辛温开窍法治疗痰浊瘀阻型急性缺血性脑卒中的临床研究

发布时间：2018-07-10 14:14

本文选题：辛温开窍法 + 急性缺血性脑卒中　；参考：《山东中医药大学》2016年硕士论文

【摘要】：目的:观察运用辛温开窍法治疗痰浊瘀阻型急性缺血性脑卒中(AIS)的临床疗效,及对缺血性脑卒中急性期炎性因子的影响,进一步探讨辛温开窍法在AIS治疗中的临床意义,并运用中医理论探讨AIS痰浊瘀阻证的病因病机,以丰富中医诊疗方法,完善中医理论。方法:将符合纳入标准的60例痰浊瘀阻型AIS患者按入院时间2014年9月-2016年2月先后顺序,随机分为治疗组和对照组,各30例。按照《中国急性缺血性脑卒中诊治指南2010》,给予对照组规范的二级预防和卒中治疗,治疗组在对照组治疗基础上,另给予导师自创辛温开窍方治疗,14天为一个疗程,一日一剂,于早晚餐后半小时后温服(麝香末1g二等份随方冲服),入院后于治疗前的第一个工作日对两组患者进行量表评分和化验检查,并于治疗14天后再次评价。其中炎性指标、安全指标等实验室检查由潍坊市中医院化验室完成,功能评价由观察医师完成,并进行疗效评价及结果分析。结果:1.两组患者一般资料比较两组患者在年龄、性别、病程、基础疾病方面比较无统计学差异(P均0.05),两组具有可比性。2.辛温开窍法对痰浊瘀阻型AIS疗效分析经统计学分析:治疗前,在中医证候学积分、神经功能缺损评分(NIHSS评分)、炎性因子等生化指标方面,两组比较无统计学差异(P均0.05),两组具有可比性。治疗后,在中医证候学积分、NIHSS评分、炎性因子,分别与治疗前比较,均有明显改善(P0.05)。治疗组在神经功能缺损程度疗效方面,显著优于对照组(P0.05);在中医证候疗效方面,与对照组比较,有十分显著差异(P0.01)。3.安全性观察指标及不良反应治疗期间,两组患者治疗前后的安全性观察指标(三大常规、肝肾功、心电图等)比较未有显著变化,未发现过敏及不良反应。结果说明辛温开窍方在治疗痰浊瘀阻型AIS方面疗效显著,无明显毒副作用。结论:运用辛温开窍法治疗痰浊瘀阻型AIS,能有效改善神经功能缺损状况,改善中医证候评分,改善炎性反应,改善临床预后,临床应用安全有效。中医理论研究亦发现辛温开窍法可使血行痰化,清窍通利。因而运用辛温开窍法治疗AIS值得临床推广应用。
[Abstract]:Objective: to observe the clinical effect of Xin Wen Kai Qiao method on acute ischemic stroke (AIS) of phlegm turbid and stasis type, and to explore the clinical significance of Xin Wen Kai Qiao method in the treatment of acute ischemic cerebral apoplexy (AIS). The etiology and pathogenesis of AIS syndrome of phlegm turbidity and stasis were discussed in order to enrich the methods of diagnosis and treatment of traditional Chinese medicine and perfect the theory of traditional Chinese medicine. Methods: sixty AIS patients with turbid phlegm stasis were randomly divided into treatment group (n = 30) and control group (n = 30) according to the order of admission time from September 2014 to February 2016. According to the guidelines for the diagnosis and treatment of Acute Ischemic Stroke in China (2010), the control group was given standard secondary prevention and stroke treatment. The treatment group was treated with Xin-Wen Kaiqiao recipe for 14 days as a course of treatment, one dose per day, on the basis of the treatment of the control group. After half an hour of morning and evening meal, the patients in the two groups were given warm clothes (musk 1g second class). The patients in the two groups were evaluated again after 14 days of treatment on the first working day before treatment. The laboratory examination of inflammatory index and safety index was completed by the laboratory of Weifang traditional Chinese Medicine Hospital, and the function evaluation was completed by the observation physician, and the curative effect was evaluated and the result was analyzed. The result is 1: 1. There was no significant difference in age, sex, course of disease and basic disease between the two groups (P 0.05). Analysis of curative effect of Xin Wen Kai Qiao method on AIS of phlegm turbid and stasis type: before treatment, biochemical indexes such as TCM syndromes score, neurological deficit score (NIHSS), inflammatory factors, etc. There was no statistical difference between the two groups (P 0.05), and the two groups were comparable. After treatment, the scores of NIHSS and inflammatory factors in TCM syndromes were significantly improved compared with those before treatment (P0.05). The therapeutic effect of the treatment group was significantly better than that of the control group in the degree of nerve function defect (P0.05); in traditional Chinese medicine syndromes curative effect, compared with the control group, there was a very significant difference (P0.01). 3. During the period of safety observation and adverse reaction treatment, there were no significant changes in safety observation indexes (three major routine, liver and kidney function, electrocardiogram, etc.) before and after treatment, and no allergies and adverse reactions were found in the two groups. The results showed that Xin-wen Kaiqiao recipe was effective in treating AIS of phlegm turbid and stasis type, and had no obvious side effects. Conclusion: the treatment of phlegm turbid and stasis type AIS with Xin Wen Kai Qiao method can effectively improve the neurological function defect, improve TCM syndrome score, improve inflammatory reaction, improve clinical prognosis, and be safe and effective in clinical application. The research of TCM theory also found that Xin-Wen Kaiqiao method can make blood phlegm become clear and clear orifices. Therefore, the use of Xin-Wen method to treat AIS is worthy of clinical application.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R277.7

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