苇茎汤合麻杏石甘汤加减治疗卒中相关性肺炎痰热蕴肺证的临床观察

发布时间：2017-12-27 14:05

本文关键词：苇茎汤合麻杏石甘汤加减治疗卒中相关性肺炎痰热蕴肺证的临床观察　出处：《湖北中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：研究目的:评价苇茎汤合麻杏石甘汤加减治疗卒中相关性肺炎痰热蕴肺证的临床疗效及安全性。研究方法:收集2014年3月至2015年9月在湖北省中医院脑病科病房住院治疗的符合卒中相关性肺炎痰热蕴肺证纳入标准的病例60例,随机分为治疗组30例,对照组30例,两组均施以卒中相关性肺炎的规范治疗,治疗组则在对照组的基础上加用苇茎汤合麻杏石甘汤加减中药方,疗程为14天,观察两组总疗效、中医证候积分、炎性指标、Bathel指数评分等指标的变化,并观察治疗过程中可能出现的不良反应。采用SPSS17.0统计软件对数据资料进行分析。结果:1.中医证候总疗效:治疗组总有效率为93.33%,高于对照组总有效率(83.33%),差异有统计学意义(P0.05)。2.中医证候总积分:对照组和治疗组在治疗后中医证候总积分均比治疗前显著降低,差异有统计学意义。对治疗后的中医证候总积分进行组间比较,差异有统计学意义(P0.05),治疗组优于对照组。3.中医证候单项积分:治疗组治疗后的各项中医证候积分进行比较,均有显著下降(P0.01),差异有统计学意义。对照组患者治疗后的中医证候积分在发热、咳嗽、痰色、痰质、胸痛、口干等方面均较治疗前明显下降(P0.01),在改善脉滑数方面也有下降(P0.05),但是腹胀便秘及舌红苔黄等好转不明显,差异无统计学意义(P0.05)。对治疗后对照组和治疗组的患者各单项证候进行组间比较,治疗组在改善SAP患者咳嗽、痰色、痰质、口干、腹胀便秘、舌红苔黄、脉滑数等方面优于对照组(P0.05),差异有统计学意义。但是在改善发热和胸痛等方面,和对照组相比,差异无统计学意义(P0.05)。4.治疗前后炎性指标比较:两组患者治疗后炎性指标均较治疗前显著下降(P0.01),差异有统计学意义,但是对两组患者治疗后炎性指标进行组间比较,发现无显著差异(P0.05)。5.治疗前后Bathel指数积分比较:分别对两组患者治疗前后的Bathel指数积分进行比较,差异无统计学意义(P0.05);治疗后进行组间比较,差异无统计学意义(P0.05)。6.安全性:两组患者在治疗期间都没有出现不良反应。结论:1.苇茎汤合麻杏石甘汤加减治疗卒中相关性肺炎痰热蕴肺证在改善总有效率、中医证候总积分、部分单项中医证候方面优于单用西药治疗。2.苇茎汤合麻杏石甘汤加减在治疗过程中未发生不良反应,安全性高。
[Abstract]:Objective: To evaluate the efficacy and safety of Weijing Decoction and Maxingshigan Decoction in the treatment of stroke associated pneumonia phlegm. Methods: from March 2014 to September 2015 in Hubei Provincial Traditional Chinese Medical Hospital Department of encephalopathy hospitalized for treatment of stroke associated pneumonia with phlegm and 60 cases were included in the standard case, were randomly divided into treatment group of 30 cases, 30 cases in the control group, two groups were treated with standardized treatment of stroke associated pneumonia, the treatment group on the basis of the control group with reed stem of Maxingshigan Decoction Decoction prescription, treatment for 14 days, to observe the change of the total effect of the two groups, TCM syndrome integral, inflammatory index, Bathel index and other indicators, and to observe the possible adverse reactions during treatment. The SPSS17.0 statistical software was used to analyze the data. Results: 1. the total curative effect of TCM syndrome: the total effective rate of the treatment group was 93.33%, which was higher than the control group (83.33%), and the difference was statistically significant (P0.05). 2. total score of TCM syndrome: the total score of TCM syndrome in the control group and the treatment group was significantly lower than that before the treatment, and the difference was statistically significant. The total score of TCM syndrome after treatment was compared between groups, the difference was statistically significant (P0.05), and the treatment group was better than the control group. 3. single score of TCM syndrome: the scores of TCM syndromes in the treatment group were compared, and there was a significant decrease (P0.01), the difference was statistically significant. The control group of TCM syndrome score after treatment in patients with cough, fever, sputum, sputum color in the matter, chest pain, dry mouth and so on were significantly lower than before treatment (P0.01), in improving the slippery pulse number has decreased (P0.05), but abdominal distension constipation and red tongue etc. improvement is not obvious, there is no statistical difference meaning (P0.05). For each single syndrome after the treatment in the control group and treatment group were compared between the two groups, the treatment group in the improvement of cough, phlegm, phlegm in patients with SAP color, dry mouth, abdominal distension, constipation, red tongue, slippery pulse number is better than the control group (P0.05), the difference was statistically significant. However, there was no significant difference in the improvement of fever and chest pain compared with the control group (P0.05). 4. before and after treatment, inflammatory markers were compared: the inflammatory indexes in two groups were significantly lower than those before treatment (P0.01), but the difference was statistically significant. However, there was no significant difference between the two groups in the inflammatory markers after treatment (P0.05). 5. before and after treatment, the Bathel index scores were compared. There was no significant difference in the Bathel index scores between the two groups before and after treatment (P0.05). There was no significant difference between the two groups after treatment (P0.05). 6. safety: two groups of patients had no adverse reactions during the treatment. Conclusion: 1. Weijing Decoction and Maxingshigan Decoction in the treatment of stroke associated pneumonia phlegm in improving the total efficiency, total score of TCM symptoms, better than the single part of TCM with western medicine alone. 2. Weijing Decoction and Maxingshigan Decoction in the treatment process, no adverse reaction, high safety.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259;R277.7

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