中大量高血压脑出血中西医结合综合疗法方案研究

发布时间：2018-10-31 18:23

【摘要】： 背景：高血压脑出血(HCH)是严重威胁人类生命的三大疾病之一，发病率、病死率和致残率高，但是没有有效的处理方法，对其的防治研究越来越受到医学界的重视，特别是应用分子生物学、电镜显微检测技术、影像学等方法和手段，以及中医的发展和中西医结合的综合优势，已改变了过去对许多问题的认识及概念，，提高了临床诊断和治疗水平，有力的促进了中风脑病的发展。目前国内外医学界均认为，中西医结合综合救治是高血压性脑出血治疗的基本有效模式，是现代医疗方式的要求和现代卒中治疗的标志和趋向。因而，有必要对中大量高血压性脑出血进行中西医结合综合救治规范化的深入探索。目的：拟就中大量高血压脑出血急性期中西医结合综合疗法方案在临床中的应用提出自己研究思路。方法：将所有入选病例随机分为两组，分别是中西医结合综合治疗组、西医综合治疗对照组，采用神经功能缺损积分(NFI)变化及《泰安标准》的疗效评定标准等对治疗情况进行监测、记录，最后利用统计学方法处理相关数据，行疗效评价，科学总结。结果：经过一个疗程的治疗后，两组的临床症状及体征均得到了改善，但两组在改善的特点方面存在差异。治疗前两组的性别、年龄及神经功能缺损评分(NFD)、GCS评分、血肿量、中医症候评分比较及初始症候类型分度情况等无明显差异。但两组患者一周后疗效水平、达到有效或显效或痊愈的例数、神经功能缺损评分和《泰安标准》的疗效评定标准评分和总的生活能力状态(ADL)比较及生存质量(QLI指数)在治疗后7、14、28天的改变方面存在明显差异，经统计学方法处理，差异均有显著性意义(P＜0.05或．P＜0.01)。结论：规范化的中西医结合综合治疗能降低高血压脑出血患者死亡率、促进脑神经功能恢复、改善远期生存质量状况和减少残废率。
[Abstract]:Background: hypertensive intracerebral hemorrhage (HCH) is one of the three serious threats to human life. The morbidity, mortality and disability rate are high, but there is no effective treatment. In particular, the application of molecular biology, electron microscopy, imaging and other methods and means, as well as the development of traditional Chinese medicine and the comprehensive advantages of integration of traditional Chinese and western medicine, have changed the understanding and concept of many issues in the past. Improve the clinical diagnosis and treatment, and promote the development of stroke encephalopathy. At present, the comprehensive treatment of integrated traditional Chinese and western medicine is the basic effective mode of hypertensive intracerebral hemorrhage, which is the requirement of modern medical treatment and the symbol and trend of modern stroke treatment. Therefore, it is necessary to explore the standardization of integrated treatment of hypertension intracerebral hemorrhage. Objective: to study the clinical application of integrated Chinese and western medicine in the acute stage of hypertensive intracerebral hemorrhage. Methods: all the selected cases were randomly divided into two groups: the integrated treatment group and the control group. The changes of (NFI) and the evaluation standard of the therapeutic effect of Tai'an Standard were used to monitor and record the treatment situation. Finally, the relevant data were processed by statistical method, and the curative effect was evaluated and summarized scientifically. Results: after a course of treatment, the clinical symptoms and signs of the two groups were improved, but there were differences in the improvement characteristics between the two groups. There was no significant difference between the two groups in sex, age and neurological impairment score, (NFD), GCS score, hematoma volume, TCM symptom score and initial symptom classification before treatment. But the two groups of patients after a week of curative effect level, to achieve effective or significant effect or recovery of the number of cases, There were significant differences between the scores of neurological function defect and the evaluation standard of curative effect of Tai'an Standard, (ADL) and the quality of life (QLI index) in 7 days after treatment and 1428 days after treatment, which were dealt with by statistical method. The difference was significant (P < 0.05 or .P < 0.01). Conclusion: the standardized integrated treatment of traditional Chinese and western medicine can reduce the mortality of patients with hypertensive intracerebral hemorrhage, promote the recovery of cerebral nerve function, improve the long-term quality of life and reduce the rate of disability.
【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】：2007
【分类号】：R743.34

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