山药补肺元汤合熊胆散治疗太阴人老年缺血性中风恢复期的临床研究

发布时间：2018-07-28 20:20

【摘要】：研究目的:通过临床观察山药补肺元汤合熊胆散治疗太阴人老年缺血性中风恢复期患者的疗效,与丹参酮IIA治疗太阴人老年缺血性中风恢复期患者疗效进行对比,通过两者对太阴人老年缺血性中风恢复期患者治疗后的美国国立卫生研究院卒中量表评分(NIHSS)、日常生活活动能力量表指数(BI)、中医症候评分及血脂血糖、血液流变学等变化的程度进行比较,来研究探讨临床上采用山药补肺元汤合熊胆散治疗太阴人老年缺血性中风恢复期患者的有效性及安全性,为临床上更多医务人员运用山药补肺元汤合熊胆散治疗太阴人老年缺血性中风恢复期患者提供可靠的实验依据。研究方法:将40例太阴人老年缺血性中风恢复期患者采用随机对照研究方法分成实验组和对照组各20例,实验组采用山药补肺元汤(麦门冬15g,桔梗10g,五味子5g,薏苡仁10g,山药10g,莱菔子10g)和熊胆散,每日1付,水煎服400ml,分两次早晚饭后服用,熊胆散(熊胆粉2g装入胶囊),每日一次口服。对照组20例患者给予丹参酮IIA 40mg配合0.9%的氯化钠250ml进行静脉注射,每日一次。两组治疗时间均为4周(1个疗程)。观察比较治疗前后,实验组和对照组患者在包括口眼歪斜、偏身麻木、语言謇塞等情况的中医症状评分,以及美国国立卫生研究院卒中量表评分(NIHSS)和日常生活活动能力量表指数(BI)情况,进行疗效评价。对比治疗前后两组患者血脂血糖含量、血液流变学情况,判断药物的安全性。最后,将数据运用统计软件SPSS 22进行统计分析。计量资料以均数士标准差(X±S)表示,运用t检验。计数资料比较运用卡方检验。等级资料运用秩和检验分析。研究结果:1.经统计学分析结果显示,治疗前两组患者在性别、年龄、病程、烟酒及体重指数等基本条件方面,无显著差异,可以进行对比(P0.05)。2.总有效率:药物治疗后,实验组总有效例数为19例,总有效率为950%,对照组总有效例数为14例,总有效率为70%。山药补肺元汤合熊胆散总有效率高于丹参酮IIA组(P0.05),有统计学意义。3.NIHSS评分:治疗后,实验组与对照组的NIHSS评分与治疗前相比均有明显降低,实验组降低程度高于对照组。4.BI指数:治疗后与治疗前相比,两组中风患者的BI指数均有所提高,实验组明显高于对照组。5.血液流变学指标:在降低全血高切黏度、血小板聚集率以及血浆黏度等方面,实验组效果更佳。用药后实验组和对照组患者的总胆固醇、甘油三酯、低密度脂蛋白胆固醇与用药前相比有明显下降,实验组在高密度脂蛋白胆固醇水平无明显变化,治疗后,实验组比对照组在降低总胆固醇、甘油三酯、低密度脂蛋白胆固醇方面更有优势。6.中医症候评分:用药后,每位患者的中医症状均有所改善,实验组与对照组中医症候评分均下降,采用山药补肺元汤合熊胆散治疗的患者组总体下降程度较丹参酮IIA组更为明显。7.用药安全性:用药后两组患者均未产生副作用,无明显异常反应。结论:山药补肺元汤合熊胆散在对太阴人老年缺血性中风恢复期患者治疗过程中,口眼歪斜、偏身麻木、语言春塞等中医症状得到改善,同时使血液黏度有效降低,减少血栓形成的概率,对于神经功能和肢体活动功能起到改善作用,总体来看,对太阴人老年缺血性中风恢复期患者的治疗有较好疗效。治疗中未见不良反应和毒副作用,较为安全。
[Abstract]:Objective: To observe the curative effect of yam tonic Yuan Tang and bear gall powder in the treatment of patients with ischemic stroke in the elderly, and compare the curative effect of tanshinone IIA in the recovery period of ischemic stroke in the elderly. The research institute Stroke Scale score (NIHSS), daily living ability scale index (BI), TCM syndrome score and blood lipid blood sugar, blood rheology and other changes are compared to study the effectiveness and safety of the clinical use of yam tonifying lung yuan Decoction and bear gall powder in the treatment of the elderly patients with ischemic stroke in the elderly. More medical personnel on the bed provide reliable experimental basis for the treatment of patients with ischemic stroke in the old age of the Tai Yin people by using yam, tonifying lung yuan soup and bear gall powder to treat the patients with ischemic stroke in the elderly. 40 cases of the elderly patients with ischemic stroke in the elderly were divided into experimental group and control group with 20 cases, and the experimental group was treated with yam. Yuan Tang (15g, Platycodon 10g, Schisandra 5g, coix seed 10g, yam 10g, semen sulforaphone 10g) and bear gall powder, 1 payment per day, water decocted 400ml, two times after breakfast and evening meal, bear bile powder (bear bile powder 2G loaded capsule), once a day. 20 patients in the control group were given intravenous injection of sodium tanshinone IIA 40mg with 0.9% sodium chloride 250ml, daily intravenous injection, daily intravenous injection, daily intravenous injection, daily intravenous injection, daily one intravenous injection, daily a daily injection, daily one intravenous injection, daily one intravenous injection, daily one intravenous injection, daily one intravenous injection, daily one intravenous injection, daily one intravenous injection, daily one intravenous injection, daily one intravenous injection, daily one intravenous injection, daily one intravenous injection, daily one intravenous injection, daily one intravenous injection, daily one intravenous injection, daily one intravenous injection, daily one intravenous injection, daily one intravenous injection, daily one intravenous injection, daily one intravenous injection, daily one intravenous injection, daily one intravenous injection, daily one intravenous injection, daily one intravenous injection, daily one intravenous injection, daily one intravenous injection, daily one intravenous injection, daily 1 The treatment time of the two groups was 4 weeks (1 courses of treatment). Before and after the observation and comparison, the patients in the experimental group and the control group were included in the TCM symptom score, including the skew of the mouth, the numbness of the body, the language Jian, as well as the National Institutes of Health Stroke Scale (NIHSS) and the daily living activity capacity scale index (BI), and to evaluate the curative effect. Two groups of patients before and after treatment were compared with two groups of blood lipids, blood and blood sugar, hemorrheology, and the safety of the drugs. Finally, the data were statistically analyzed using the statistical software SPSS 22. The measurement data were represented by the standard deviation (X + S), and the t test was used. The count data were compared with the chi square test. The rank data was analyzed by the rank sum test analysis. Results: 1. the results of statistical analysis showed that there was no significant difference in the basic conditions of sex, age, course of disease, tobacco and wine and body mass index in the two groups before the treatment, and the total effective rate of the contrast (P0.05).2. could be compared. After the treatment, the total effective number of the experimental group was 19, the total effective rate was 950%, the total effective number of the control group was 14 cases, and the total effective was effective. The rate of 70%. yam tonifying lung Yuan Tang and bear gall powder total effective rate high Yu Dan ginseng IIA group (P0.05), there is a statistically significant.3.NIHSS score: after treatment, the experimental group and the control group compared with the NIHSS score compared with before treatment, the experimental group was higher than the control group.4.BI index: after treatment and before treatment, the two groups of stroke patients BI finger. The experimental group was significantly higher than the control group.5. blood rheology index: the experimental group had better effect on reducing the whole blood high shear viscosity, platelet aggregation rate and plasma viscosity. The total cholesterol, triglyceride and low density lipoprotein cholesterol in the experimental group and the control group were significantly lower than those before the drug use. There was no obvious change in the level of high density lipoprotein cholesterol. After treatment, the experimental group had more advantages than the control group in reducing total cholesterol, triglyceride, low density lipoprotein cholesterol and.6. syndrome score. After medication, the TCM symptoms of each patient were improved, and the scores of TCM syndrome in the experimental group and the control group were all decreased. The total decrease degree of the patients in the treatment group of yam, tonifying lung yuan soup and bear gall powder was more obvious than that in the group of tanshinone IIA. The two groups had no side effects and no obvious abnormal reaction after the drug use. Conclusion: yam tonifying lung Yuan Tang and bear gall powder were in the treatment process of patients with ischemic stroke in the elderly. The symptoms of traditional Chinese medicine such as deviation and numbness, language spring stopper are improved, the blood viscosity is reduced effectively, the probability of thrombosis is reduced, and the function of nerve function and limb activity is improved. On the whole, it has a good effect on the treatment of the patients in the recovery period of ischemic stroke in the elderly of the Tai Yin people. No adverse reactions and toxic and side effects are found in the treatment. It's safe.
【学位授予单位】：延边大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R255.2
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本文编号：2151464