【摘要】：目的：觀察臨床上給予缺血性中風風痰瘀阻型患者朝醫(yī)方太陰調胃湯合熊膽散與丹參酮IIA治療的療效,分析比較兩組藥物對口眼歪斜、偏身麻木等臨床癥狀的療效,對血脂、血液流變學、空腹血糖等生化指標的影響,恢復患者神經功能和日�；顒幽芰Φ那闆r。對臨床上采用太陰調胃湯合熊膽散治療風痰瘀阻型缺血性中風的有效性及安全性進行評價,為進一步推廣應用朝醫(yī)方藥太陰調胃湯合熊膽散治療缺血性中風提供有效的臨床依據(jù)。方法：將于2015年1月至11月被延吉市中醫(yī)院神經內科確診為缺血性中風風痰瘀阻型的40例患者作為觀察病例。20例對照組患者給予40mg丹參酮IIA注射液靜脈滴注,每日1次；20例觀察組患者給予太陰調胃湯(薏苡仁15g,五味子5g,萊菔子l0g,麥門冬10g,石菖蒲15g,桔梗l0g,干栗10g,麻黃5g),日1劑水煎300m1,分早晚溫服(早飯前半小時、晚飯后1小時服用),熊膽散(熊膽粉1.5g)制成膠囊,每日19時頓服。并對兩組患者合并的血壓升高、血糖升高、血脂異常、心絞痛等合并癥進行對癥處理。2周為1個療程,觀察1個療程。分析比較治療后兩組患者半身不遂、口眼歪斜等不適癥狀的改善程度,患者損傷的腦神經功能的修復情況,患者日常獨立生活能力提高的情況,以及患者體內血脂的含量、血液的黏稠度、空腹血糖的含量等變化情況以評價兩組藥物的總體療效。結果：治療前兩組中風患者的基礎資料、影響因素、日常生活活動能力(BI)指數(shù)評分及神經功能缺損(NIHSS)評分等觀察指標具有可比性(P0.05)。藥物治療2周后患者的中醫(yī)證候療效、臨床療效的組內差異均具有統(tǒng)計學意義(P0.05),且組間比較觀察組藥物的治療效果明顯較對照組更好；治療后兩組患者的神經功能明顯恢復,日常獨立自理的能力明顯提高,觀察組與對照組比較具有統(tǒng)計學意義上的差異(P0.05)；與治療前相比經藥物治療后的兩組中風患者體內血脂的含量降低、血液流變速度增快(P0.05),且太陰調胃湯組藥物調節(jié)血脂及血液流變學的療效較對照組更高(P0.05)。結論：太陰調胃湯合熊膽散治療缺血性中風風痰瘀阻型可有效改善患者因腦神經損傷所出現(xiàn)的神經缺損的癥狀,恢復患者四肢肌力,提高患者獨立自理的生活能力,并且治療過程中無不良反應及毒副反應發(fā)生。
[Abstract]:Objective: to observe the therapeutic effect of Taiyin Tiaowi decoction combined with tanshinone IIA in treating patients with wind-phlegm-stasis type of ischemic apoplexy. The effects of hemorheology, fasting blood glucose and other biochemical indexes on the recovery of neurological function and daily activity of patients. To evaluate the efficacy and safety of Taiyin Tiaowei decoction combined with Xiongdan Powder in the treatment of ischemic stroke of wind-phlegm-stasis type. To provide effective clinical basis for the treatment of ischemic apoplexy with Taiyin Tiaowi decoction and Xiongdan Powder. Methods: from January to November, 2015, 40 patients diagnosed as wind-phlegm stasis type of ischemic stroke by Department of Neurology, Yanji Hospital of traditional Chinese Medicine were treated with 40mg tanshinone IIA injection once a day. 20 patients in the observation group were given Taiyin Tiaowi decoction (Coix seed 15g, Schisandra Schisandra 5g, Raphani 10g, wheat winter 10g, Acorus calamus 15g, Platycodon grandiflorum 10g, dried chestnut 10g, ephedra 5g). 1 hour after supper), Xiong Dan San (bear gall powder 1.5 g) is made into capsule and taken at 19:00 daily. The complications of hypertension, blood glucose, dyslipidemia and angina pectoris were treated for 2 weeks as a course of treatment, and a course of treatment was observed. The degree of improvement of symptoms of hemiplegia, obliquity of mouth and eye, the repair of injured brain nerve function, the improvement of patients' daily independent living ability, and the content of blood lipid in patients were analyzed and compared after treatment. Changes in blood viscosity and fasting blood glucose were used to evaluate the overall efficacy of the two groups. Results: the basic data, influencing factors, activity of daily living (ADL) (BI) index and neurological deficit (NIHSS) were comparable between the two groups before treatment (P0.05). After 2 weeks of drug therapy, there were significant differences in the effect of TCM syndromes and clinical efficacy between the two groups (P0.05), and the therapeutic effect of the observation group was significantly better than that of the control group; after treatment, the neurological function of the patients in the two groups recovered significantly. The ability of daily independent self-care was significantly improved, the observation group and the control group compared with the statistical difference (P0.05); compared with the treatment before and after the treatment of two groups of apoplexy patients after the reduction of blood lipids, The hemorheological velocity increased (P0.05), and the efficacy of Taiyin Tiaowei decoction group in regulating blood lipid and hemorheology was higher than that in the control group (P0.05). Conclusion: Taiyin Tiaowei decoction combined with Xiong Dan San can effectively improve the symptoms of nerve defect caused by cerebral nerve injury, recover the muscle strength of limbs, and improve the independent living ability of patients with ischemic apoplexy of wind-phlegm stagnation type. No adverse reactions and side effects occurred in the course of treatment.
【學位授予單位】：延邊大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R277.7

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