国际中医中药杂志
國際中醫中藥雜誌
국제중의중약잡지
INTERNATIONAL JOURNAL OF TRIDITIONAL CHINESE MEDICINE
2013年
2期
112-116
,共5页
短暂性脑缺血发作%中药%针刺%临床评价
短暫性腦缺血髮作%中藥%針刺%臨床評價
단잠성뇌결혈발작%중약%침자%림상평개
TIA%Chinese medicine%Acupuncture%Clinical evaluation
目的 观察针药并用对短暂性脑缺血发作(transienti schemic attact,TIA)高危因素及预后的影响.方法 选择2010年3月至2011年5月高密市人民医院和高密市中医院就诊的TIA患者120例,按病例尾号以1:1:1的比例随机分为三组各40例.针药组采用电针内关穴,同时口服加味天麻钩藤饮治疗,3次/d;中药组单纯服用加味天麻钩藤饮治疗,3次/d；西药组口服阿司匹林肠溶片,0.1g,1次/d.三组均治疗15 d为1个疗程,连续治疗2个疗程.观察三组患者治疗前后中医证候评分、血压、血脂、血液流变学、血糖的变化.并随访一年,观察复发率及脑卒中发生率.结果 ①治疗后针药组总胆固醇(5.21±0.97) mmol/L,全血黏度[(4.26±0.66) 200 mPa·s、(5.69±0.15) 30 mPa·s、(9.72±2.33)5 mPa·s],纤维蛋白原(2.12±0.46) g/L,收缩压(124.13±9.96)mm Hg(1 mm Hg =0.133 kPa),舒张压(79.23±7.50) mm Hg,血糖(5.59±0.78) mmol/L;中药组总胆固醇(5.43±1.04) mmol/L,全血黏度[(4.25±0.25) 200 mPa·s、(5.46±0.55) 30 mPa·s、(9.81±2.01)5 mPa·s],纤维蛋白原(2.32±0.33) g/L,收缩压(129.78±14.25) mm Hg,舒张压(79.54±7.65) mm Hg,血糖(5.60±0.75) mmol/L;西药组总胆固醇(5.52± 1.16) mmol/L,全血黏度[(4.12±0.54) 200mPa·s、(5.45±0.65) 30 mPa·s、(9.09±1.11)5 mPa·s],纤维蛋白原(2.41±0.44) g/L,收缩压(129.83±14.91) mm Hg,舒张压(80.72±7.47) mm Hg,血糖(5.75±0.61) mmol/L均较同组治疗前明显改善(P均＜0.05),且针药组改善情况优于中药组、西药组(P均＜0.05).②随访1年,针药组无复发；中药组、西药组各复发6例,复发率为15％,针药组TIA的复发率低于中药组、西药组.结论 针药并用不仅可改善TIA患者的临床症状,且对其血压、血脂、血液流变学、血糖等高危因素均有明显改善,并能有效降低其复发率及脑卒中的发生率.
目的 觀察針藥併用對短暫性腦缺血髮作(transienti schemic attact,TIA)高危因素及預後的影響.方法 選擇2010年3月至2011年5月高密市人民醫院和高密市中醫院就診的TIA患者120例,按病例尾號以1:1:1的比例隨機分為三組各40例.針藥組採用電針內關穴,同時口服加味天痳鉤籐飲治療,3次/d;中藥組單純服用加味天痳鉤籐飲治療,3次/d；西藥組口服阿司匹林腸溶片,0.1g,1次/d.三組均治療15 d為1箇療程,連續治療2箇療程.觀察三組患者治療前後中醫證候評分、血壓、血脂、血液流變學、血糖的變化.併隨訪一年,觀察複髮率及腦卒中髮生率.結果 ①治療後針藥組總膽固醇(5.21±0.97) mmol/L,全血黏度[(4.26±0.66) 200 mPa·s、(5.69±0.15) 30 mPa·s、(9.72±2.33)5 mPa·s],纖維蛋白原(2.12±0.46) g/L,收縮壓(124.13±9.96)mm Hg(1 mm Hg =0.133 kPa),舒張壓(79.23±7.50) mm Hg,血糖(5.59±0.78) mmol/L;中藥組總膽固醇(5.43±1.04) mmol/L,全血黏度[(4.25±0.25) 200 mPa·s、(5.46±0.55) 30 mPa·s、(9.81±2.01)5 mPa·s],纖維蛋白原(2.32±0.33) g/L,收縮壓(129.78±14.25) mm Hg,舒張壓(79.54±7.65) mm Hg,血糖(5.60±0.75) mmol/L;西藥組總膽固醇(5.52± 1.16) mmol/L,全血黏度[(4.12±0.54) 200mPa·s、(5.45±0.65) 30 mPa·s、(9.09±1.11)5 mPa·s],纖維蛋白原(2.41±0.44) g/L,收縮壓(129.83±14.91) mm Hg,舒張壓(80.72±7.47) mm Hg,血糖(5.75±0.61) mmol/L均較同組治療前明顯改善(P均＜0.05),且針藥組改善情況優于中藥組、西藥組(P均＜0.05).②隨訪1年,針藥組無複髮；中藥組、西藥組各複髮6例,複髮率為15％,針藥組TIA的複髮率低于中藥組、西藥組.結論 針藥併用不僅可改善TIA患者的臨床癥狀,且對其血壓、血脂、血液流變學、血糖等高危因素均有明顯改善,併能有效降低其複髮率及腦卒中的髮生率.
목적 관찰침약병용대단잠성뇌결혈발작(transienti schemic attact,TIA)고위인소급예후적영향.방법 선택2010년3월지2011년5월고밀시인민의원화고밀시중의원취진적TIA환자120례,안병례미호이1:1:1적비례수궤분위삼조각40례.침약조채용전침내관혈,동시구복가미천마구등음치료,3차/d;중약조단순복용가미천마구등음치료,3차/d；서약조구복아사필림장용편,0.1g,1차/d.삼조균치료15 d위1개료정,련속치료2개료정.관찰삼조환자치료전후중의증후평분、혈압、혈지、혈액류변학、혈당적변화.병수방일년,관찰복발솔급뇌졸중발생솔.결과 ①치료후침약조총담고순(5.21±0.97) mmol/L,전혈점도[(4.26±0.66) 200 mPa·s、(5.69±0.15) 30 mPa·s、(9.72±2.33)5 mPa·s],섬유단백원(2.12±0.46) g/L,수축압(124.13±9.96)mm Hg(1 mm Hg =0.133 kPa),서장압(79.23±7.50) mm Hg,혈당(5.59±0.78) mmol/L;중약조총담고순(5.43±1.04) mmol/L,전혈점도[(4.25±0.25) 200 mPa·s、(5.46±0.55) 30 mPa·s、(9.81±2.01)5 mPa·s],섬유단백원(2.32±0.33) g/L,수축압(129.78±14.25) mm Hg,서장압(79.54±7.65) mm Hg,혈당(5.60±0.75) mmol/L;서약조총담고순(5.52± 1.16) mmol/L,전혈점도[(4.12±0.54) 200mPa·s、(5.45±0.65) 30 mPa·s、(9.09±1.11)5 mPa·s],섬유단백원(2.41±0.44) g/L,수축압(129.83±14.91) mm Hg,서장압(80.72±7.47) mm Hg,혈당(5.75±0.61) mmol/L균교동조치료전명현개선(P균＜0.05),차침약조개선정황우우중약조、서약조(P균＜0.05).②수방1년,침약조무복발；중약조、서약조각복발6례,복발솔위15％,침약조TIA적복발솔저우중약조、서약조.결론 침약병용불부가개선TIA환자적림상증상,차대기혈압、혈지、혈액류변학、혈당등고위인소균유명현개선,병능유효강저기복발솔급뇌졸중적발생솔.
Objective To observe the effect of acupuncture and herbs on risk factors and prognosis of transient ischemic attack (TIA).Methods 120 patients received treatment from March to May 2011 in Gaomi People's Hospital and the Hospital of Gaomi were randomly divided into three groups,with 40 cases in each.Acupuncture and Chinese medicine group was treated with needling Neiguan and administered with modified Tianmagouteng decoction,3 times/d; Chinese medicine group was treated with modified Tianmagouteng diction exclusively,3 times/d; Western medicine group was treated with Aspirin,0.1 g,1 times/d.The three groups were treated for 30 d of two therapeutic courses.TCM syndrome score,blood pressure,blood lipids,blood rheology,blood sugar changes in the three groups of patients were observed before and after the treatment.And follow-up of elapse rate and the incidence of stroke in a year were observed.Results After treatment,① in the acupuncture and Chinese medicine group: the total cholesterol was (5.21 ± 0.97)mmol/L,whole blood viscosity was [(4.26±0.66) 200 mPa · s,(5.69±0.15) 30 mPa · s,(9.72±2.33) mPa · s],fibrinogen was (2.12± 0.46)g/L,systolic blood pressure was (124.13±9.96) mm Hg,diastolic blood pressure was (79.23±7.50) mm Hg,blood glucose was (5.59 ±0.78) mmol/L; in the Chinese medicine group,the total cholesterol was (5.43± 1.04) mmol/L,whole blood viscosity was [(4.25±0.25) 200 mPa · s,(5.46±0.55) 30 mPa · s,(9.81± 2.01) 5 mPa · s],fibrinogenwas (2.32±0.33) g/L,systolic blood pressure was (129.78±14.25) mm Hg,diastolic blood pressure was (79.54± 7.65) mm Hg,blood glucose was (5.60± 0.75) mmol/L; in the western medicine group,the total cholesterol was (5.52± 1.16) mmol/ L,full blood viscosity was [(4.12±0.54) 200 mPa · s,(5.45± 0.65) 30 mPa · s,(9.09 ± 1.11) mPa · s],fibrinogen was (2.41 ± 0.44) g/L,systolic blood pressure was (129.83 ± 14.91) mm Hg,diastolic blood pressure was (80.72±7.47) mm Hg,blood glucose was (5.75 ± 0.61) mmol/L.all these results were improved significantly than those before the treatment in the same group (P＜0.05),and the acupuncture and Chinese medicine group improved better than the other two groups (P＜0.05).② In 1-year follow-up,TIA recurrence rate of stroke in the acupuncture group were lower than the other two groups.Conclusion Acupuncture and Chinese medicine treatment were not only be able to improve the clinical symptoms of patients with TIA and blood pressure,blood lipids,blood theology,blood sugar and other risk factors for TIA patients significantly,but also can effectively reduced the relapse rate and the incidence of stroke.
