太阴调胃汤合熊胆散治疗缺血性中风的临床研究
发布时间：2018-08-24 07:57
【摘要】：目的：观察临床上给予缺血性中风风痰瘀阻型患者朝医方太阴调胃汤合熊胆散与丹参酮IIA治疗的疗效,分析比较两组药物对口眼歪斜、偏身麻木等临床症状的疗效,对血脂、血液流变学、空腹血糖等生化指标的影响,恢复患者神经功能和日常活动能力的情况。对临床上采用太阴调胃汤合熊胆散治疗风痰瘀阻型缺血性中风的有效性及安全性进行评价,为进一步推广应用朝医方药太阴调胃汤合熊胆散治疗缺血性中风提供有效的临床依据。方法：将于2015年1月至11月被延吉市中医院神经内科确诊为缺血性中风风痰瘀阻型的40例患者作为观察病例。20例对照组患者给予40mg丹参酮IIA注射液静脉滴注,每日1次；20例观察组患者给予太阴调胃汤(薏苡仁15g,五味子5g,莱菔子l0g,麦门冬10g,石菖蒲15g,桔梗l0g,干栗10g,麻黄5g),日1剂水煎300m1,分早晚温服(早饭前半小时、晚饭后1小时服用),熊胆散(熊胆粉1.5g)制成胶囊,每日19时顿服。并对两组患者合并的血压升高、血糖升高、血脂异常、心绞痛等合并症进行对症处理。2周为1个疗程,观察1个疗程。分析比较治疗后两组患者半身不遂、口眼歪斜等不适症状的改善程度,患者损伤的脑神经功能的修复情况,患者日常独立生活能力提高的情况,以及患者体内血脂的含量、血液的黏稠度、空腹血糖的含量等变化情况以评价两组药物的总体疗效。结果：治疗前两组中风患者的基础资料、影响因素、日常生活活动能力(BI)指数评分及神经功能缺损(NIHSS)评分等观察指标具有可比性(P0.05)。药物治疗2周后患者的中医证候疗效、临床疗效的组内差异均具有统计学意义(P0.05),且组间比较观察组药物的治疗效果明显较对照组更好；治疗后两组患者的神经功能明显恢复,日常独立自理的能力明显提高,观察组与对照组比较具有统计学意义上的差异(P0.05)；与治疗前相比经药物治疗后的两组中风患者体内血脂的含量降低、血液流变速度增快(P0.05),且太阴调胃汤组药物调节血脂及血液流变学的疗效较对照组更高(P0.05)。结论：太阴调胃汤合熊胆散治疗缺血性中风风痰瘀阻型可有效改善患者因脑神经损伤所出现的神经缺损的症状,恢复患者四肢肌力,提高患者独立自理的生活能力,并且治疗过程中无不良反应及毒副反应发生。
[Abstract]:Objective: to observe the therapeutic effect of Taiyin Tiaowi decoction combined with tanshinone IIA in treating patients with wind-phlegm-stasis type of ischemic apoplexy. The effects of hemorheology, fasting blood glucose and other biochemical indexes on the recovery of neurological function and daily activity of patients. To evaluate the efficacy and safety of Taiyin Tiaowei decoction combined with Xiongdan Powder in the treatment of ischemic stroke of wind-phlegm-stasis type. To provide effective clinical basis for the treatment of ischemic apoplexy with Taiyin Tiaowi decoction and Xiongdan Powder. Methods: from January to November, 2015, 40 patients diagnosed as wind-phlegm stasis type of ischemic stroke by Department of Neurology, Yanji Hospital of traditional Chinese Medicine were treated with 40mg tanshinone IIA injection once a day. 20 patients in the observation group were given Taiyin Tiaowi decoction (Coix seed 15g, Schisandra Schisandra 5g, Raphani 10g, wheat winter 10g, Acorus calamus 15g, Platycodon grandiflorum 10g, dried chestnut 10g, ephedra 5g). 1 hour after supper), Xiong Dan San (bear gall powder 1.5 g) is made into capsule and taken at 19:00 daily. The complications of hypertension, blood glucose, dyslipidemia and angina pectoris were treated for 2 weeks as a course of treatment, and a course of treatment was observed. The degree of improvement of symptoms of hemiplegia, obliquity of mouth and eye, the repair of injured brain nerve function, the improvement of patients' daily independent living ability, and the content of blood lipid in patients were analyzed and compared after treatment. Changes in blood viscosity and fasting blood glucose were used to evaluate the overall efficacy of the two groups. Results: the basic data, influencing factors, activity of daily living (ADL) (BI) index and neurological deficit (NIHSS) were comparable between the two groups before treatment (P0.05). After 2 weeks of drug therapy, there were significant differences in the effect of TCM syndromes and clinical efficacy between the two groups (P0.05), and the therapeutic effect of the observation group was significantly better than that of the control group; after treatment, the neurological function of the patients in the two groups recovered significantly. The ability of daily independent self-care was significantly improved, the observation group and the control group compared with the statistical difference (P0.05); compared with the treatment before and after the treatment of two groups of apoplexy patients after the reduction of blood lipids, The hemorheological velocity increased (P0.05), and the efficacy of Taiyin Tiaowei decoction group in regulating blood lipid and hemorheology was higher than that in the control group (P0.05). Conclusion: Taiyin Tiaowei decoction combined with Xiong Dan San can effectively improve the symptoms of nerve defect caused by cerebral nerve injury, recover the muscle strength of limbs, and improve the independent living ability of patients with ischemic apoplexy of wind-phlegm stagnation type. No adverse reactions and side effects occurred in the course of treatment.
【学位授予单位】：延边大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R277.7
本文编号：2200141
[Abstract]:Objective: to observe the therapeutic effect of Taiyin Tiaowi decoction combined with tanshinone IIA in treating patients with wind-phlegm-stasis type of ischemic apoplexy. The effects of hemorheology, fasting blood glucose and other biochemical indexes on the recovery of neurological function and daily activity of patients. To evaluate the efficacy and safety of Taiyin Tiaowei decoction combined with Xiongdan Powder in the treatment of ischemic stroke of wind-phlegm-stasis type. To provide effective clinical basis for the treatment of ischemic apoplexy with Taiyin Tiaowi decoction and Xiongdan Powder. Methods: from January to November, 2015, 40 patients diagnosed as wind-phlegm stasis type of ischemic stroke by Department of Neurology, Yanji Hospital of traditional Chinese Medicine were treated with 40mg tanshinone IIA injection once a day. 20 patients in the observation group were given Taiyin Tiaowi decoction (Coix seed 15g, Schisandra Schisandra 5g, Raphani 10g, wheat winter 10g, Acorus calamus 15g, Platycodon grandiflorum 10g, dried chestnut 10g, ephedra 5g). 1 hour after supper), Xiong Dan San (bear gall powder 1.5 g) is made into capsule and taken at 19:00 daily. The complications of hypertension, blood glucose, dyslipidemia and angina pectoris were treated for 2 weeks as a course of treatment, and a course of treatment was observed. The degree of improvement of symptoms of hemiplegia, obliquity of mouth and eye, the repair of injured brain nerve function, the improvement of patients' daily independent living ability, and the content of blood lipid in patients were analyzed and compared after treatment. Changes in blood viscosity and fasting blood glucose were used to evaluate the overall efficacy of the two groups. Results: the basic data, influencing factors, activity of daily living (ADL) (BI) index and neurological deficit (NIHSS) were comparable between the two groups before treatment (P0.05). After 2 weeks of drug therapy, there were significant differences in the effect of TCM syndromes and clinical efficacy between the two groups (P0.05), and the therapeutic effect of the observation group was significantly better than that of the control group; after treatment, the neurological function of the patients in the two groups recovered significantly. The ability of daily independent self-care was significantly improved, the observation group and the control group compared with the statistical difference (P0.05); compared with the treatment before and after the treatment of two groups of apoplexy patients after the reduction of blood lipids, The hemorheological velocity increased (P0.05), and the efficacy of Taiyin Tiaowei decoction group in regulating blood lipid and hemorheology was higher than that in the control group (P0.05). Conclusion: Taiyin Tiaowei decoction combined with Xiong Dan San can effectively improve the symptoms of nerve defect caused by cerebral nerve injury, recover the muscle strength of limbs, and improve the independent living ability of patients with ischemic apoplexy of wind-phlegm stagnation type. No adverse reactions and side effects occurred in the course of treatment.
【学位授予单位】：延边大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R277.7
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