益气活血法预防进展性脑卒中的临床研究

发布时间：2018-04-29 15:13

本文选题：进展性脑卒中 + 益气活血法　；参考：《河北医科大学》2016年硕士论文

【摘要】：目的:本研究通过对168例急性早期缺血脑卒中患者的临床研究,观察治疗前与益气活血药治疗至发病第8天的NIHSS评分及中医证候量化评分,评价益气活血法在预防进展性脑卒中的疗效。方法:符合纳入标准的患者168例,随机分为对照组86例给予西医常规治疗;治疗组82例在西医常规治疗的基础上给予参芪扶正注射液联合丹红注射液干预,连续用药至发病第7天。统计分析两组美国国立卫生研究院卒中量表(NIHSS)和中医证候量化评分,对治疗组与对照组评分变化进行组内前后比较,以及两组治疗前后评分进行比较,并观察两组治疗前后证型分布特征。结果:治疗组1例发生进展性脑卒中,对照组7例;益气活血组发生进展性脑卒中的患者明显少于对照组,差异具有统计学意义(P0.05);治疗组治疗前后NIHSS评分比较(P0.05),表明差异无统计学意义;对照组治疗前后NIHSS评分比较,治疗后明显高于治疗前评分(P0.05),治疗前后差异有统计学意义。治疗组治疗前后中医证候量化评分比较(P0.05),表明治疗组中医证候量化评分差异无显著统计学意义;对照组治疗前后中医证候量化评分比较,对照组治疗后评分高于治疗前,(P0.05),表明对照组治疗前后中医证候量化评分差异具有统计学意义。两组治疗前NIHSS评分比较(P0.05),差异无统计学意义;两组治疗前中医证候量化评分比较(P0.05),差异无统计学意义。两组治疗后NIHSS评分比较(P0.05),差异具有统计学意义,表明治疗组神经缺损程度改善明显优于对照组;两组治疗后中医证候量化评分比较(P0.05),差异无统计学意义。治疗组各证素治疗前后(P0.05),无统计学意义。表明火热证候未见明显变化。证素之间比较未见明显变化(P0.05);对照组各证候治疗前后(P0.05),无统计学意义。各证素之间比较,风证与瘀证有明显变化,具有统计学意义(P0.05),其余证素之间未见明显变化,无统计学意义(P0.05)。表明对照组治疗前后火热证未见明显变化。两组血压比较治疗组第一天143.94±19.18,第二天141.21±17.04,第三天138.15±15.41;对照组第一天145.44±15.18,第二天141.51±14.71第三天138.24±12.92,无统计学意义(P0.05)。结论:1气虚血瘀是影响缺血性脑卒中病理进程的主要机制,尤其决定着进展性脑卒中的预后转归;2益气活血法可有效控制进展性脑卒中发生,能减少并发症的出现,未发现改药有明显的不良反应;3益气活血法可有效改善急性脑卒中患者神经功能缺损。
[Abstract]:Objective: through the clinical study of 168 patients with acute early ischemic stroke, the NIHSS score and the quantitative score of TCM syndromes were observed before treatment and 8 days after treatment with Yiqi Huoxue medicine. Objective: to evaluate the efficacy of Yiqi Huoxue method in the prevention of progressive stroke. Methods: 168 patients who met the inclusion criteria were randomly divided into control group (86 cases) and treatment group (82 cases) treated with Shenqi Fuzheng injection combined with Danhong injection. The patients were treated continuously until the 7th day. The stroke scale NIHSS (National Institutes of Health) and the quantitative score of TCM syndromes in the two groups were statistically analyzed. The scores of the treatment group and the control group were compared before and after treatment, and the scores before and after treatment were compared between the two groups. The distribution characteristics of syndromes before and after treatment were observed. Results: one case of progressive stroke occurred in the treatment group and 7 cases in the control group, and the number of patients with progressive stroke in the Yiqi and Huoxue group was significantly lower than that in the control group. The difference was statistically significant (P 0.05); the comparison of NIHSS scores before and after treatment in the treatment group showed no statistical significance; in the control group, the comparison of NIHSS score before and after treatment was significantly higher than that before and after treatment (P 0.05), and the difference before and after treatment was statistically significant. Comparison of quantitative scores of TCM Syndromes before and after treatment in the treatment Group (P0.05), which indicated that there was no significant difference in the quantitative scores of TCM syndromes in the treatment group, while in the control group, the quantitative scores of TCM syndromes were compared before and after treatment. The scores after treatment in the control group were higher than those in the control group before and after treatment, indicating that the quantitative score of TCM syndrome in the control group had statistical significance before and after treatment. There was no significant difference in NIHSS score before treatment between the two groups, and there was no significant difference between the two groups in the quantitative score of TCM syndromes before treatment. After treatment, the NIHSS score of the two groups was significantly higher than that of the control group, and the difference was statistically significant, indicating that the improvement of the degree of nerve defect in the treatment group was significantly better than that in the control group, while the quantitative score of TCM syndrome after treatment in the two groups had no statistical significance. In the treatment group, there was no statistical significance before and after treatment. The results showed that there was no obvious change in the syndrome of hot fever. There was no significant change in the syndromes between the two syndromes, but there was no significant difference between the control group and the control group before and after treatment. Compared with other syndromes, wind syndrome and blood stasis syndrome had significant changes (P 0.05), while the other syndromes had no significant change (P 0.05). The results showed that the control group had no obvious change before and after treatment. The blood pressure of the two groups was 143.94 卤19.18 on the first day, 141.21 卤17.04on the second day, 138.15 卤15.41 on the third day, and 145.44 卤15.18 on the first day and 138.24 卤12.92 on the second day in the control group. Conclusion 1 qi deficiency and blood stasis is the main mechanism that affects the pathological process of ischemic stroke, especially the prognosis of progressive stroke can be controlled effectively and the complications can be reduced by the method of promoting Qi and activating Blood Circulation, which can effectively control the occurrence of progressive stroke. It was not found that the modified drug had obvious adverse reactions. The method of supplementing qi and activating blood circulation could effectively improve the nerve function defect in patients with acute stroke.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R277.7

【相似文献】