【摘要】：目的:通過臨床對照觀察和磁共振彌散張量成像(DTI)分析,評價痰瘀阻絡方對急性腦梗死痰瘀阻絡證患者的神經功能缺損、生存質量等以及新發(fā)梗死灶區(qū)細胞內自由水分子彌散運動改善情況的療效,分析患者顱內新發(fā)梗死灶區(qū)細胞內自由水分子彌散運動情況與患者神經功能缺損、生存質量等的關系。方法:采用開放對照的試驗設計,選取急性腦梗死痰瘀阻絡證患者40例,分為治療組和對照組各20例。兩組均給予常規(guī)西藥治療,治療組加用痰瘀阻絡方。觀察對比患者治療7d時新發(fā)梗死灶區(qū)和對側鏡像區(qū)部分各向異性(FA)、表觀彌散系數(shù)(ADC)水平,治療第 0d、7d、14d、28d 的 NIHSS 評分、Barthel 指數(shù)(BI)、Modified Rankin Scale(mRS)積分、生存質量指數(shù)變化。結果:兩組在性別、年齡、發(fā)病時間、病情程度、基礎疾病、各項臨床評分等方面差異均無統(tǒng)計學意義(P0.05),具有可比性。治療后,兩組NIHSS評分較治療前均明顯下降,生存質量指數(shù)較發(fā)病后1周顯著升高(P0.05);治療組NIHSS評分較對照組降低,生存質量指數(shù)較對照組提高(P0.05)。結論:痰瘀阻絡方治療急性腦梗死痰瘀阻絡證臨床療效顯著,能明顯改善患者神經功能缺損癥狀、提高患者生活質量;通過DTI檢查,客觀地證明痰瘀阻絡方對梗死病灶區(qū)細胞內自由水分子彌散運動的改善作用。本次研究未能驗證rFA與NIHSS評分的相關性。
[Abstract]:Objective: to evaluate the effect of Tanyu Zholuo recipe on neurological deficit, quality of life and improvement of intracellular free water molecule diffusion movement in patients with acute cerebral infarction with phlegm and blood stasis syndrome by clinical comparative observation and magnetic resonance diffusion tensor imaging (DTI), and to analyze the diffusion movement of free water molecules and neurological deficit in patients with new intracranial infarction. The relationship between quality of life, etc. Methods: forty patients with phlegm and blood stasis syndrome in acute cerebral infarction were divided into treatment group (n = 20) and control group (n = 20). Both groups were treated with routine western medicine, and the treatment group was treated with phlegm and blood stasis blocking collaterals prescription. The apparent diffusion coefficient (ADC) of partial anisotropy (FA), in the new infarction area and the contralateral mirror area were observed and compared on the 7th day, the 14th day, the 28th day, the NIHSS score, the Barthel index (BI), Modified Rankin Scale (mRS) score and the quality of life index. Results: there was no significant difference in sex, age, time of onset, degree of illness, basic disease and clinical score between the two groups (P 0.05), and there was no significant difference between the two groups in sex, age, time of onset, degree of illness, basic disease and clinical score (P 0.05). After treatment, the NIHSS score of the two groups was significantly lower than that before treatment, and the quality of life index (QOL) was significantly higher than that of the control group (P 0.05). The NIHSS score of the treatment group was lower than that of the control group, and the QOL index of the treatment group was higher than that of the control group (P 0.05). Conclusion: Tanyu blocking collateral recipe is effective in the treatment of acute cerebral infarction with phlegm and blood stasis syndrome, which can obviously improve the symptoms of neurological deficit and improve the quality of life of patients, and objectively prove the effect of Tanyu blocking collateral recipe on the diffusion movement of free water molecules in the focal area of infarction by DTI examination. This study failed to verify the correlation between rFA and NIHSS score.
【學位授予單位】：南京中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R277.7

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