通阳活血颗粒对气虚血瘀型中风患者证侯的影响
发布时间：2018-12-14 03:20
【摘要】：背景：中风病是危害我国城乡人民健康的主要疾病之一,脑血管疾病已经取代心血管疾病成为引起我国城市和农村人口死亡的头号杀手[1],,2010年中国大陆因中风病及相关并发症而死亡的人数高达170万[2,且其发病有逐年增多、年轻化的趋势。我国现存中风病患者大约有700余万人,其中近70%患者为缺血性卒中[3]。中风病有着高致死率、高致残率、高复发率的特点,是目前治疗的难点。现代医学以超早期溶栓、抗血小板聚集、抗凝、降纤、调脂稳斑、神经保护等作为主要治疗方法[4],是目前防治中风的主流方法,但仍存在着溶栓时间窗过短、出血转化、再发等问题[5]。中医中药早在2千多年前就开始应用于治疗中风,现代中医发展了中药汤剂、中药针剂、口服中成药、针灸、推拿等多种治疗方法,在中风的治疗中有独特的作用和潜在的优势,但其作用和疗效缺乏客观评价和大样本循证医学证据。全国第五批名老中医药学术继承工作指导老师、佛山市中医院脑病科学术带头人谭峰教授在总结历代医家中风学说和治验基础上,结合自己多年临床实践,提出血瘀是中风的关键因素,在全国率先提出运用“三早”(早期活血化瘀、早期心理调护、早期康复综合治疗)治疗缺血性中风,尤其是在早期运用益气活血通络法治疗气虚血瘀型缺血性中风病疗效显著,但未进行定量评估疗效的随机对照研究,其机制尚未完全阐明。本研究从传承谭峰教授早期运用益气活血通络法治疗气虚血瘀型中风的学术经验出发,选用具有益气活血通络之功的通阳活血颗粒治疗气虚血瘀型缺血性中风,研究通阳活血颗粒治疗前后中风患者中医证候的变化,同时运用三重磁刺激(TST)、美国国立卫生研究院卒中量表(NIHSS)对其疗效进行定量评价。探讨通阳活血颗粒治疗气虚血瘀型缺血性中风的中医机制,总结谭峰教授运用益气活血通络法治疗缺血性中风的学术经验,为中医药防治缺血性中风提供更多依据。目的：观察通阳活血颗粒对气虚血瘀型中风患者中医证侯的影响,传承谭峰教授运用益气活血通络法治疗缺血性中风的经验。方法：①选择2015年3月至2015年12月期间、发病6h-7天内并被确诊为缺血性中风的佛山市中医院脑病科住院患者共156例,选择其中确诊为气虚血瘀型的缺血性中风患者47例,随机分为两组,其中治疗组(通阳活血颗粒+基础治疗)24例、对照组(基础治疗)23例；②采用《缺血性中风证候要素诊断量表》,由专人评定两组缺血性中风患者治疗前、治疗后14天的中医证侯学评分；③采用NIHSS评价两组缺血性中风患者治疗前、治疗后14天神经功能学评分；④采用TST检测两组缺血性中风患者治疗前、治疗后第14天偏瘫侧肢体TSTtest测试值。结果：①血瘀气虚型缺血性中风患者在本组缺血性中风患者中占30.13%,是缺血性中风最主要的证型之一。②本组气虚血瘀型缺血性中风患者的NIHSS与TSTtest测试值呈正相关(P0.05)；③本组气虚血瘀型缺血性中风患者治疗组治疗后与治疗前的TSTest测试值差值高于对照组,差异有统计学意义(P0.05)；④本组气虚血瘀型缺血性中风患者治疗组治疗前后的中医证侯痰湿、血瘀、气虚评分差值高于对照组,差异有统计学意义(P0.05)；两组患者治疗前后的中医证侯内风、内火、阴虚评分差值比较无统计学意义(P0.05)。结论：①血瘀气虚证型是缺血性中风早期主要证型之一；②TSTest测试值可定量分析皮质脊髓束的损伤程度；反映缺血性中风患者神经功能中运动功能缺损程度；③通阳活血颗粒可改善气虚血瘀型缺血性中风患者的TSTtest测试值,从而改善肢体运动功能；④通阳活血颗粒颗粒可改善气虚血瘀型缺血性中风患者的气虚、血瘀、痰湿证侯,与通阳活血颗粒益气活血通络之方义基本一致。
[Abstract]:Background: Stroke is one of the main diseases which are harmful to the health of our country and the urban and rural people. The cerebrovascular disease has replaced the cardiovascular disease as the number one killer[1] causing the death of the urban and rural population in our country. In 2010, the number of deaths due to stroke and related complications in the mainland of China reached 1.7 million[2], and its incidence increased year by year. The number of patients with stroke in our country is about 7 million, of which nearly 70% of the patients are ischemic stroke[3]. Apoplexy has the characteristics of high fatality rate, high disability rate and high recurrence rate, and is the difficult point of the current treatment. Modern medicine is the main treatment method for the treatment of apoplexy, such as ultra-early thrombolysis, anti-platelet aggregation, anti-coagulation, fiber-lowering, lipid-regulating, and neuroprotection. The traditional Chinese medicine has started to be applied to the treatment of apoplexy more than 2,000 years ago, and the modern Chinese medicine has developed a plurality of treatment methods such as the traditional Chinese medicine decoction, the traditional Chinese medicine injection, the oral Chinese patent medicine, the acupuncture, the massage and the like, and has a unique effect and a potential advantage in the treatment of the apoplexy, But its effect and curative effect lack objective evaluation and large-sample evidence of evidence-based medicine. in that fifth batch of the nation's fifth batch of traditional Chinese medicine academic inheritance work-guidance teacher, professor Tan Feng, the leader of the science of the science of encephalopathy in the middle hospital of Foshan, on the basis of summing up the stroke theory and the rule of medicine of the past dynasties, combined with his own multi-year clinical practice, put forward that blood stasis is the key factor of stroke, It is the first to put forward the application of 鈥渢hree-morning鈥，
本文编号：2377819
[Abstract]:Background: Stroke is one of the main diseases which are harmful to the health of our country and the urban and rural people. The cerebrovascular disease has replaced the cardiovascular disease as the number one killer[1] causing the death of the urban and rural population in our country. In 2010, the number of deaths due to stroke and related complications in the mainland of China reached 1.7 million[2], and its incidence increased year by year. The number of patients with stroke in our country is about 7 million, of which nearly 70% of the patients are ischemic stroke[3]. Apoplexy has the characteristics of high fatality rate, high disability rate and high recurrence rate, and is the difficult point of the current treatment. Modern medicine is the main treatment method for the treatment of apoplexy, such as ultra-early thrombolysis, anti-platelet aggregation, anti-coagulation, fiber-lowering, lipid-regulating, and neuroprotection. The traditional Chinese medicine has started to be applied to the treatment of apoplexy more than 2,000 years ago, and the modern Chinese medicine has developed a plurality of treatment methods such as the traditional Chinese medicine decoction, the traditional Chinese medicine injection, the oral Chinese patent medicine, the acupuncture, the massage and the like, and has a unique effect and a potential advantage in the treatment of the apoplexy, But its effect and curative effect lack objective evaluation and large-sample evidence of evidence-based medicine. in that fifth batch of the nation's fifth batch of traditional Chinese medicine academic inheritance work-guidance teacher, professor Tan Feng, the leader of the science of the science of encephalopathy in the middle hospital of Foshan, on the basis of summing up the stroke theory and the rule of medicine of the past dynasties, combined with his own multi-year clinical practice, put forward that blood stasis is the key factor of stroke, It is the first to put forward the application of 鈥渢hree-morning鈥，
本文编号：2377819
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