涤痰熄风通络汤治疗急性脑梗死（中经络风痰瘀阻证）的临床观察及对血脂的影响
发布时间：2018-08-22 09:59
【摘要】：研究目的:观察涤痰熄风通络汤对脑梗死急性期(中经络风痰瘀阻证)患者的临床疗效及血脂的影响,并评价其安全性。研究方法:将60例符合纳入标准的急性脑梗死(ACI)中经络风痰瘀阻证患者随机分为治疗组30例、对照组30例。对照组给予ACI西医常规治疗;治疗组在对照组基础上加用涤痰熄风通络汤,日一剂,分早晚2次口服,疗程14天。疗程结束后,对两组患者治疗前后的三大常规、血生化、凝血功能、心电图、中医证候积分、中医证候总疗效、神经功能缺损程度、BI评分、m RS量表评分进行观察比较,并进行统计学分析。研究结果:(1)中医证候总疗效比较:治疗14天后,治疗组总有效率90.00%,对照组总有效率66.67%,两组比较差异有统计学意义(P0.05)。(2)中医证候总积分比较:治疗14天后,治疗组中医证候总积分为(14.67±6.26)分,对照组为(18.87±7.37)分,两组组内治疗前后中医证候总积分比较有显著差异(P0.01);两组组间治疗后比较差异有统计学意义(P0.05),治疗组优于对照组。(3)单项中医证候积分比较:治疗14天后,治疗组的单项中医证候积分除感觉减退外均较治疗前明显改善(P0.01),对照组的单项中医证候积分在上肢不遂、口舌歪斜、语言蹇涩、头晕目眩方面均较治疗前明显改善(P0.05);两组组间治疗后比较显示治疗组在上下肢不遂、头晕目眩、痰多方面改善明显(P0.05),但在改善口舌歪斜、语言蹇涩、感觉减退方面两组差异无统计学意义(P0.05)。(4)神经功能缺损程度比较:治疗14天后,治疗组神经功能缺损评分为(5.20±3.58)分,对照组为(7.53±4.69)分,两组组内治疗前后神经功能缺损评分比较有显著差异(P0.01);两组组间治疗后比较差异有统计学意义(P0.05),治疗组优于对照组。(5)Barthel指数评分比较:发病3月,治疗组Barthel指数评分为(85.17±16.27)分,对照组为(72.83±20.24)分,两组组内治疗前后Barthel指数评分比较有显著差异(P0.01);两组组间治疗后比较差异有统计学意义(P0.05),治疗组优于对照组。(6)改良Rankin量表评分比较:发病3月时,两组组内治疗前后改良Rankin量表评分比较有显著差异(P0.01);两组组间治疗后比较差异有统计学意义(P0.05),治疗组优于对照组。(7)血脂比较:发病3月时,两组在调节胆固醇、甘油三酯、低密度脂蛋白胆固醇及高密度脂蛋白胆固醇水平方面均较治疗前差异显著(P0.01);两组组间治疗后比较显示治疗组在调节高密度脂蛋白胆固醇及低密度脂蛋白胆固醇方面较对照组更优(P0.01)。(8)安全性评价:治疗前后观察两组患者血常规、二便常规、肝肾功能、血糖、凝血功能、心电图等指标,均未见明显异常。研究结论:(1)涤痰熄风通络汤联合西医常规治疗急性脑梗死,在改善患者中医证候总疗效、中医证候总积分、部分中医证候积分方面明显优于对照组。(2)涤痰熄风通络汤联合西医常规治疗急性脑梗死,可有效改善患者神经功能缺损程度、提高日常生活活动能力、降低致残率,且明显优于对照组。(3)涤痰熄风通络汤可有效调节急性脑梗死患者血脂水平。(4)治疗期间,两组均未发生明显不良反应,安全性佳。综上,涤痰熄风通络汤是治疗急性脑梗死的有效方剂,临床疗效确切,安全性佳,可有效改善患者预后及血脂水平,临床值得进一步研究。
[Abstract]:Objective: To observe the effect of Ditan Xifeng Tongluo Decoction on the clinical efficacy and blood lipids of patients with acute cerebral infarction (middle meridian wind phlegm stasis syndrome), and evaluate its safety.Methods: 60 patients with acute cerebral infarction (ACI) were randomly divided into treatment group (30 cases) and control group (30 cases). The treatment group was given Ditan Xifeng Tongluo Decoction twice a day for 14 days on the basis of the control group. After the treatment, three routines, blood biochemistry, coagulation function, electrocardiogram, TCM syndrome integral, total curative effect of TCM syndrome, degree of nerve function defect, BI score, and MRS scale were used for the two groups. Results: (1) After 14 days of treatment, the total effective rate of the treatment group was 90.00%, while that of the control group was 66.67%. There was significant difference between the two groups (P 0.05). (2) Comparing the total score of TCM syndromes: After 14 days of treatment, the total score of TCM syndromes in the treatment group was (14.67 +6.2). 6) The control group was (18.87 +7.37) points, there was a significant difference between the two groups before and after treatment (P 0.01); there was a significant difference between the two groups after treatment (P 0.05), the treatment group was better than the control group. (3) Comparison of single TCM syndrome score: 14 days after treatment, the treatment group had a single TCM syndrome score except hypoesthesia. Compared with pre-treatment, the scores of single TCM syndromes in the control group were significantly improved (P 0.01). Compared with pre-treatment, the scores of single TCM syndromes in the treatment group were significantly improved (P 0.05). After treatment, the two groups showed that the treatment group was significantly improved in upper and lower limb dysfunction, dizziness, dizziness, sputum and other aspects (P 0.05). There was no significant difference between the two groups (P 0.05). (4) Neurological deficit degree comparison: 14 days after treatment, the nerve function deficit score of the treatment group was (5.20 + 3.58) and that of the control group was (7.53 + 4.69). There was significant difference between the two groups before and after treatment (P 0.01). The difference was statistically significant (P 0.05), the treatment group was better than the control group. (5) Barthel index score comparison: 3 months after onset, the treatment group Barthel index score was (85.17 16.27) points, the control group was (72.83 20.24) points, two groups before and after treatment Barthel index score was significantly different between the two groups (P 0.01); (P 0.05), the treatment group is better than the control group. (6) Modified Rankin scale score comparison: at 3 months of onset, the two groups before and after treatment improved Rankin scale score was significantly different (P 0.01); the difference between the two groups after treatment was statistically significant (P 0.05), the treatment group is better than the control group. (7) Blood lipid comparison: at 3 months of onset, the two groups in the regulation of cholesterol. The levels of triglyceride, low density lipoprotein cholesterol and high density lipoprotein cholesterol were significantly different before and after treatment (P 0.01); the comparison between the two groups showed that the treatment group was better than the control group in regulating high density lipoprotein cholesterol and low density lipoprotein cholesterol (P 0.01). (8) Safety evaluation: observation before and after treatment There were no obvious abnormalities in the indexes of blood routine, routine defecation, liver and kidney function, blood glucose, blood coagulation function, electrocardiogram and so on. Ditan Xifeng Tongluo Decoction combined with routine western medicine in the treatment of acute cerebral infarction can effectively improve the degree of neurological impairment, improve the ability of daily living, reduce the disability rate, and is significantly better than the control group. (3) Ditan Xifeng Tongluo Decoction can effectively regulate the level of blood lipid in patients with acute cerebral infarction. (4) During the treatment, no significant adverse reactions occurred in both groups. To sum up, Ditan Xifeng Tongluo Decoction is an effective prescription for acute cerebral infarction, with definite clinical effect and good safety. It can effectively improve the prognosis and blood lipid level of patients, and is worthy of further study.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R277.7
本文编号：2196761
[Abstract]:Objective: To observe the effect of Ditan Xifeng Tongluo Decoction on the clinical efficacy and blood lipids of patients with acute cerebral infarction (middle meridian wind phlegm stasis syndrome), and evaluate its safety.Methods: 60 patients with acute cerebral infarction (ACI) were randomly divided into treatment group (30 cases) and control group (30 cases). The treatment group was given Ditan Xifeng Tongluo Decoction twice a day for 14 days on the basis of the control group. After the treatment, three routines, blood biochemistry, coagulation function, electrocardiogram, TCM syndrome integral, total curative effect of TCM syndrome, degree of nerve function defect, BI score, and MRS scale were used for the two groups. Results: (1) After 14 days of treatment, the total effective rate of the treatment group was 90.00%, while that of the control group was 66.67%. There was significant difference between the two groups (P 0.05). (2) Comparing the total score of TCM syndromes: After 14 days of treatment, the total score of TCM syndromes in the treatment group was (14.67 +6.2). 6) The control group was (18.87 +7.37) points, there was a significant difference between the two groups before and after treatment (P 0.01); there was a significant difference between the two groups after treatment (P 0.05), the treatment group was better than the control group. (3) Comparison of single TCM syndrome score: 14 days after treatment, the treatment group had a single TCM syndrome score except hypoesthesia. Compared with pre-treatment, the scores of single TCM syndromes in the control group were significantly improved (P 0.01). Compared with pre-treatment, the scores of single TCM syndromes in the treatment group were significantly improved (P 0.05). After treatment, the two groups showed that the treatment group was significantly improved in upper and lower limb dysfunction, dizziness, dizziness, sputum and other aspects (P 0.05). There was no significant difference between the two groups (P 0.05). (4) Neurological deficit degree comparison: 14 days after treatment, the nerve function deficit score of the treatment group was (5.20 + 3.58) and that of the control group was (7.53 + 4.69). There was significant difference between the two groups before and after treatment (P 0.01). The difference was statistically significant (P 0.05), the treatment group was better than the control group. (5) Barthel index score comparison: 3 months after onset, the treatment group Barthel index score was (85.17 16.27) points, the control group was (72.83 20.24) points, two groups before and after treatment Barthel index score was significantly different between the two groups (P 0.01); (P 0.05), the treatment group is better than the control group. (6) Modified Rankin scale score comparison: at 3 months of onset, the two groups before and after treatment improved Rankin scale score was significantly different (P 0.01); the difference between the two groups after treatment was statistically significant (P 0.05), the treatment group is better than the control group. (7) Blood lipid comparison: at 3 months of onset, the two groups in the regulation of cholesterol. The levels of triglyceride, low density lipoprotein cholesterol and high density lipoprotein cholesterol were significantly different before and after treatment (P 0.01); the comparison between the two groups showed that the treatment group was better than the control group in regulating high density lipoprotein cholesterol and low density lipoprotein cholesterol (P 0.01). (8) Safety evaluation: observation before and after treatment There were no obvious abnormalities in the indexes of blood routine, routine defecation, liver and kidney function, blood glucose, blood coagulation function, electrocardiogram and so on. Ditan Xifeng Tongluo Decoction combined with routine western medicine in the treatment of acute cerebral infarction can effectively improve the degree of neurological impairment, improve the ability of daily living, reduce the disability rate, and is significantly better than the control group. (3) Ditan Xifeng Tongluo Decoction can effectively regulate the level of blood lipid in patients with acute cerebral infarction. (4) During the treatment, no significant adverse reactions occurred in both groups. To sum up, Ditan Xifeng Tongluo Decoction is an effective prescription for acute cerebral infarction, with definite clinical effect and good safety. It can effectively improve the prognosis and blood lipid level of patients, and is worthy of further study.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R277.7
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