【摘要】：目的:觀察舒郁解語湯加減對中風后運動性失語患者(氣滯痰瘀型)的臨床療效,并探討其理論依據(jù)。方法:選取符合課題納入標準的30例門診患者,經診斷為中風病恢復期并伴有運動性失語。將符合標準的30例門診患者給予舒郁解語湯為主方進行加減,水煎服300ml,日2次早晚分服,療程為4周。分別在治療前、治療2周后、治療4周后,記錄、觀察患者的言語功能評分、失語癥嚴重程度分級、卒中后失語抑郁量表評分以及中醫(yī)證候積分的變化情況。結果:1.在治療2周、治療4周與治療前相比較,言語功能總評分增高,差異具有統(tǒng)計學意義;言語功能各項積分除治療前與治療2周理解項與命名項無顯著差異外,其余各項在各時點相比較均有統(tǒng)計學意義(P0.01);2.失語嚴重程度分級:在治療2周、4周后,分級為1、2、3級的人數(shù)減少,4、5級的人數(shù)相對增加,治療前、2周、4周相比較,差異具有統(tǒng)計學意義(P0.01);3.患者在治療2周、治療4周后與治療前相比SADQ總積分均有降低,且在治療4周后的SADQ總積分與治療2周相比較有明顯降低,差異均有統(tǒng)計學意義(P0.01);4.治療2周、4周后與治療前相比,中醫(yī)證候總積分有所降低,差異具有統(tǒng)計學意義(P0.01);中醫(yī)證候各項積分在治療2周、治療4周后與治療前相比,積分均有所降低,差異具有統(tǒng)計學意義(P0.01);5.療效:在治療2周、4周后,患者的言語功能得到不同程度的改善,臨床療效總有效率分別為23.3%、96.7%,兩者相比較,差異有統(tǒng)計學意義(P0.01);治療2周、4周后,中醫(yī)證候評價總有效率分別為70.0%、96.7%,兩者相比較,差異有統(tǒng)計學意義(P0.01)。結論:1.舒郁解語湯在治療4周后能使氣滯痰瘀型失語患者的言語功能、失語程度分級及卒中后抑郁的臨床癥狀得到更大程度的改善。2.舒郁解語湯加減可以有效的改善中風后失語患者的中醫(yī)證候。
[Abstract]:Objective: To observe the clinical effect of Shu Yu Jie Yu Decoction on the patients with motor aphasia (qi stagnation and stasis type) after apoplexy, and to explore the theoretical basis. Methods: 30 outpatients who were in convalescence of apoplexy and accompanied by athletic aphasia were selected in accordance with the standard of the subject, and 30 patients with the standard were given Shu Yu Jie Yu Decoction. The main side was added and subtract, decoction of 300ml, 2 times in the morning and evening, the course was 4 weeks. Before treatment, 2 weeks after treatment, 2 weeks after treatment, 4 weeks after treatment, records, observation of speech function scores, aphasia severity grade, post stroke aphasia Depression Scale score and TCM syndrome score changes. Results: 1. in 2 weeks, treatment 4 weeks and treatment. Compared with the former, the total score of speech function was higher, and the difference was statistically significant. Except for the 2 weeks of understanding and naming items before and after treatment, the rest of the speech function scores were statistically significant (P0.01). 2. the grade of aphasia severity was reduced: at 2 weeks and after 4 weeks, the number of grade 1,2,3 was reduced. The number of 4,5 levels increased relatively. The difference was statistically significant (P0.01) before treatment, 2 weeks and 4 weeks. 3. patients were treated for 2 weeks, and after 4 weeks of treatment, the total score of SADQ was reduced compared with that before treatment, and the total score of SADQ was significantly lower after 4 weeks of treatment than in the 2 week treatment (P0.01); 4. for 2 weeks, 4 Compared with before treatment, the total score of TCM syndrome was reduced, the difference was statistically significant (P0.01). The scores of TCM syndromes were reduced in 2 weeks and 4 weeks after treatment, and the difference was statistically significant (P0.01); the 5. effect: after 2 weeks of treatment and 4 weeks, the patients' speech function was changed to varying degrees. The total effective rate of clinical curative effect was 23.3% and 96.7% respectively. The difference was statistically significant (P0.01). After 2 weeks of treatment and 4 weeks, the total effective rate of TCM Syndrome Evaluation was 70% and 96.7% respectively. The difference was statistically significant (P0.01). Conclusion: 1. Shu Yu Yu Jie Yu Decoction can make the speech of qi stagnation phlegm stasis type aphasia patients after the treatment of 4 weeks. The function, the degree of aphasia and the clinical symptoms of depression after stroke have been improved to a greater degree,.2. Shu Yu Jie Yu Decoction can effectively improve the TCM syndrome of aphasia after apoplexy.
【學位授予單位】：黑龍江中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R255.2

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