刺血对高血压脑出血急性期血压控制的临床研究

发布时间：2018-03-08 23:27

本文选题：刺血　切入点：中医疗法　出处：《广州中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:观察刺血疗法对高血压脑出血急性期的中短期降压效果,为刺血降压提供依据,明确刺血降压对高血压脑出血急性期患者血压控制的可行性,进一步探讨刺血对高血压脑出血患者预后的影响。方法:本课题将2016年5月至2017年3月期间广东省中医院高血压脑出血急性期住院患者为研究对象,并根据病例纳入、排除及剔除标准纳入患者,患者随机分为治疗组及对照组,每组各30例患者。治疗组:在使用西药降压的基础治疗上,对脑出血部位对侧肢体十宣穴及耳尖穴进行刺血治疗;对照组:常规使用西药降压治疗。研究人员通过观察两组患者血压波动情况、脑血肿是否进展、意识、肢体功能恢复情况等,如实填写临床病例观察表,保存原始临床资料。将各患者的临床病例观察表录入Excel建立数据库,运用统计学软件SPSS21.0对两组数据进行重复测量方差分析进行数据统计。结果:本课题共计收集患者62名高血压脑出血患者,剔除2名,因两名患者提前出院而终止,最后共计纳入60名高血压脑出血患者。其中治疗组和对照组分别有16、13例行手术治疗,两组患者均未出现死亡同时治疗组患者经刺血治疗后均未出现不良反应。经统计学处理可知治疗组与对照组的患者一般情况无统计学差异,治疗前两组患者来源于同一个总体。我们通过对两组患者血压进行组间对比,发现刺血组患者血压在刺血后短时间内下降,血压下降后血压相对平稳,血压控制效果优于对照组;其他观察指标方面,经统计学处理,结果提示两组间GOS评分、GCS评分、脑血肿大小、肌力未见明显统计学差异,但是组内患者治疗前后自身对照,发现组内患者后的GOS评分、GCS评分、脑血肿大小、肌力与治疗前对比有统计学差异。两组患者中仅对照组发生1例脑血肿扩大。此外初步统计治疗组联合使用的降压药物更少且血压更平稳。结论:高血压脑出血急性期患者可采用刺血疗法,该疗法可在短时间内降低血压,同时使高血压脑出血患者中短期血压更加稳定,血压控制效果更佳。刺血疗法具有祛邪扶正、清热解毒、醒神开窍等功效,其可在一定程度上促进患者的意识恢复、改善神经功能缺损、维持脑血肿稳定同时减少降压药使用。刺血疗法为高血压脑出血早期积极降压提供迅速有效的治疗方法,此疗法让传统医学与现代医学优势互相结合,让中西医的更好的为人类健康服务,也为传统医学的现代化应用研究提供新方向。概而言之,该疗法操作简便,安全有效,值得在广大基层推广,让更多患者受益。
[Abstract]:Objective: to observe the effect of blood pricking therapy on blood pressure reduction in the acute stage of hypertensive intracerebral hemorrhage, to provide basis for blood pricking and lowering blood pressure, and to determine the feasibility of blood pressure control in patients with hypertensive intracerebral hemorrhage at the acute stage of hypertensive intracerebral hemorrhage. Methods: from May 2016 to March 2017, the inpatients with hypertensive intracerebral hemorrhage in Guangdong Provincial Hospital of traditional Chinese Medicine were included in the study. The patients were randomly divided into treatment group (n = 30) and control group (n = 30). Control group: routine use of western medicine to reduce blood pressure. By observing the fluctuation of blood pressure, progress of cerebral hematoma, consciousness, recovery of limb function, and so on, the researchers truthfully filled out the observation form of clinical cases. Save the original clinical data. Input the clinical observation form of each patient into the Excel to establish the database. Results: 62 patients with hypertensive intracerebral hemorrhage were collected, 2 patients were excluded, and 2 patients were terminated because two patients were discharged early. Finally, a total of 60 patients with hypertensive intracerebral hemorrhage were included. Among them, 1613 patients in the treatment group and the control group received surgical treatment respectively. There was no death in the two groups and there was no adverse reaction in the treatment group after blood prick treatment. There was no statistical difference between the treatment group and the control group. Before treatment, the two groups came from the same population. By comparing the blood pressure between the two groups, we found that the blood pressure of the patients in the blood pricking group decreased in a short period of time after the prick, and the blood pressure after the blood pressure drop was relatively stable. The effect of blood pressure control was better than that of the control group. The results showed that there was no significant difference in GOS score, hematoma size and muscle strength between the two groups, but there was no significant difference between the two groups before and after treatment, but there was no significant difference between the two groups before and after treatment. The GOS score, the size of cerebral hematoma, and the size of cerebral hematoma were found in the patients of the group. There was statistical difference between muscle strength and pre-treatment. In the two groups, only one case of cerebral hematoma was enlarged in the control group. In addition, the combined use of antihypertensive drugs and blood pressure in the preliminary statistical treatment group was less and the blood pressure was more stable. Conclusion: hypertensive intracerebral hemorrhage is more stable. Patients in acute stage can be treated with blood pricking therapy. This therapy can lower blood pressure in a short time, at the same time make the blood pressure of patients with hypertensive intracerebral hemorrhage more stable, blood pressure control effect is better. Pricking blood therapy has the functions of dispelling evil and strengthening, clearing away heat and detoxifying, waking up the spirit and opening the orifices, etc. To a certain extent, it can promote the recovery of consciousness, improve the nerve function defect, maintain the stability of cerebral hematoma and reduce the use of antihypertensive drugs. Blood pricking therapy can provide a rapid and effective treatment for the early stage of hypertensive intracerebral hemorrhage. This therapy combines the advantages of traditional medicine and modern medicine, so that traditional Chinese and western medicine can better serve human health, and also provide a new direction for the modern application of traditional medicine. In summary, the treatment is simple, safe and effective. Worth popularizing in broad grass-roots, let more patient benefit.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R743.34

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