舒郁解语汤加减治疗中风后运动性失语（气滞痰瘀型）的临床观察

发布时间：2018-07-26 19:50

【摘要】：目的:观察舒郁解语汤加减对中风后运动性失语患者(气滞痰瘀型)的临床疗效,并探讨其理论依据。方法:选取符合课题纳入标准的30例门诊患者,经诊断为中风病恢复期并伴有运动性失语。将符合标准的30例门诊患者给予舒郁解语汤为主方进行加减,水煎服300ml,日2次早晚分服,疗程为4周。分别在治疗前、治疗2周后、治疗4周后,记录、观察患者的言语功能评分、失语症严重程度分级、卒中后失语抑郁量表评分以及中医证候积分的变化情况。结果:1.在治疗2周、治疗4周与治疗前相比较,言语功能总评分增高,差异具有统计学意义;言语功能各项积分除治疗前与治疗2周理解项与命名项无显著差异外,其余各项在各时点相比较均有统计学意义(P0.01);2.失语严重程度分级:在治疗2周、4周后,分级为1、2、3级的人数减少,4、5级的人数相对增加,治疗前、2周、4周相比较,差异具有统计学意义(P0.01);3.患者在治疗2周、治疗4周后与治疗前相比SADQ总积分均有降低,且在治疗4周后的SADQ总积分与治疗2周相比较有明显降低,差异均有统计学意义(P0.01);4.治疗2周、4周后与治疗前相比,中医证候总积分有所降低,差异具有统计学意义(P0.01);中医证候各项积分在治疗2周、治疗4周后与治疗前相比,积分均有所降低,差异具有统计学意义(P0.01);5.疗效:在治疗2周、4周后,患者的言语功能得到不同程度的改善,临床疗效总有效率分别为23.3%、96.7%,两者相比较,差异有统计学意义(P0.01);治疗2周、4周后,中医证候评价总有效率分别为70.0%、96.7%,两者相比较,差异有统计学意义(P0.01)。结论:1.舒郁解语汤在治疗4周后能使气滞痰瘀型失语患者的言语功能、失语程度分级及卒中后抑郁的临床症状得到更大程度的改善。2.舒郁解语汤加减可以有效的改善中风后失语患者的中医证候。
[Abstract]:Objective: To observe the clinical effect of Shu Yu Jie Yu Decoction on the patients with motor aphasia (qi stagnation and stasis type) after apoplexy, and to explore the theoretical basis. Methods: 30 outpatients who were in convalescence of apoplexy and accompanied by athletic aphasia were selected in accordance with the standard of the subject, and 30 patients with the standard were given Shu Yu Jie Yu Decoction. The main side was added and subtract, decoction of 300ml, 2 times in the morning and evening, the course was 4 weeks. Before treatment, 2 weeks after treatment, 2 weeks after treatment, 4 weeks after treatment, records, observation of speech function scores, aphasia severity grade, post stroke aphasia Depression Scale score and TCM syndrome score changes. Results: 1. in 2 weeks, treatment 4 weeks and treatment. Compared with the former, the total score of speech function was higher, and the difference was statistically significant. Except for the 2 weeks of understanding and naming items before and after treatment, the rest of the speech function scores were statistically significant (P0.01). 2. the grade of aphasia severity was reduced: at 2 weeks and after 4 weeks, the number of grade 1,2,3 was reduced. The number of 4,5 levels increased relatively. The difference was statistically significant (P0.01) before treatment, 2 weeks and 4 weeks. 3. patients were treated for 2 weeks, and after 4 weeks of treatment, the total score of SADQ was reduced compared with that before treatment, and the total score of SADQ was significantly lower after 4 weeks of treatment than in the 2 week treatment (P0.01); 4. for 2 weeks, 4 Compared with before treatment, the total score of TCM syndrome was reduced, the difference was statistically significant (P0.01). The scores of TCM syndromes were reduced in 2 weeks and 4 weeks after treatment, and the difference was statistically significant (P0.01); the 5. effect: after 2 weeks of treatment and 4 weeks, the patients' speech function was changed to varying degrees. The total effective rate of clinical curative effect was 23.3% and 96.7% respectively. The difference was statistically significant (P0.01). After 2 weeks of treatment and 4 weeks, the total effective rate of TCM Syndrome Evaluation was 70% and 96.7% respectively. The difference was statistically significant (P0.01). Conclusion: 1. Shu Yu Yu Jie Yu Decoction can make the speech of qi stagnation phlegm stasis type aphasia patients after the treatment of 4 weeks. The function, the degree of aphasia and the clinical symptoms of depression after stroke have been improved to a greater degree,.2. Shu Yu Jie Yu Decoction can effectively improve the TCM syndrome of aphasia after apoplexy.
【学位授予单位】：黑龙江中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R255.2

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