化痰通络汤加减联合头皮针治疗急性脑梗死（风痰瘀阻证）的临床观察

发布时间：2018-01-21 19:52

本文关键词： 脑梗死化痰通络汤针灸血脂血液流变学　出处：《广西中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:观察以化痰通络汤为主方加减联合头皮针治疗急性脑梗死(风痰瘀阻证)的临床疗效,为中医药治疗急性脑梗死提供中医理论基础。方法:选择2014年6月~2015年6月广西中医药大学附属钦州市中医医院收治的80例脑梗死急性期患者,中医符合风痰瘀阻证,并均经头部CT或MRI检查确诊。采用随机数字标法随机分为观察组和对照组,每组各40例。对照组予阿司匹林肠溶片、阿托伐他汀钙片等常规西医治疗,观察组在对照组西医常规治疗基础上予化痰通络汤加减联合头皮针治疗,治疗15d后观察比较两组的临床疗效,两组治疗前后神经功能缺损评分及中医症候积分的变化情况,同时检测两组患者治疗前后的血脂各项指标包括总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、低密度脂蛋白(low density lipoprotein,LDL)、高密度脂蛋白(high density lipoprotein,HDL)水平,血液流变学各项指标包括全血黏度(高切、低切)、血浆黏度,并计算红细胞聚集指数、红细胞变形指数,并进行对比分析。结果:(1)临床疗效:观察组治疗后的总有效率92.5%,显著高于对照组的总有效率70.0%,差异有统计学意义(P0.05),提示观察组的临床疗效显著优于对照组。(2)神经功能缺损评分(NDS):治疗后两组患者的神经功能缺损评分均显著下降,观察组治疗前后差值显著高于对照组,差异有统计学意义(P0.05),提示观察组的神经功能缺损改善情况显著优于对照组。(3)中医症候积分:治疗后两组患者的中医症候积分与治疗前比较显著降低,且观察组治疗前后差值显著高于对照组,差异有统计学意义(P0.05),提示观察组的中医临床症状改善优于对照组。(4)各项血脂指标:治疗后观察组各项血脂指标TC、TG、LDL、HDL水平分别较对照组变化更显著,差异有统计学意义(P0.05)。(5)各项血液流变学指标:观察组各项血液流变学指标全血黏度(高切、低切)、血浆黏度,红细胞聚集指数、红细胞变形指数分别较对照组变化更显著,差异有统计学意义(P0.05)。结论:以化痰通络汤为主方加减联合头皮针治疗急性脑梗死(风痰瘀阻证)疗效显著,可有效改善风痰瘀阻证急性脑梗死患者的临床症状体征,改善患者的神经功能,降低血脂及改善血液流变学各项指标,值得临床推广应用。
[Abstract]:Objective: to observe the clinical effect of Huatan Tongluo decoction (Huatan Tongluo decoction) combined with scalp acupuncture in the treatment of acute cerebral infarction (wind-phlegm stasis syndrome). To provide the theoretical basis of Chinese medicine for the treatment of acute cerebral infarction. Methods:. From June 2014 to June 2015, 80 patients with acute cerebral infarction were selected from Qinzhou Hospital of traditional Chinese Medicine, affiliated to Guangxi University of traditional Chinese Medicine. Chinese medicine accord with the syndrome of wind and phlegm stasis and were diagnosed by CT or MRI. The patients were randomly divided into observation group and control group with 40 cases in each group. The control group was treated with aspirin enteric-coated tablets. The observation group was treated with Huatan Tongluo decoction combined with scalp acupuncture on the basis of routine western medicine treatment in the control group. After 15 days of treatment, the clinical effects of the two groups were observed and compared. Changes of neurological deficit score and TCM symptom score before and after treatment in both groups. Serum lipids were measured before and after treatment in both groups, including total cholesterol cholesterol (TC) and triglyceride triglyceride (TG). Low density lipoprotein, high density lipoprotein, high density lipoprotein. HDL, hemorheology, including whole blood viscosity (high shear, low shear, plasma viscosity, erythrocyte aggregation index, erythrocyte deformability index). Results: the total effective rate of the observation group after treatment was 92.5, significantly higher than that of the control group, the total effective rate was significantly higher than that of the control group, the difference was statistically significant (P 0.05). The results suggest that the clinical efficacy of the observation group is significantly better than that of the control group. The difference before and after treatment in the observation group was significantly higher than that in the control group (P 0.05). It is suggested that the improvement of nerve function defect in the observation group is significantly better than that in the control group. 3) the TCM symptom score of the two groups after treatment is significantly lower than that before treatment. The difference before and after treatment in the observation group was significantly higher than that in the control group (P 0.05). It is suggested that the improvement of TCM clinical symptoms in the observation group is better than that in the control group. (4) the changes of serum lipids in the observation group are more significant than those in the control group after treatment. The difference was statistically significant (P 0.05. 0. 05. 5) the hemorheological indexes of the observation group were the whole blood viscosity (high shear, low shear, plasma viscosity, erythrocyte aggregation index). The erythrocyte deformability index was more significant than that of the control group. Conclusion: Huatan Tongluo decoction plus or minus scalp acupuncture treatment of acute cerebral infarction (wind and phlegm stasis syndrome) has a significant effect. It can effectively improve the clinical symptoms and signs of patients with acute cerebral infarction of wind-phlegm and stasis syndrome, improve the neurological function of patients, reduce blood lipid and improve the indexes of hemorheology, which is worthy of clinical popularization and application.
【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】：2016
【分类号】：R277.7

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