中成药注射液治疗缺血性脑卒中情况调查分析

发布时间：2018-05-29 06:15

本文选题：缺血性脑卒中 + 脑梗死　；参考：《承德医学院》2017年硕士论文

【摘要】：缺血性脑卒中即脑梗死,占全部卒中的85%,临床表现为半身不遂口眼?斜、语言不利,中国脑卒中发病率居世界首位。全国第3次死因回顾抽样调查资料表明,当前脑卒中已经成为我国导致患者死亡和致残的第一位因素。2013年,脑卒中导致的死亡人数已高达170万,数据显示,再次复发率也很高。尽管治疗脑血管病的医疗技术在不断的提高,脑梗死的病死率、复发率和致残率仍没有很大改善。依据中华医学会神经病学分会脑血管病学组撰写的《中国急性期缺血性脑卒中诊治指南2014》,其中提到西医治疗主要以改善脑血循环和神经保护为重点,而中成药和中成药注射液治疗急性缺血性脑卒中的疗效还需要更多的高质量临床随机对照试验进一步证实。所以对缺血性脑卒中(脑梗死)治疗中中成药注射剂的应用情况进行调查分析,了解其用药情况和不良反应的发生情况,可以为科研和临床治疗用药提供参考。目的:调查分析中成药注射液治疗缺血性卒中的临床治疗文献中的中成药注射剂的种类、数量、研究类型(随机对照文献和非随机对照文献)、样本量、剂量、疗程、溶媒、合并用药、不良反应的具体情况,并得出结论,为今后相关研究工作和临床用药提供参考。方法:文献资料来源于2016年10月1日前中国知网全文数据库(CNKI)、万方全文数据库发表的期刊、硕博论文、会议、报纸,以中成药注射液为干预措施的临床病例、对照文献。运用文献调查研究的方法了解文献的发表数量及研究内容采用Noteexpress进行文献检索,检索式为篇名=“注射液/剂”and篇名=“缺血性脑卒中”or“脑梗死”or“脑梗塞”or“脑栓塞”or“脑血栓”or“缺血性卒中”or“缺血性脑血管病”or“缺血性中风”and篇名=“临床”or“病例”or“对照”,进行统计分析与辅助作图。结果:知网检出文献2033篇,去掉内容交叉的1391篇,剩余642篇。万方检出文献2133,去掉内容交叉的19篇,剩余2114篇。两库文献相加去掉两个库重复的968篇文献,剩余1788篇文献。所用的中成药注射液总共68种,按中医理论辩证分型,文献中提到比较多的有活血化瘀类包括丹红注射液、疏血通注射液、灯盏花素注射液、灯盏细辛注射液、葛根素注射液、脉络宁注射液、苦碟子注射液;清热解毒、活血开窍醒脑类醒脑静注射液;益气扶正类的黄芪注射液;平补肝肾、益精壮骨类的刺五加注射液;益气固脱养阴生津类的参麦注射液;回阳救逆类的参附注射液;息风止痉,平抑肝阳祛风通络类的天麻素注射液;养血活血类的香丹注射液;行气除满,开胸除痹类的瓜蒌皮注射液等。结论:1.此类文献中提到的临床研究类型大多为随机对照研究,临床观察类较少。2.此类注射液多用于急性期,恢复期和后遗症期比较少,不管是哪一期,辩证用药都比较少。3.活血化瘀类用药最多,黄芪补气类合并用药最多。4.基本没有关于正常剂量和超剂量使用的临床随机对照试验研究,今后应该增加这方面的研究。5.超疗程使用情况也存在,应尽量间隔一段时间再继续用药,尽量中病及止。6.存在不按说明书使用溶媒的情况。7.联合用药时需要适当间隔一定时间,不建议间隔输液后序贯给药,在保证安全的情况下可以辩证联合不同功效的药物。8.不良反应存在记录不明确的情况。
[Abstract]:Ischemic stroke is cerebral infarction, which accounts for 85% of all stroke. Clinical manifestations are hemiplegia, oblique, and bad language. The incidence of stroke in China ranks first in the world. The data of the national third cause of death review shows that the current stroke has become the first factor leading to death and disability in China,.2013 years, and stroke caused by stroke. The number of deaths is up to 1 million 700 thousand, and the recurrence rate is also high. Despite the continuous improvement in the treatment of cerebrovascular diseases, the mortality rate, the recurrence rate and the rate of disability are still not greatly improved. According to the Chinese Medical Association neurology branch cerebrovascular disease group, the diagnosis and treatment of acute ischemic stroke in China The treatment of Western medicine mainly focuses on the improvement of cerebral blood circulation and neuroprotection, and the curative effect of Chinese patent medicine and Chinese patent medicine injection in the treatment of acute ischemic stroke should be further confirmed by more high quality clinical randomized controlled trials. Therefore, the application of Chinese medicine injection in the treatment of ischemic stroke (cerebral infarction), 2014> Investigation and analysis, to understand the situation of drug use and the occurrence of adverse reactions, can provide reference for scientific research and clinical treatment. Objective: To investigate the types, quantity and types of Chinese patent medicine injection in the literature of treatment of ischemic stroke by Chinese patent medicine injection (random control literature and non random control) Sample volume, dose, course of treatment, solvent, combined use of drugs, adverse reactions, and draw conclusions for future related research and clinical use. Methods: literature from the full text database of Chinese net (CNKI) before October 1, 2016, journals published by Wanfang full text database, large papers, conferences, newspapers, and The clinical cases of intervention measures were the clinical cases and the control literature. Using the method of literature investigation, the number of publications and the contents of the literature were searched by Noteexpress. The title = "injection / agent" and name = "ischemic stroke", "cerebral infarction", "cerebral infarction", "cerebral infarction", "cerebral embolism", "or", "or", "Noteexpress" Cerebral thrombosis "or" ischemic stroke "or" ischemic cerebrovascular disease "ischemic stroke" or "ischemic stroke" and name = "clinical" or "case" or "control", statistical analysis and auxiliary mapping. Results: 2033 papers, 1391 pieces of content crossing, the remaining 642 pieces were removed. 2133 of the documents were detected by Wan Fang, and 19 pieces of cross content were removed. The remaining 2114 articles. The two library documents are added to the 968 literature of two libraries, and the remaining 1788 documents. There are 68 kinds of Chinese traditional Chinese medicine injection. According to the dialectical classification of traditional Chinese medicine, there are a lot of blood circulation and blood stasis types including Danhong injection, Shuxuetong injection, caperabine injection, Erigeron Breviscapine injection, and puerarin injection. Injection of liquid, mailuing injection, kusezi injection; clearing heat and detoxifying, Xingnao Xingnaojing injection of activating blood and resuscitation; astragalus injection of Yiqi Fuzheng class; Ping supplementing liver and kidney, benefiting essence and Zhuanggu injection; Shenmai injection, nourishing qi and nourishing yin and nourishing Yin, Shenfu injection of Huiyang rescue and antispasm, relieving spasmodic and relieving wind and dredging the collaterals of liver Yang Type of Gastrodin Injection; nourishing blood and activating blood class Xiangdan injection; gas removal to full, open chest and arthralgia Trichosanthes peel injection. Conclusion: 1. the clinical research types mentioned in this literature are mostly randomized controlled study, the clinical observation class less.2. injection is mostly used in the acute period, the recovery period and the sequela period are relatively few, whatever Period, the dialectical drug use is less.3. activating blood and removing blood stasis drugs most, the Astragalus Qi supplementing type combined with the most.4. does not have the basic clinical randomized controlled trial study on the normal dose and the super dose. In the future, we should increase this aspect of the study of.5. super course of treatment, and try to keep the use of drugs as far as possible as far as possible. The disease and the presence of.6. do not exist in the case of the use of solvent in the instructions of the instruction of.7., it is necessary to have a proper interval of time, not to recommend the sequential administration after the interval infusion. In the case of safety, the adverse reaction of the drug.8. can be dialectically combined with different efficacy.
【学位授予单位】：承德医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R277.7

【参考文献】