破血逐瘀法与活血化瘀法对缺血性中风急性期疗效对比研究

发布时间：2018-06-09 21:23

本文选题：缺血性中风急性期 + 破血逐瘀　；参考：《河南中医药大学》2016年硕士论文

【摘要】：目的:通过随机对照试验,对比破血逐瘀法与活血化瘀法对缺血性中风急性期患者的临床疗效及安全性,初步评价破血逐瘀、活血化瘀两种疗法的作用强弱,进一步对两种疗法在缺血性中风急性期的应用做一定位、排序,以期为临床治疗提供指导。方法:选取符合条件的患者70例,采用SPSS随机数字生成器随机分成试验组、对照组,每组35例。两组患者均给予缺血性中风急性期常规治疗,试验组加以疏血通注射液6ml,静滴,每天1次;对照组加以血塞通注射液400mg,静滴,每天1次,两组疗程均为2周。观察患者治疗前、后的中医证候评分、神经功能缺损评分、生活质量评分(ADL),记录并对以上数据进行统计分析。结果:1.临床疗效比较:试验组和对照组总有效率各为94.3%、77.1%。总有效率,试验组明显优于对照组,两组疗效经秩和检验分析有统计学意义(p0.05),说明在缺血性中风急性期治疗中破血逐瘀法临床疗效显著优于活血化瘀法;2.中医证候积分、神经功能缺损评分比较:治疗后,试验组与对照组比较,中医证候积分、神经功能缺损评分均明显下降(p0.01),组间比较亦具有显著性差异(p0.05),表明两组在改善缺血性中风病急性期患者的症状及体征方面均有效,但改善程度试验组优于对照组;3.ADL评分比较:治疗后,试验组与对照组比较,两组ADL评分较治疗前均升高,但改善程度试验组优于对照组(p0.05),组间比较亦有统计学意义(p0.05),说明两组均能改善缺血性中风急性期患者生活能力,但改善程度试验组优于对照组;4.在本次试验过程中未发生不良反应。结论:1.破血逐瘀法能明显改善缺血性中风急性期的中医证候积分、神经功能缺损评分,可以提高患者生活质量,且无明显的不良反应。2.对于常用于治疗错过溶栓时间窗、溶栓失败或者不能接受溶栓治疗的缺血性中风急性期患者的活血类中药注射液,以疏血通注射液为代表的破血逐瘀法疗效显著宜首选。
[Abstract]:Objective: to compare the clinical efficacy and safety of the methods of breaking blood and removing blood stasis and activating blood circulation and removing blood stasis in patients with acute ischemic apoplexy by randomized controlled trial, and to evaluate the effect of breaking blood and removing blood stasis and activating blood circulation and removing blood stasis. In order to provide guidance for clinical treatment, the application of two kinds of therapies in acute stage of ischemic apoplexy is further defined and sorted. Methods: 70 eligible patients were randomly divided into trial group (n = 35) and control group (n = 35) with SPSS random number generator. The patients in both groups were given routine treatment in acute phase of ischemic stroke. The experimental group was treated with Shuxuetong injection 6 ml, iv drip once a day, and the control group with 400 mg Xuesaitong injection, once a day. The course of treatment in both groups was 2 weeks. The scores of TCM syndromes, neurological impairment and quality of life were observed before and after treatment, and the above data were recorded and analyzed statistically. The result is 1: 1. Comparison of clinical efficacy: the total effective rate of the test group and the control group was 94.30.77. 1 respectively. The total effective rate in the experimental group was significantly better than that in the control group, and the curative effect of the two groups was statistically significant by rank sum test analysis, indicating that the clinical efficacy of the method of breaking blood and removing blood stasis in the acute stage of ischemic apoplexy was significantly better than that of activating blood circulation and removing blood stasis. Comparison of TCM syndromes score and neurological deficit score: after treatment, the experimental group compared with the control group, TCM syndromes integral, The scores of neurological impairment were significantly decreased (P < 0.01), and there was significant difference between the two groups (P 0.05), which indicated that the two groups were effective in improving the symptoms and signs of patients with acute ischemic apoplexy. But the improvement degree of the experimental group was better than that of the control group. 3. The ADL score of the two groups was higher than that of the control group after treatment, and after treatment, the ADL score of the two groups was higher than that of the control group. But the improvement degree test group was superior to the control group (P 0.05), and the comparison between the two groups was also statistically significant, which indicated that both groups could improve the life ability of the patients in the acute stage of ischemic stroke, but the improvement degree test group was better than the control group (P 0.05). No adverse reactions occurred during this trial. Conclusion 1. The method of breaking blood and removing blood stasis can obviously improve the score of TCM syndromes and the score of nerve function defect in the acute stage of ischemic apoplexy. It can improve the quality of life of patients, and there is no obvious adverse reaction. 2. For the patients who are often used in the treatment of missed thrombolytic time window, the failure of thrombolysis or the failure of thrombolytic therapy or the failure to accept thrombolytic therapy, the traditional Chinese medicine injection of activating blood circulation, represented by Shuxuetong injection, should be chosen as the first choice.
【学位授予单位】：河南中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R277.7

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