發(fā)布時間：2018-07-28 20:20

【摘要】：研究目的:通過臨床觀察山藥補(bǔ)肺元湯合熊膽散治療太陰人老年缺血性中風(fēng)恢復(fù)期患者的療效,與丹參酮IIA治療太陰人老年缺血性中風(fēng)恢復(fù)期患者療效進(jìn)行對比,通過兩者對太陰人老年缺血性中風(fēng)恢復(fù)期患者治療后的美國國立衛(wèi)生研究院卒中量表評分(NIHSS)、日常生活活動能力量表指數(shù)(BI)、中醫(yī)癥候評分及血脂血糖、血液流變學(xué)等變化的程度進(jìn)行比較,來研究探討臨床上采用山藥補(bǔ)肺元湯合熊膽散治療太陰人老年缺血性中風(fēng)恢復(fù)期患者的有效性及安全性,為臨床上更多醫(yī)務(wù)人員運(yùn)用山藥補(bǔ)肺元湯合熊膽散治療太陰人老年缺血性中風(fēng)恢復(fù)期患者提供可靠的實(shí)驗(yàn)依據(jù)。研究方法:將40例太陰人老年缺血性中風(fēng)恢復(fù)期患者采用隨機(jī)對照研究方法分成實(shí)驗(yàn)組和對照組各20例,實(shí)驗(yàn)組采用山藥補(bǔ)肺元湯(麥門冬15g,桔梗10g,五味子5g,薏苡仁10g,山藥10g,萊菔子10g)和熊膽散,每日1付,水煎服400ml,分兩次早晚飯后服用,熊膽散(熊膽粉2g裝入膠囊),每日一次口服。對照組20例患者給予丹參酮IIA 40mg配合0.9%的氯化鈉250ml進(jìn)行靜脈注射,每日一次。兩組治療時間均為4周(1個療程)。觀察比較治療前后,實(shí)驗(yàn)組和對照組患者在包括口眼歪斜、偏身麻木、語言謇塞等情況的中醫(yī)癥狀評分,以及美國國立衛(wèi)生研究院卒中量表評分(NIHSS)和日常生活活動能力量表指數(shù)(BI)情況,進(jìn)行療效評價。對比治療前后兩組患者血脂血糖含量、血液流變學(xué)情況,判斷藥物的安全性。最后,將數(shù)據(jù)運(yùn)用統(tǒng)計軟件SPSS 22進(jìn)行統(tǒng)計分析。計量資料以均數(shù)士標(biāo)準(zhǔn)差(X±S)表示,運(yùn)用t檢驗(yàn)。計數(shù)資料比較運(yùn)用卡方檢驗(yàn)。等級資料運(yùn)用秩和檢驗(yàn)分析。研究結(jié)果:1.經(jīng)統(tǒng)計學(xué)分析結(jié)果顯示,治療前兩組患者在性別、年齡、病程、煙酒及體重指數(shù)等基本條件方面,無顯著差異,可以進(jìn)行對比(P0.05)。2.總有效率:藥物治療后,實(shí)驗(yàn)組總有效例數(shù)為19例,總有效率為950%,對照組總有效例數(shù)為14例,總有效率為70%。山藥補(bǔ)肺元湯合熊膽散總有效率高于丹參酮IIA組(P0.05),有統(tǒng)計學(xué)意義。3.NIHSS評分:治療后,實(shí)驗(yàn)組與對照組的NIHSS評分與治療前相比均有明顯降低,實(shí)驗(yàn)組降低程度高于對照組。4.BI指數(shù):治療后與治療前相比,兩組中風(fēng)患者的BI指數(shù)均有所提高,實(shí)驗(yàn)組明顯高于對照組。5.血液流變學(xué)指標(biāo):在降低全血高切黏度、血小板聚集率以及血漿黏度等方面,實(shí)驗(yàn)組效果更佳。用藥后實(shí)驗(yàn)組和對照組患者的總膽固醇、甘油三酯、低密度脂蛋白膽固醇與用藥前相比有明顯下降,實(shí)驗(yàn)組在高密度脂蛋白膽固醇水平無明顯變化,治療后,實(shí)驗(yàn)組比對照組在降低總膽固醇、甘油三酯、低密度脂蛋白膽固醇方面更有優(yōu)勢。6.中醫(yī)癥候評分:用藥后,每位患者的中醫(yī)癥狀均有所改善,實(shí)驗(yàn)組與對照組中醫(yī)癥候評分均下降,采用山藥補(bǔ)肺元湯合熊膽散治療的患者組總體下降程度較丹參酮IIA組更為明顯。7.用藥安全性:用藥后兩組患者均未產(chǎn)生副作用,無明顯異常反應(yīng)。結(jié)論:山藥補(bǔ)肺元湯合熊膽散在對太陰人老年缺血性中風(fēng)恢復(fù)期患者治療過程中,口眼歪斜、偏身麻木、語言春塞等中醫(yī)癥狀得到改善,同時使血液黏度有效降低,減少血栓形成的概率,對于神經(jīng)功能和肢體活動功能起到改善作用,總體來看,對太陰人老年缺血性中風(fēng)恢復(fù)期患者的治療有較好療效。治療中未見不良反應(yīng)和毒副作用,較為安全。
[Abstract]:Objective: To observe the curative effect of yam tonic Yuan Tang and bear gall powder in the treatment of patients with ischemic stroke in the elderly, and compare the curative effect of tanshinone IIA in the recovery period of ischemic stroke in the elderly. The research institute Stroke Scale score (NIHSS), daily living ability scale index (BI), TCM syndrome score and blood lipid blood sugar, blood rheology and other changes are compared to study the effectiveness and safety of the clinical use of yam tonifying lung yuan Decoction and bear gall powder in the treatment of the elderly patients with ischemic stroke in the elderly. More medical personnel on the bed provide reliable experimental basis for the treatment of patients with ischemic stroke in the old age of the Tai Yin people by using yam, tonifying lung yuan soup and bear gall powder to treat the patients with ischemic stroke in the elderly. 40 cases of the elderly patients with ischemic stroke in the elderly were divided into experimental group and control group with 20 cases, and the experimental group was treated with yam. Yuan Tang (15g, Platycodon 10g, Schisandra 5g, coix seed 10g, yam 10g, semen sulforaphone 10g) and bear gall powder, 1 payment per day, water decocted 400ml, two times after breakfast and evening meal, bear bile powder (bear bile powder 2G loaded capsule), once a day. 20 patients in the control group were given intravenous injection of sodium tanshinone IIA 40mg with 0.9% sodium chloride 250ml, daily intravenous injection, daily intravenous injection, daily intravenous injection, daily intravenous injection, daily one intravenous injection, daily a daily injection, daily one intravenous injection, daily one intravenous injection, daily one intravenous injection, daily one intravenous injection, daily one intravenous injection, daily one intravenous injection, daily one intravenous injection, daily one intravenous injection, daily one intravenous injection, daily one intravenous injection, daily one intravenous injection, daily one intravenous injection, daily one intravenous injection, daily one intravenous injection, daily one intravenous injection, daily one intravenous injection, daily one intravenous injection, daily one intravenous injection, daily one intravenous injection, daily one intravenous injection, daily one intravenous injection, daily one intravenous injection, daily one intravenous injection, daily one intravenous injection, daily one intravenous injection, daily 1 The treatment time of the two groups was 4 weeks (1 courses of treatment). Before and after the observation and comparison, the patients in the experimental group and the control group were included in the TCM symptom score, including the skew of the mouth, the numbness of the body, the language Jian, as well as the National Institutes of Health Stroke Scale (NIHSS) and the daily living activity capacity scale index (BI), and to evaluate the curative effect. Two groups of patients before and after treatment were compared with two groups of blood lipids, blood and blood sugar, hemorrheology, and the safety of the drugs. Finally, the data were statistically analyzed using the statistical software SPSS 22. The measurement data were represented by the standard deviation (X + S), and the t test was used. The count data were compared with the chi square test. The rank data was analyzed by the rank sum test analysis. Results: 1. the results of statistical analysis showed that there was no significant difference in the basic conditions of sex, age, course of disease, tobacco and wine and body mass index in the two groups before the treatment, and the total effective rate of the contrast (P0.05).2. could be compared. After the treatment, the total effective number of the experimental group was 19, the total effective rate was 950%, the total effective number of the control group was 14 cases, and the total effective was effective. The rate of 70%. yam tonifying lung Yuan Tang and bear gall powder total effective rate high Yu Dan ginseng IIA group (P0.05), there is a statistically significant.3.NIHSS score: after treatment, the experimental group and the control group compared with the NIHSS score compared with before treatment, the experimental group was higher than the control group.4.BI index: after treatment and before treatment, the two groups of stroke patients BI finger. The experimental group was significantly higher than the control group.5. blood rheology index: the experimental group had better effect on reducing the whole blood high shear viscosity, platelet aggregation rate and plasma viscosity. The total cholesterol, triglyceride and low density lipoprotein cholesterol in the experimental group and the control group were significantly lower than those before the drug use. There was no obvious change in the level of high density lipoprotein cholesterol. After treatment, the experimental group had more advantages than the control group in reducing total cholesterol, triglyceride, low density lipoprotein cholesterol and.6. syndrome score. After medication, the TCM symptoms of each patient were improved, and the scores of TCM syndrome in the experimental group and the control group were all decreased. The total decrease degree of the patients in the treatment group of yam, tonifying lung yuan soup and bear gall powder was more obvious than that in the group of tanshinone IIA. The two groups had no side effects and no obvious abnormal reaction after the drug use. Conclusion: yam tonifying lung Yuan Tang and bear gall powder were in the treatment process of patients with ischemic stroke in the elderly. The symptoms of traditional Chinese medicine such as deviation and numbness, language spring stopper are improved, the blood viscosity is reduced effectively, the probability of thrombosis is reduced, and the function of nerve function and limb activity is improved. On the whole, it has a good effect on the treatment of the patients in the recovery period of ischemic stroke in the elderly of the Tai Yin people. No adverse reactions and toxic and side effects are found in the treatment. It's safe.
【學(xué)位授予單位】：延邊大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R255.2
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本文編號：2151464