本文選題：缺血性腦卒中 + 腦梗死��； 參考：《承德醫(yī)學院》2017年碩士論文

【摘要】：缺血性腦卒中即腦梗死,占全部卒中的85%,臨床表現(xiàn)為半身不遂口眼?斜、語言不利,中國腦卒中發(fā)病率居世界首位。全國第3次死因回顧抽樣調(diào)查資料表明,當前腦卒中已經(jīng)成為我國導致患者死亡和致殘的第一位因素。2013年,腦卒中導致的死亡人數(shù)已高達170萬,數(shù)據(jù)顯示,再次復發(fā)率也很高。盡管治療腦血管病的醫(yī)療技術(shù)在不斷的提高,腦梗死的病死率、復發(fā)率和致殘率仍沒有很大改善。依據(jù)中華醫(yī)學會神經(jīng)病學分會腦血管病學組撰寫的《中國急性期缺血性腦卒中診治指南2014》,其中提到西醫(yī)治療主要以改善腦血循環(huán)和神經(jīng)保護為重點,而中成藥和中成藥注射液治療急性缺血性腦卒中的療效還需要更多的高質(zhì)量臨床隨機對照試驗進一步證實。所以對缺血性腦卒中(腦梗死)治療中中成藥注射劑的應用情況進行調(diào)查分析,了解其用藥情況和不良反應的發(fā)生情況,可以為科研和臨床治療用藥提供參考。目的:調(diào)查分析中成藥注射液治療缺血性卒中的臨床治療文獻中的中成藥注射劑的種類、數(shù)量、研究類型(隨機對照文獻和非隨機對照文獻)、樣本量、劑量、療程、溶媒、合并用藥、不良反應的具體情況,并得出結(jié)論,為今后相關(guān)研究工作和臨床用藥提供參考。方法:文獻資料來源于2016年10月1日前中國知網(wǎng)全文數(shù)據(jù)庫(CNKI)、萬方全文數(shù)據(jù)庫發(fā)表的期刊、碩博論文、會議、報紙,以中成藥注射液為干預措施的臨床病例、對照文獻。運用文獻調(diào)查研究的方法了解文獻的發(fā)表數(shù)量及研究內(nèi)容采用Noteexpress進行文獻檢索,檢索式為篇名=“注射液/劑”and篇名=“缺血性腦卒中”or“腦梗死”or“腦梗塞”or“腦栓塞”or“腦血栓”or“缺血性卒中”or“缺血性腦血管病”or“缺血性中風”and篇名=“臨床”or“病例”or“對照”,進行統(tǒng)計分析與輔助作圖。結(jié)果:知網(wǎng)檢出文獻2033篇,去掉內(nèi)容交叉的1391篇,剩余642篇。萬方檢出文獻2133,去掉內(nèi)容交叉的19篇,剩余2114篇。兩庫文獻相加去掉兩個庫重復的968篇文獻,剩余1788篇文獻。所用的中成藥注射液總共68種,按中醫(yī)理論辯證分型,文獻中提到比較多的有活血化瘀類包括丹紅注射液、疏血通注射液、燈盞花素注射液、燈盞細辛注射液、葛根素注射液、脈絡寧注射液、苦碟子注射液;清熱解毒、活血開竅醒腦類醒腦靜注射液;益氣扶正類的黃芪注射液;平補肝腎、益精壯骨類的刺五加注射液;益氣固脫養(yǎng)陰生津類的參麥注射液;回陽救逆類的參附注射液;息風止痙,平抑肝陽祛風通絡類的天麻素注射液;養(yǎng)血活血類的香丹注射液;行氣除滿,開胸除痹類的瓜蔞皮注射液等。結(jié)論:1.此類文獻中提到的臨床研究類型大多為隨機對照研究,臨床觀察類較少。2.此類注射液多用于急性期,恢復期和后遺癥期比較少,不管是哪一期,辯證用藥都比較少。3.活血化瘀類用藥最多,黃芪補氣類合并用藥最多。4.基本沒有關(guān)于正常劑量和超劑量使用的臨床隨機對照試驗研究,今后應該增加這方面的研究。5.超療程使用情況也存在,應盡量間隔一段時間再繼續(xù)用藥,盡量中病及止。6.存在不按說明書使用溶媒的情況。7.聯(lián)合用藥時需要適當間隔一定時間,不建議間隔輸液后序貫給藥,在保證安全的情況下可以辯證聯(lián)合不同功效的藥物。8.不良反應存在記錄不明確的情況。
[Abstract]:Ischemic stroke is cerebral infarction, which accounts for 85% of all stroke. Clinical manifestations are hemiplegia, oblique, and bad language. The incidence of stroke in China ranks first in the world. The data of the national third cause of death review shows that the current stroke has become the first factor leading to death and disability in China,.2013 years, and stroke caused by stroke. The number of deaths is up to 1 million 700 thousand, and the recurrence rate is also high. Despite the continuous improvement in the treatment of cerebrovascular diseases, the mortality rate, the recurrence rate and the rate of disability are still not greatly improved. According to the Chinese Medical Association neurology branch cerebrovascular disease group, the diagnosis and treatment of acute ischemic stroke in China The treatment of Western medicine mainly focuses on the improvement of cerebral blood circulation and neuroprotection, and the curative effect of Chinese patent medicine and Chinese patent medicine injection in the treatment of acute ischemic stroke should be further confirmed by more high quality clinical randomized controlled trials. Therefore, the application of Chinese medicine injection in the treatment of ischemic stroke (cerebral infarction), 2014> Investigation and analysis, to understand the situation of drug use and the occurrence of adverse reactions, can provide reference for scientific research and clinical treatment. Objective: To investigate the types, quantity and types of Chinese patent medicine injection in the literature of treatment of ischemic stroke by Chinese patent medicine injection (random control literature and non random control) Sample volume, dose, course of treatment, solvent, combined use of drugs, adverse reactions, and draw conclusions for future related research and clinical use. Methods: literature from the full text database of Chinese net (CNKI) before October 1, 2016, journals published by Wanfang full text database, large papers, conferences, newspapers, and The clinical cases of intervention measures were the clinical cases and the control literature. Using the method of literature investigation, the number of publications and the contents of the literature were searched by Noteexpress. The title = "injection / agent" and name = "ischemic stroke", "cerebral infarction", "cerebral infarction", "cerebral infarction", "cerebral embolism", "or", "or", "Noteexpress" Cerebral thrombosis "or" ischemic stroke "or" ischemic cerebrovascular disease "ischemic stroke" or "ischemic stroke" and name = "clinical" or "case" or "control", statistical analysis and auxiliary mapping. Results: 2033 papers, 1391 pieces of content crossing, the remaining 642 pieces were removed. 2133 of the documents were detected by Wan Fang, and 19 pieces of cross content were removed. The remaining 2114 articles. The two library documents are added to the 968 literature of two libraries, and the remaining 1788 documents. There are 68 kinds of Chinese traditional Chinese medicine injection. According to the dialectical classification of traditional Chinese medicine, there are a lot of blood circulation and blood stasis types including Danhong injection, Shuxuetong injection, caperabine injection, Erigeron Breviscapine injection, and puerarin injection. Injection of liquid, mailuing injection, kusezi injection; clearing heat and detoxifying, Xingnao Xingnaojing injection of activating blood and resuscitation; astragalus injection of Yiqi Fuzheng class; Ping supplementing liver and kidney, benefiting essence and Zhuanggu injection; Shenmai injection, nourishing qi and nourishing yin and nourishing Yin, Shenfu injection of Huiyang rescue and antispasm, relieving spasmodic and relieving wind and dredging the collaterals of liver Yang Type of Gastrodin Injection; nourishing blood and activating blood class Xiangdan injection; gas removal to full, open chest and arthralgia Trichosanthes peel injection. Conclusion: 1. the clinical research types mentioned in this literature are mostly randomized controlled study, the clinical observation class less.2. injection is mostly used in the acute period, the recovery period and the sequela period are relatively few, whatever Period, the dialectical drug use is less.3. activating blood and removing blood stasis drugs most, the Astragalus Qi supplementing type combined with the most.4. does not have the basic clinical randomized controlled trial study on the normal dose and the super dose. In the future, we should increase this aspect of the study of.5. super course of treatment, and try to keep the use of drugs as far as possible as far as possible. The disease and the presence of.6. do not exist in the case of the use of solvent in the instructions of the instruction of.7., it is necessary to have a proper interval of time, not to recommend the sequential administration after the interval infusion. In the case of safety, the adverse reaction of the drug.8. can be dialectically combined with different efficacy.
【學位授予單位】：承德醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R277.7

【參考文獻】

相關(guān)期刊論文 前10條

1 李怡;桂萬弟;;78例刺五加注射液致過敏反應的文獻分析[J];中南藥學;2016年12期

2 周彬;李R，

本文編號：1949809