大柴胡汤治疗证属少阳阳明经合病缺血性卒中急性期的临床疗效观察

发布时间：2018-05-24 08:45

本文选题：缺血性卒中急性期 + 大柴胡汤　；参考：《广西中医药大学》2017年硕士论文

【摘要】：目的:观察大柴胡汤治疗证属少阳阳明经合病的缺血性卒中急性期的临床疗效。方法:本研究纳入缺血性卒中急性期证属少阳阳明合病患者60例,随机分为对照组与治疗组各30例,对照组给予抗血小板药物、他汀类药物治疗,同时控制血压、血糖、体温,予以康复指导。治疗组在对照组治疗基础上加用大柴胡汤,连续治疗2周,用神经功能缺损评分(NIHSS评分)、日常生活活动能力量表Barthel指数(BI评分)、实际完成日常生活活动的改良Rankin量表(MRS评分)以及中医证候积分、中医证候疗效进行评价,记录各组患者治疗前后不良反应及评估其安全性,同时通过观察2组间的数据差异对比及统计学分析,进而综合评测大柴胡汤治疗缺血性卒中急性期病属少阳阳明合病的临床疗效及安全性。结果:(1)临床疗效:治疗组总有效率为92.86%,对照组总有效率为71.43%,两组的总有效率比较具有差异性(P0.05)治疗组有效率优于对照组。(2)中医证候积分:两组治疗前后中医证候积分均有显著差异。组间比较提示治疗组与对照组均可显著改善中医证候,但以治疗组为优。(3)在神经功能缺损程度评分(NIHSS)及实际完成日常生活活动的改良Rankin量表(MRS评分)方面,两组治疗前均具有可比性(P0.05),两组治疗后比较,差异均有统计学意义(P0.05),结果显示治疗组优于对照组。(4)日常生活活动能力量表Barthel指数(BI评分):两组治疗前具有可比性(P0.05),两组治疗后比较,具有显著性差异(P0.05),两组治疗前后差值比较,具有统计学意义(P0.05),治疗组优于对照组。(5)安全性评价:两组治疗前后的血、尿、粪常规,肝、肾功能,凝血功能及心电图检查均无明显改变,两组治疗前后比较差异均无统计学意义(P0.05)。结论:大柴胡汤能改善证属少阳阳明经合病缺血性卒中急性期患者神经功能缺损程度,提高日常生活活动能力。
[Abstract]:Objective: to observe the clinical effect of Dachaihu decoction on acute ischemic stroke with Shaoyang Yangming disease. Methods: sixty patients with acute ischemic stroke were randomly divided into two groups: control group (n = 30) and treatment group (n = 30). The control group was treated with antiplatelet drugs and statins, and the blood pressure, blood glucose and body temperature were controlled at the same time. Give rehabilitation guidance. The treatment group was treated with Dachaihu decoction on the basis of control group for 2 weeks. The neurological deficit score (NIHSS), the activity of daily living (Barthel) index (BI), the modified Rankin scale (Mrs) and the TCM syndromes score were used to evaluate the efficacy of TCM syndromes. Adverse reactions before and after treatment were recorded and their safety was evaluated. Meanwhile, the data differences between the two groups were compared and statistically analyzed. The clinical efficacy and safety of Dachaihu decoction in treating acute ischemic stroke were evaluated. Results: the total effective rate of the treatment group was 92.86, the total effective rate of the control group was 71.43, the total effective rate of the two groups was different (P0.05) the effective rate of the treatment group was better than that of the control group. There are significant differences in integral. The comparison between the two groups indicated that both the treatment group and the control group could significantly improve the TCM syndromes, but the treatment group was the best. The comparison was made between the two groups before and after treatment. The difference was statistically significant (P 0.05). The results showed that the treatment group was superior to the control group (P < 0.05). The Barthel index and BI score of the activity of daily living scale (ADL) were significantly higher in the treatment group than in the control group (P < 0.05). The difference between the two groups was statistically significant (P 0.05). The safety of the treatment group was better than that of the control group (P 0.05): the blood, urine, fecal routine, liver and kidney function of the two groups before and after treatment were evaluated. There were no significant changes in coagulation function and electrocardiogram, and there was no significant difference between the two groups before and after treatment (P 0.05). Conclusion: Dachaihu decoction can improve the degree of nerve function defect and improve the activity of daily living in the patients with acute stroke of Shaoyang Yangming disease.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R743.3

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