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  本文選題：缺血性中風(fēng)急性期 + 破血逐瘀�。� 參考：《河南中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的:通過隨機對照試驗,對比破血逐瘀法與活血化瘀法對缺血性中風(fēng)急性期患者的臨床療效及安全性,初步評價破血逐瘀、活血化瘀兩種療法的作用強弱,進(jìn)一步對兩種療法在缺血性中風(fēng)急性期的應(yīng)用做一定位、排序,以期為臨床治療提供指導(dǎo)。方法:選取符合條件的患者70例,采用SPSS隨機數(shù)字生成器隨機分成試驗組、對照組,每組35例。兩組患者均給予缺血性中風(fēng)急性期常規(guī)治療,試驗組加以疏血通注射液6ml,靜滴,每天1次;對照組加以血塞通注射液400mg,靜滴,每天1次,兩組療程均為2周。觀察患者治療前、后的中醫(yī)證候評分、神經(jīng)功能缺損評分、生活質(zhì)量評分(ADL),記錄并對以上數(shù)據(jù)進(jìn)行統(tǒng)計分析。結(jié)果:1.臨床療效比較:試驗組和對照組總有效率各為94.3%、77.1%�？傆行�,試驗組明顯優(yōu)于對照組,兩組療效經(jīng)秩和檢驗分析有統(tǒng)計學(xué)意義(p0.05),說明在缺血性中風(fēng)急性期治療中破血逐瘀法臨床療效顯著優(yōu)于活血化瘀法;2.中醫(yī)證候積分、神經(jīng)功能缺損評分比較:治療后,試驗組與對照組比較,中醫(yī)證候積分、神經(jīng)功能缺損評分均明顯下降(p0.01),組間比較亦具有顯著性差異(p0.05),表明兩組在改善缺血性中風(fēng)病急性期患者的癥狀及體征方面均有效,但改善程度試驗組優(yōu)于對照組;3.ADL評分比較:治療后,試驗組與對照組比較,兩組ADL評分較治療前均升高,但改善程度試驗組優(yōu)于對照組(p0.05),組間比較亦有統(tǒng)計學(xué)意義(p0.05),說明兩組均能改善缺血性中風(fēng)急性期患者生活能力,但改善程度試驗組優(yōu)于對照組;4.在本次試驗過程中未發(fā)生不良反應(yīng)。結(jié)論:1.破血逐瘀法能明顯改善缺血性中風(fēng)急性期的中醫(yī)證候積分、神經(jīng)功能缺損評分,可以提高患者生活質(zhì)量,且無明顯的不良反應(yīng)。2.對于常用于治療錯過溶栓時間窗、溶栓失敗或者不能接受溶栓治療的缺血性中風(fēng)急性期患者的活血類中藥注射液,以疏血通注射液為代表的破血逐瘀法療效顯著宜首選。
[Abstract]:Objective: to compare the clinical efficacy and safety of the methods of breaking blood and removing blood stasis and activating blood circulation and removing blood stasis in patients with acute ischemic apoplexy by randomized controlled trial, and to evaluate the effect of breaking blood and removing blood stasis and activating blood circulation and removing blood stasis. In order to provide guidance for clinical treatment, the application of two kinds of therapies in acute stage of ischemic apoplexy is further defined and sorted. Methods: 70 eligible patients were randomly divided into trial group (n = 35) and control group (n = 35) with SPSS random number generator. The patients in both groups were given routine treatment in acute phase of ischemic stroke. The experimental group was treated with Shuxuetong injection 6 ml, iv drip once a day, and the control group with 400 mg Xuesaitong injection, once a day. The course of treatment in both groups was 2 weeks. The scores of TCM syndromes, neurological impairment and quality of life were observed before and after treatment, and the above data were recorded and analyzed statistically. The result is 1: 1. Comparison of clinical efficacy: the total effective rate of the test group and the control group was 94.30.77. 1 respectively. The total effective rate in the experimental group was significantly better than that in the control group, and the curative effect of the two groups was statistically significant by rank sum test analysis, indicating that the clinical efficacy of the method of breaking blood and removing blood stasis in the acute stage of ischemic apoplexy was significantly better than that of activating blood circulation and removing blood stasis. Comparison of TCM syndromes score and neurological deficit score: after treatment, the experimental group compared with the control group, TCM syndromes integral, The scores of neurological impairment were significantly decreased (P < 0.01), and there was significant difference between the two groups (P 0.05), which indicated that the two groups were effective in improving the symptoms and signs of patients with acute ischemic apoplexy. But the improvement degree of the experimental group was better than that of the control group. 3. The ADL score of the two groups was higher than that of the control group after treatment, and after treatment, the ADL score of the two groups was higher than that of the control group. But the improvement degree test group was superior to the control group (P 0.05), and the comparison between the two groups was also statistically significant, which indicated that both groups could improve the life ability of the patients in the acute stage of ischemic stroke, but the improvement degree test group was better than the control group (P 0.05). No adverse reactions occurred during this trial. Conclusion 1. The method of breaking blood and removing blood stasis can obviously improve the score of TCM syndromes and the score of nerve function defect in the acute stage of ischemic apoplexy. It can improve the quality of life of patients, and there is no obvious adverse reaction. 2. For the patients who are often used in the treatment of missed thrombolytic time window, the failure of thrombolysis or the failure of thrombolytic therapy or the failure to accept thrombolytic therapy, the traditional Chinese medicine injection of activating blood circulation, represented by Shuxuetong injection, should be chosen as the first choice.
【學(xué)位授予單位】：河南中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R277.7

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