外科手术结合中医“通腑化痰祛瘀法”治疗高血压脑出血“痰热腑实证”的临床观察

发布时间：2018-03-10 16:44

本文选题：通腑化痰祛瘀法　切入点：外科手术　出处：《河南中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:观察外科手术结合中医“通腑化痰祛瘀法”治疗高血压脑出血痰热腑实证的疗效。方法:根据已经制定的纳入标准,随机将60例辨证为痰热腑实证的高血压脑出血患者分为中西医结合治疗组和西医治疗组,所有患者均于发病后24h内清除血肿,术后西医治疗组给予西医常规治疗;中西医结合治疗组在西医常规治疗的基础上在术后第三天开始加用中药口服或鼻饲治疗。两组疗程均为22天,观察两组在手术前后及术后不同时期患者临床神经功能缺损程度评分、残余血肿量、和中医症候积分的差异性,进行临床疗效评定。对于试验中所得到的数据采用统计学分析方法,使用SPSS18.0统计学软件进行数据处理。观察中医学在高血压脑出血术后治疗的临床改善情况。结果:(1)两组患者的一般资料(性别、年龄)方面差异性比较:通过采用统计学中x2检验、t检验和秩和检验等检验方法分别对两组患者一般资料(性别、年龄、伴发病或既往史)进行分析比较,统计学软件分析结果显示两组患者在上述方面具有可比性,无明显差异(P0.05)。(2)两组在手术前后的神经功能缺损程度评分、残余血肿量、和中医症候积分均有显著差异(P0.05)。(3)与西医治疗组比较,中西医治疗组术后第7、14、21天时神经功能缺损程度评分降低均有明显差异(P0.05)。(4)与西医治疗组比较,中西医治疗组术后第7、14天时残余血肿有明显差异(P0.05),第21天时无明显差异(P0.05)。(5)中西医结合治疗组对比西医治疗组在改善中医证候积分方面在7、14、21天时有着明显差异(P0.05)。结论:1.中西医结合治疗组较西医治疗组在治疗高血压脑出血痰热腑实证有明显优势。2.中西医结合治疗组在促进高血压脑出血的神经功能恢复、改善中医症候方面较西医治疗组有明显优势。3.中西医结合治疗组在血肿吸收方面与西医治疗组在前期存在优势,在后期血肿吸收无明显优势。
[Abstract]:Objective: to observe the curative effect of treating hypertensive cerebral hemorrhage with phlegm heat and heat in combination with surgical operation and traditional Chinese medicine "removing phlegm and removing blood stasis". Methods: according to the standard of inclusion, Sixty cases of hypertensive intracerebral hemorrhage with syndrome differentiation of phlegm and heat were randomly divided into two groups: the group treated with combination of traditional Chinese and western medicine and the group treated with western medicine. All the patients were cleared of hematoma within 24 hours after the onset of the disease. The western medicine group was given routine western medicine treatment after operation. On the third day after operation, the traditional Chinese medicine or nasal feeding was added to the traditional Chinese medicine treatment group. The course of treatment in both groups was 22 days. To observe the difference of clinical neurological function defect score, residual hematoma quantity and TCM symptom score between the two groups before and after operation and at different time after operation. To evaluate the clinical efficacy. Statistical analysis was used for the data obtained in the trial. SPSS18.0 statistical software was used to process the data. The clinical improvement of traditional Chinese medicine (TCM) in the treatment of hypertensive intracerebral hemorrhage after operation was observed. Results the general data of the two groups (sex, gender, Age differences: the general data (sex, age, onset or past history) of the two groups were analyzed and compared by using the x2 test and rank sum test respectively. The results of statistical software analysis showed that the two groups were comparable in the above aspects. There was no significant difference between the two groups in the degree of neurological impairment and the amount of residual hematoma before and after operation. There were significant differences in scores of symptoms and symptoms between TCM group and western medicine group (P0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05). There were significant differences in residual hematoma on the 7th day after operation between the traditional Chinese and western medicine treatment group and at the 21st day after operation. There was no significant difference between the traditional Chinese and western medicine treatment group and the western medicine treatment group in improving the score of TCM syndromes on the 71421 days after operation, there was significant difference between the treatment group and the western medicine group in improving the score of TCM syndromes at 71421 days. The combination of traditional Chinese and Western Medicine has obvious advantages in the treatment of phlegm and heat in hypertensive intracerebral hemorrhage. 2. The treatment group is promoting the recovery of nerve function of hypertensive intracerebral hemorrhage. Compared with the western medicine treatment group, the traditional Chinese medicine treatment group has obvious advantages in hematoma absorption, and the western medicine treatment group has the advantage in the early stage, but in the late stage there is no obvious advantage in hematoma absorption.
【学位授予单位】：河南中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R544.1;R651.1

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