臭氧自血疗法辅助治疗急性脑梗死的疗效观察

发布时间：2018-04-29 20:59

本文选题：臭氧自血疗法 + 急性脑梗死　；参考：《吉林大学》2014年硕士论文

【摘要】：臭氧治疗脑梗塞及其后遗症的原理是通过医用臭氧与人体血液混合发生生化反应，生成一些生物促进因子和充足的氧气，从而达到溶解血栓、提高红细胞携氧能力、加快血液流速、降低血液粘性，溶解血管壁上的脂类杂质、恢复血管弹性，营养神经，恢复神经功能的作用。目的：通过观察臭氧自血疗法在脑梗死治疗方面的疗效，观察臭氧对脑梗死患者血脂的改变、评价臭氧对脑梗死患者神经功能缺损的影响、同时观察臭氧治疗的安全性，包括不良反应、合并症的发生，为臭氧治疗脑梗死这一新方法提供临床依据，以期减少后遗症的发生，提高患者的生活质量。方法：纳入2013年至2014年我院神经内科收入院的急性脑梗死患者130例，随机分为对照组65例和实验组65例，两组性别、年龄、体重指数、既往病史、发病时间等资料无统计学差异(P0.05)，具有可比性。对照组只给予活血化瘀、清除自由基、抗血小板聚集、调整血脂等基础用药及系统规范康复治疗。实验组在上述治疗的基础上加用臭氧自血疗法，具体操作步骤：应用德国郝尔曼多功能臭氧系统，1次/天，治疗10天。患者入院24h、住院治疗2周后(第15天)，分别于清晨空腹12小时以上的情况下抽取肘静脉血5ml，采用日立7600全自动生化仪及配套试剂测定甘油三脂(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平及血常规、肝功、肾功能。患者入院24小时、住院2周后(第15天)分别进行神经功能缺损程度评分及日常生活能力评分。本文采用NIHSS评分即美国国立卫生院神经功能缺损评分，采用Barthel指数，简称BI，评价日常生活能力。使用SAS9.0软件进行数据统计分析，各组计量资料用x s表示，组间比较使用ｔ检验及秩和检验；计数资料以率表示，组间比较采用χ２检验，P 0.05为差异有统计学意义。结果：治疗前两组患者血脂各项指标均无统计学差异；治疗2周后，两组患者甘油三酯、总胆固醇和高密度脂蛋白各项指标均无统计学差异（P0.05），低密度脂蛋白指标差异具有统计学意义（P0.05）；实验组与对照组患者疗效差异有统计学意义（Z=-2.14，P=0.02），总有效率实验组高于对照组。NIHSS评分结果显示，治疗前两组评分差异无统计学意义；治疗2周后，两组评分中，肢体活动和凝视指标差异具有统计学意义（P0.05），其他指标均无统计学差异（P＞0.05）；实验组与对照组NIHSS各项指标差值评分中，面瘫和肢体活动指标差异具有统计学意义（P0.05），其他指标均无统计学差异（P＞0.05）；Barthel评分结果显示，治疗前两组评分无统计学差异，，治疗后两组评分差异有统计学意义，两组治疗前后Barthel评分差值比较差异有统计学意义。治疗过程中未发现明显的不良反应，两组治疗对血常规、肝功能、肾功能指标均没有不良影响。结论：臭氧自血疗法辅助治疗脑梗死有较好疗效，可改善患者神经功能缺损、尤其对神经功能的运动功能有较大改善，提高日常生活能力，减轻后遗症程度，改善预后；也可改善血脂水平，尤其对降低低密度脂蛋白胆固醇及总胆固醇效果较好。且不良反应少，安全性好，在临床治疗中值得推广使用。
[Abstract]:The principle of ozone therapy for cerebral infarction and its sequelae is to produce some biological promoting factors and sufficient oxygen by mixing medical ozone with human blood to produce some biological promoting factors and sufficient oxygen to achieve thrombolytic thrombus, increase the oxygen carrying capacity of red blood cells, accelerate blood flow velocity, reduce blood viscosity, dissolve the lipid impurities on the blood vessel wall, and restore the vascular elasticity, Nourishment nerve, restore the function of nerve function.
Objective: To observe the curative effect of ozone self blood therapy in the treatment of cerebral infarction, observe the changes of the blood lipid of the patients with cerebral infarction, evaluate the effect of ozone on the nerve function defect of the patients with cerebral infarction, and observe the safety of the ozone treatment, including the adverse reaction and the occurrence of the complication, and provide the new method for the treatment of cerebral infarction by ozone. Clinical basis, in order to reduce the occurrence of sequelae and improve the quality of life of patients.
Methods: 130 cases of acute cerebral infarction in the Department of Neurology income Hospital of our hospital from 2013 to 2014 were randomly divided into 65 cases in the control group and 65 cases in the experimental group. The two groups of sex, age, body mass index, previous history, time of onset, and other data were not statistically different (P0.05). The control group was only given blood circulation to remove blood stasis, free radical scavenging, and anti blood small On the basis of the above treatment, the experimental group was added with ozone autologous blood therapy on the basis of the above treatment. The specific operation steps were: the German Herman multifunctional ozone system, 1 times / day, 10 days of treatment. The patients were admitted to hospital for 24h, and the hospitalization for 2 weeks (fifteenth days), respectively, more than 12 hours in the morning empty stomach. The blood 5ml of the elbow vein was extracted, and the Hitachi 7600 full automatic biochemical analyzer and the matching reagent were used to determine the glycerol three fat (TG), the total cholesterol (TC), the high density lipoprotein cholesterol (HDL-C), the low density lipoprotein cholesterol (LDL-C) level, the blood routine, the liver function and the renal function. The patients were admitted to hospital for 24 hours, and the neurological deficit course was carried out after 2 weeks of hospitalization (fifteenth days), respectively. Degree score and daily life ability score. The NIHSS score was used to score the neurological deficit of the National Institutes of health, and the Barthel index was used to evaluate daily living ability. The data were analyzed by SAS9.0 software. The measurement data of each group were expressed by x s, and the t test and rank sum test were used among the groups, and the count data were counted. The results showed that chi square test was used in comparison between groups, and P 0.05 was statistically significant in difference between 2 groups.
Results: there was no statistical difference between the two groups before the treatment. After 2 weeks of treatment, there was no statistical difference between the triglycerides, total cholesterol and high density lipoprotein in the two groups (P0.05), and the difference of low density lipoprotein index was statistically significant (P0.05), and the difference of curative effect between the experimental group and the control group was statistically significant. Significance (Z=-2.14, P=0.02), the total efficiency experimental group was higher than the control group.NIHSS score results showed that there was no significant difference between the two groups before the treatment. After 2 weeks of treatment, the differences of limb activity and gaze index in the two groups were statistically significant (P0.05), and the other indexes were not statistically different (P > 0.05), and the experimental group and the control group were NIHSS respectively. The difference between the facial paralysis and the limb activity index was statistically significant (P0.05), and the other indexes were not statistically different (P > 0.05). The results of Barthel score showed that there was no statistical difference between the two groups before treatment, and the difference between the two groups after the treatment was statistically significant, and the difference of the two groups before and after the treatment was different. No significant adverse reactions were found in the course of treatment. There was no adverse effect on blood routine, liver function and renal function in the two groups.
Conclusion: the adjuvant therapy of ozonemia has a good effect on cerebral infarction. It can improve the nerve function defect, especially improve the motor function of nerve function, improve the daily living ability, reduce the degree of sequelae, improve the prognosis, and also improve the blood lipid level, especially to reduce the low density lipoprotein cholesterol and total cholesterol. The fruit is good, and has few adverse reactions and good safety. It is worth popularizing in clinical treatment.

【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R743.3

【参考文献】