痰瘀阻络方治疗急性脑梗死痰瘀阻络证的临床疗效观察和磁共振弥散张量分析
发布时间：2019-07-01 18:11
【摘要】：目的:通过临床对照观察和磁共振弥散张量成像(DTI)分析,评价痰瘀阻络方对急性脑梗死痰瘀阻络证患者的神经功能缺损、生存质量等以及新发梗死灶区细胞内自由水分子弥散运动改善情况的疗效,分析患者颅内新发梗死灶区细胞内自由水分子弥散运动情况与患者神经功能缺损、生存质量等的关系。方法:采用开放对照的试验设计,选取急性脑梗死痰瘀阻络证患者40例,分为治疗组和对照组各20例。两组均给予常规西药治疗,治疗组加用痰瘀阻络方。观察对比患者治疗7d时新发梗死灶区和对侧镜像区部分各向异性(FA)、表观弥散系数(ADC)水平,治疗第 0d、7d、14d、28d 的 NIHSS 评分、Barthel 指数(BI)、Modified Rankin Scale(mRS)积分、生存质量指数变化。结果:两组在性别、年龄、发病时间、病情程度、基础疾病、各项临床评分等方面差异均无统计学意义(P0.05),具有可比性。治疗后,两组NIHSS评分较治疗前均明显下降,生存质量指数较发病后1周显著升高(P0.05);治疗组NIHSS评分较对照组降低,生存质量指数较对照组提高(P0.05)。结论:痰瘀阻络方治疗急性脑梗死痰瘀阻络证临床疗效显著,能明显改善患者神经功能缺损症状、提高患者生活质量;通过DTI检查,客观地证明痰瘀阻络方对梗死病灶区细胞内自由水分子弥散运动的改善作用。本次研究未能验证rFA与NIHSS评分的相关性。
[Abstract]:Objective: to evaluate the effect of Tanyu Zholuo recipe on neurological deficit, quality of life and improvement of intracellular free water molecule diffusion movement in patients with acute cerebral infarction with phlegm and blood stasis syndrome by clinical comparative observation and magnetic resonance diffusion tensor imaging (DTI), and to analyze the diffusion movement of free water molecules and neurological deficit in patients with new intracranial infarction. The relationship between quality of life, etc. Methods: forty patients with phlegm and blood stasis syndrome in acute cerebral infarction were divided into treatment group (n = 20) and control group (n = 20). Both groups were treated with routine western medicine, and the treatment group was treated with phlegm and blood stasis blocking collaterals prescription. The apparent diffusion coefficient (ADC) of partial anisotropy (FA), in the new infarction area and the contralateral mirror area were observed and compared on the 7th day, the 14th day, the 28th day, the NIHSS score, the Barthel index (BI), Modified Rankin Scale (mRS) score and the quality of life index. Results: there was no significant difference in sex, age, time of onset, degree of illness, basic disease and clinical score between the two groups (P 0.05), and there was no significant difference between the two groups in sex, age, time of onset, degree of illness, basic disease and clinical score (P 0.05). After treatment, the NIHSS score of the two groups was significantly lower than that before treatment, and the quality of life index (QOL) was significantly higher than that of the control group (P 0.05). The NIHSS score of the treatment group was lower than that of the control group, and the QOL index of the treatment group was higher than that of the control group (P 0.05). Conclusion: Tanyu blocking collateral recipe is effective in the treatment of acute cerebral infarction with phlegm and blood stasis syndrome, which can obviously improve the symptoms of neurological deficit and improve the quality of life of patients, and objectively prove the effect of Tanyu blocking collateral recipe on the diffusion movement of free water molecules in the focal area of infarction by DTI examination. This study failed to verify the correlation between rFA and NIHSS score.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R277.7
本文编号：2508695
[Abstract]:Objective: to evaluate the effect of Tanyu Zholuo recipe on neurological deficit, quality of life and improvement of intracellular free water molecule diffusion movement in patients with acute cerebral infarction with phlegm and blood stasis syndrome by clinical comparative observation and magnetic resonance diffusion tensor imaging (DTI), and to analyze the diffusion movement of free water molecules and neurological deficit in patients with new intracranial infarction. The relationship between quality of life, etc. Methods: forty patients with phlegm and blood stasis syndrome in acute cerebral infarction were divided into treatment group (n = 20) and control group (n = 20). Both groups were treated with routine western medicine, and the treatment group was treated with phlegm and blood stasis blocking collaterals prescription. The apparent diffusion coefficient (ADC) of partial anisotropy (FA), in the new infarction area and the contralateral mirror area were observed and compared on the 7th day, the 14th day, the 28th day, the NIHSS score, the Barthel index (BI), Modified Rankin Scale (mRS) score and the quality of life index. Results: there was no significant difference in sex, age, time of onset, degree of illness, basic disease and clinical score between the two groups (P 0.05), and there was no significant difference between the two groups in sex, age, time of onset, degree of illness, basic disease and clinical score (P 0.05). After treatment, the NIHSS score of the two groups was significantly lower than that before treatment, and the quality of life index (QOL) was significantly higher than that of the control group (P 0.05). The NIHSS score of the treatment group was lower than that of the control group, and the QOL index of the treatment group was higher than that of the control group (P 0.05). Conclusion: Tanyu blocking collateral recipe is effective in the treatment of acute cerebral infarction with phlegm and blood stasis syndrome, which can obviously improve the symptoms of neurological deficit and improve the quality of life of patients, and objectively prove the effect of Tanyu blocking collateral recipe on the diffusion movement of free water molecules in the focal area of infarction by DTI examination. This study failed to verify the correlation between rFA and NIHSS score.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R277.7
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