通络解语丸配合针刺治疗中风后假性球麻痹临床观察

发布时间：2018-09-17 18:53

【摘要】：目的:观察通络解语丸配合针刺治疗中风后假性球麻痹的临床疗效。方法:依据本案已选定的中、西医诊断标准、病例纳入标准和病例排除标准,通过使用随机数字表法,将入选的病例(共计64例),且辨证为痰瘀阻络型假性球麻痹的患者,随机分为两组各32例(分为治疗组和对照组)。在治疗方面,对照组仅使用基础治疗,而治疗组则在基础治疗的基础上,加用通络解语丸配合针刺治疗。其中入选的64例患者,其入院时间即为入组第1天,总疗程共计14天。于治疗前后,观察两组患者在洼田饮水试验、假性球麻痹各项临床表现和中医证候积分以及改良日常生活能力评分之间的差异性,进行相应的临床疗效判定。本试验中得到的相关数据资料,采用科学的统计学分析方法,即spss21.0数据分析软件处理。结果:1.入选的两组患者,在一般资料(性别、年龄及病程)比较:采用统计学中X2检验及t检验,比较结果显示:两组患者在性别、年龄及病程方面P0.05,表明无明显差异,有统计学意义。2.治疗后比较:经治,治疗组及对照组患者吞咽饮水功能障碍均得到不同程度的改善(P0.05),但治疗组疗效明显优于对照组(P0.05);经治,治疗组及对照组假性球麻痹的各项临床表现均有不同程度的改善(P0.05),但治疗组疗效明显优于对照组(P0.05);治疗后,两组改良日常生活能力评分数值,均可增加(P0.05),但治疗组的效果明显优于对照组(P0.05);经治疗,治疗组、对照组患者的中医证候积分均可降低(P0.05),但治疗组疗效明显优于对照组(P0.05)。3.治疗组在治疗脑卒中后假性球麻痹痰瘀阻络型的临床总有效率达到83.87%,对照组为65.63%,经卡方检验,P=0.015(P0.05),两组治疗效果具有显著差异。4.在安全性方面,治疗前及治疗后常规检查血、尿常规,肝、肾功能,比对前后结果发现:两组患者在整个治疗过程中未见明显肝肾损害及其他不良反应。在本试验实施过程中,治疗组1例患者因不能耐受针刺而未能完成实验,自动脱出本试验,余患者均按要求完成试验。结论:通络解语丸配合针刺治疗,可明显改善中风后假性球麻痹(痰瘀阻络型)临床症状:能够安全有效的改善中风后假性球麻痹的吞咽、构音功能,改良日常生活能力及中医症候积分。中药联合针刺的综合治疗方法确有良效,值得借鉴、学习与推广。
[Abstract]:Objective: to observe the clinical effect of Tongluojieyu pills combined with acupuncture on pseudobulbar paralysis after stroke. Methods: according to the diagnostic criteria of traditional Chinese and western medicine, the criteria of inclusion and exclusion of cases, the selected cases (64 cases in total) were selected according to the method of random digital table, and the syndrome differentiation was the pseudobulbar paralysis of phlegm and blood stasis type. They were randomly divided into two groups, 32 cases in each group (treatment group and control group). In terms of treatment, the control group was treated only with basic therapy, while the treatment group was treated with Tongluojieyu pill combined with acupuncture on the basis of basic treatment. The admission time of 64 patients was the first day and the total course of treatment was 14 days. Before and after treatment, the differences among the clinical manifestations of pseudobulbar paralysis, the score of TCM syndromes and the scores of improved daily living ability were observed in Wata drinking water test, and the corresponding clinical efficacy was evaluated. The relevant data obtained in this experiment are processed by scientific statistical analysis method, I. E. spss21.0 data analysis software. The result is 1: 1. The general data (sex, age and course of disease) were compared between the two groups. The results showed that there was no significant difference between the two groups in sex, age and course of disease (P0.05). There is statistical significance. Comparison after treatment: treatment group and control group patients with dysphagia were improved to varying degrees (P0.05), but the treatment group was significantly better than the control group (P0.05); The clinical manifestations of pseudobulbar paralysis in the treatment group and the control group were improved to varying degrees (P0.05), but the curative effect in the treatment group was significantly better than that in the control group (P0.05). Can increase (P0.05), but the effect of the treatment group is significantly better than the control group (P0.05); after treatment, the treatment group, the control group, the TCM syndrome score can be reduced (P0.05), but the treatment group is significantly better than the control group (P0.05). 3. The total effective rate of the treatment group was 83.87 in treating pseudobulbar paralysis with phlegm and stasis after stroke, while that in the control group was 65.63. The therapeutic effect was significantly different between the two groups by chi-square test (P0.05). In terms of safety, blood, urine, liver and kidney function were examined before and after treatment. The results showed that there were no obvious liver and kidney damage and other adverse reactions in the whole course of treatment between the two groups. During the course of this experiment, one patient in the treatment group was unable to complete the experiment because he could not tolerate acupuncture, and the rest of the patients completed the experiment according to the requirements. Conclusion: Tongluojieyu pills combined with acupuncture therapy can obviously improve the clinical symptoms of pseudobulbar paralysis (phlegm and blood stasis type) after stroke: it can improve the function of swallowing and articulation of pseudobulbar paralysis after stroke. Improve the ability of daily life and TCM symptom score. The comprehensive treatment of traditional Chinese medicine combined with acupuncture has good effect and is worth learning and popularizing.
【学位授予单位】：河南中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R255.2

【相似文献】