第一個工作日對兩組患者進行量表評分和化驗檢查,并于治療14天后再次評價。其中炎性指標、安全指標等實驗室檢查由濰坊市中醫(yī)院化驗室完成,功能評價由觀察醫(yī)師完成,并進行療效評價及結(jié)果分析。結(jié)果:1.兩組患者一般資料比較兩組患者在年齡、性別、病程、基礎疾病方面比較無統(tǒng)計學差異(P均0.05),兩組具有可比性。2.辛溫開竅法對痰濁瘀阻型AIS療效分析經(jīng)統(tǒng)計學分析:治療前,在中醫(yī)證候?qū)W積分、神經(jīng)功能缺損評分(NIHSS評分)、炎性因子等生化指標方面,兩組比較無統(tǒng)計學差異(P均0.05),兩組具有可比性。治療后,在中醫(yī)證候?qū)W積分、NIHSS評分、炎性因子,分別與治療前比較,均有明顯改善(P0.05)。治療組在神經(jīng)功能缺損程度療效方面,顯著優(yōu)于對照組(P0.05);在中醫(yī)證候療效方面,與對照組比較,有十分顯著差異(P0.01)。3.安全性觀察指標及不良反應治療期間,兩組患者治療前后的安全性觀察指標(三大常規(guī)、肝腎功、心電圖等)比較未有顯著變化,未發(fā)現(xiàn)過敏及不良反應。結(jié)果說明辛溫開竅方在治療痰濁瘀阻型AIS方面療效顯著,無明顯毒副作用。結(jié)論:運用辛溫開竅法治療痰濁瘀阻型AIS,能有效改善神經(jīng)功能缺損狀況,改善中醫(yī)證候評分,改善炎性反應,改善臨床預后,臨床應用安全有效。中醫(yī)理論研究亦發(fā)現(xiàn)辛溫開竅法可使血行痰化,清竅通利。因而運用辛溫開竅法治療AIS值得臨床推廣應用。
[Abstract]:Objective: to observe the clinical effect of Xin Wen Kai Qiao method on acute ischemic stroke (AIS) of phlegm turbid and stasis type, and to explore the clinical significance of Xin Wen Kai Qiao method in the treatment of acute ischemic cerebral apoplexy (AIS). The etiology and pathogenesis of AIS syndrome of phlegm turbidity and stasis were discussed in order to enrich the methods of diagnosis and treatment of traditional Chinese medicine and perfect the theory of traditional Chinese medicine. Methods: sixty AIS patients with turbid phlegm stasis were randomly divided into treatment group (n = 30) and control group (n = 30) according to the order of admission time from September 2014 to February 2016. According to the guidelines for the diagnosis and treatment of Acute Ischemic Stroke in China (2010), the control group was given standard secondary prevention and stroke treatment. The treatment group was treated with Xin-Wen Kaiqiao recipe for 14 days as a course of treatment, one dose per day, on the basis of the treatment of the control group. After half an hour of morning and evening meal, the patients in the two groups were given warm clothes (musk 1g second class). The patients in the two groups were evaluated again after 14 days of treatment on the first working day before treatment. The laboratory examination of inflammatory index and safety index was completed by the laboratory of Weifang traditional Chinese Medicine Hospital, and the function evaluation was completed by the observation physician, and the curative effect was evaluated and the result was analyzed. The result is 1: 1. There was no significant difference in age, sex, course of disease and basic disease between the two groups (P 0.05). Analysis of curative effect of Xin Wen Kai Qiao method on AIS of phlegm turbid and stasis type: before treatment, biochemical indexes such as TCM syndromes score, neurological deficit score (NIHSS), inflammatory factors, etc. There was no statistical difference between the two groups (P 0.05), and the two groups were comparable. After treatment, the scores of NIHSS and inflammatory factors in TCM syndromes were significantly improved compared with those before treatment (P0.05). The therapeutic effect of the treatment group was significantly better than that of the control group in the degree of nerve function defect (P0.05); in traditional Chinese medicine syndromes curative effect, compared with the control group, there was a very significant difference (P0.01). 3. During the period of safety observation and adverse reaction treatment, there were no significant changes in safety observation indexes (three major routine, liver and kidney function, electrocardiogram, etc.) before and after treatment, and no allergies and adverse reactions were found in the two groups. The results showed that Xin-wen Kaiqiao recipe was effective in treating AIS of phlegm turbid and stasis type, and had no obvious side effects. Conclusion: the treatment of phlegm turbid and stasis type AIS with Xin Wen Kai Qiao method can effectively improve the neurological function defect, improve TCM syndrome score, improve inflammatory reaction, improve clinical prognosis, and be safe and effective in clinical application. The research of TCM theory also found that Xin-Wen Kaiqiao method can make blood phlegm become clear and clear orifices. Therefore, the use of Xin-Wen method to treat AIS is worthy of clinical application.
【學位授予單位】：山東中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R277.7

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1 李媛媛;辛溫開竅法治療痰濁瘀阻型急性缺血性腦卒中的臨床研究[D];山東中醫(yī)藥大學;2016年

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