本文關(guān)鍵詞：葦莖湯合麻杏石甘湯加減治療卒中相關(guān)性肺炎痰熱蘊(yùn)肺證的臨床觀察　出處：《湖北中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 卒中相關(guān)性肺炎 痰熱蘊(yùn)肺證 葦莖湯合麻杏石甘湯加減 臨床觀察

【摘要】：研究目的:評(píng)價(jià)葦莖湯合麻杏石甘湯加減治療卒中相關(guān)性肺炎痰熱蘊(yùn)肺證的臨床療效及安全性。研究方法:收集2014年3月至2015年9月在湖北省中醫(yī)院腦病科病房住院治療的符合卒中相關(guān)性肺炎痰熱蘊(yùn)肺證納入標(biāo)準(zhǔn)的病例60例,隨機(jī)分為治療組30例,對(duì)照組30例,兩組均施以卒中相關(guān)性肺炎的規(guī)范治療,治療組則在對(duì)照組的基礎(chǔ)上加用葦莖湯合麻杏石甘湯加減中藥方,療程為14天,觀察兩組總療效、中醫(yī)證候積分、炎性指標(biāo)、Bathel指數(shù)評(píng)分等指標(biāo)的變化,并觀察治療過(guò)程中可能出現(xiàn)的不良反應(yīng)。采用SPSS17.0統(tǒng)計(jì)軟件對(duì)數(shù)據(jù)資料進(jìn)行分析。結(jié)果:1.中醫(yī)證候總療效:治療組總有效率為93.33%,高于對(duì)照組總有效率(83.33%),差異有統(tǒng)計(jì)學(xué)意義(P0.05)。2.中醫(yī)證候總積分:對(duì)照組和治療組在治療后中醫(yī)證候總積分均比治療前顯著降低,差異有統(tǒng)計(jì)學(xué)意義。對(duì)治療后的中醫(yī)證候總積分進(jìn)行組間比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05),治療組優(yōu)于對(duì)照組。3.中醫(yī)證候單項(xiàng)積分:治療組治療后的各項(xiàng)中醫(yī)證候積分進(jìn)行比較,均有顯著下降(P0.01),差異有統(tǒng)計(jì)學(xué)意義。對(duì)照組患者治療后的中醫(yī)證候積分在發(fā)熱、咳嗽、痰色、痰質(zhì)、胸痛、口干等方面均較治療前明顯下降(P0.01),在改善脈滑數(shù)方面也有下降(P0.05),但是腹脹便秘及舌紅苔黃等好轉(zhuǎn)不明顯,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。對(duì)治療后對(duì)照組和治療組的患者各單項(xiàng)證候進(jìn)行組間比較,治療組在改善SAP患者咳嗽、痰色、痰質(zhì)、口干、腹脹便秘、舌紅苔黃、脈滑數(shù)等方面優(yōu)于對(duì)照組(P0.05),差異有統(tǒng)計(jì)學(xué)意義。但是在改善發(fā)熱和胸痛等方面,和對(duì)照組相比,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。4.治療前后炎性指標(biāo)比較:兩組患者治療后炎性指標(biāo)均較治療前顯著下降(P0.01),差異有統(tǒng)計(jì)學(xué)意義,但是對(duì)兩組患者治療后炎性指標(biāo)進(jìn)行組間比較,發(fā)現(xiàn)無(wú)顯著差異(P0.05)。5.治療前后Bathel指數(shù)積分比較:分別對(duì)兩組患者治療前后的Bathel指數(shù)積分進(jìn)行比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);治療后進(jìn)行組間比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。6.安全性:兩組患者在治療期間都沒(méi)有出現(xiàn)不良反應(yīng)。結(jié)論:1.葦莖湯合麻杏石甘湯加減治療卒中相關(guān)性肺炎痰熱蘊(yùn)肺證在改善總有效率、中醫(yī)證候總積分、部分單項(xiàng)中醫(yī)證候方面優(yōu)于單用西藥治療。2.葦莖湯合麻杏石甘湯加減在治療過(guò)程中未發(fā)生不良反應(yīng),安全性高。
[Abstract]:Objective: To evaluate the efficacy and safety of Weijing Decoction and Maxingshigan Decoction in the treatment of stroke associated pneumonia phlegm. Methods: from March 2014 to September 2015 in Hubei Provincial Traditional Chinese Medical Hospital Department of encephalopathy hospitalized for treatment of stroke associated pneumonia with phlegm and 60 cases were included in the standard case, were randomly divided into treatment group of 30 cases, 30 cases in the control group, two groups were treated with standardized treatment of stroke associated pneumonia, the treatment group on the basis of the control group with reed stem of Maxingshigan Decoction Decoction prescription, treatment for 14 days, to observe the change of the total effect of the two groups, TCM syndrome integral, inflammatory index, Bathel index and other indicators, and to observe the possible adverse reactions during treatment. The SPSS17.0 statistical software was used to analyze the data. Results: 1. the total curative effect of TCM syndrome: the total effective rate of the treatment group was 93.33%, which was higher than the control group (83.33%), and the difference was statistically significant (P0.05). 2. total score of TCM syndrome: the total score of TCM syndrome in the control group and the treatment group was significantly lower than that before the treatment, and the difference was statistically significant. The total score of TCM syndrome after treatment was compared between groups, the difference was statistically significant (P0.05), and the treatment group was better than the control group. 3. single score of TCM syndrome: the scores of TCM syndromes in the treatment group were compared, and there was a significant decrease (P0.01), the difference was statistically significant. The control group of TCM syndrome score after treatment in patients with cough, fever, sputum, sputum color in the matter, chest pain, dry mouth and so on were significantly lower than before treatment (P0.01), in improving the slippery pulse number has decreased (P0.05), but abdominal distension constipation and red tongue etc. improvement is not obvious, there is no statistical difference meaning (P0.05). For each single syndrome after the treatment in the control group and treatment group were compared between the two groups, the treatment group in the improvement of cough, phlegm, phlegm in patients with SAP color, dry mouth, abdominal distension, constipation, red tongue, slippery pulse number is better than the control group (P0.05), the difference was statistically significant. However, there was no significant difference in the improvement of fever and chest pain compared with the control group (P0.05). 4. before and after treatment, inflammatory markers were compared: the inflammatory indexes in two groups were significantly lower than those before treatment (P0.01), but the difference was statistically significant. However, there was no significant difference between the two groups in the inflammatory markers after treatment (P0.05). 5. before and after treatment, the Bathel index scores were compared. There was no significant difference in the Bathel index scores between the two groups before and after treatment (P0.05). There was no significant difference between the two groups after treatment (P0.05). 6. safety: two groups of patients had no adverse reactions during the treatment. Conclusion: 1. Weijing Decoction and Maxingshigan Decoction in the treatment of stroke associated pneumonia phlegm in improving the total efficiency, total score of TCM symptoms, better than the single part of TCM with western medicine alone. 2. Weijing Decoction and Maxingshigan Decoction in the treatment process, no adverse reaction, high safety.
【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R259;R277.7

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