分类号：学校代码： 10438密 级： 学 号：硕士学位论文题目加味补阳还五汤联合依达拉奉治疗急性脑堵塞的临床院、系所XX学 院专业XX学学位类型XXXX学 位研究生 导师 教授 教授论文起止日期: XXXX年XX月-XXXX年XX月目 录摘 要I1 前言12 资料与方法32.1 病例来源32.2 治疗方法32.3 观察指标32.4 疗效评定标准32.4.1 西医疗效评定32.4.2 中医证候疗效评定42.5 统计学处理43 结果53.1 一般资料53.2 中医证候及疗效比拟53.3 两组治疗前后血栓前体蛋白(TpP)及凝血四项的变化64 讨论74.1 急性脑堵塞的中医证候74.2 中医分型辨治急性脑堵塞74.3 加味补阳还五汤联合依达拉奉治疗效果95 结论11参考文献12综 述15加味补阳还五汤联合依达拉奉治疗急性脑堵塞的临床研 究 生：专 业：导 师：中文摘要目的： 观察加味补阳还五汤联合依达拉奉治疗急性脑堵塞的临床疗效及血栓前提蛋白前后的变化，为中西医治疗急性脑堵塞提供临床方面的依据。方法：选取2021年8月到2021年12月医院收治的64例符合急性脑堵塞纳入标准的患者随机分为两组。每组各32例，其中治疗组32例男20例，女12 例，年龄47-78岁，平均( 60.8212.05) 岁；对照组32例男21例，女11例，年龄48-80岁，平均(61.2611.87) 岁。两组均以拜阿司匹林片100mg，辛伐他丁胶囊20mg，每天各1次，1次1片，口服，疏通循环，营养神经，针灸和肢体功能康复锻炼等。对照组在常规治疗根底上采用依达拉奉注射液(昆明积大制药，批号111201) 30 mg0. 9%氯化钠注射液 100mL 静脉滴注，2 次/d，30 min 滴完。治疗组在对照组治疗的根底上，以补阳还五汤加全蝎、蜈蚣、桑寄生等为根底方组成加味补阳还五汤，水煎服后复煎，每天两次，每次200ml，口服。观察两组患者入组时及治疗7天后每组血栓前体蛋白(TpP)及凝血四项的变化，两组患者治疗前及每周的中医症候及疗效、肢体神经功能缺损变化等情况，以系统评价加味补阳还五汤治疗急性脑堵塞的临床疗效。所有资料输入SPSS18.0软件包进行统计分析，结果用均数标准差表示，组间均数比拟用t检验，P0.05)。治疗组总有效率治疗组为93.75%30/32，对照组为81.25%26/32，两组比拟，差异有显著性意义(P0. 05)，治疗组优于对照组。7d后患者血浆中血栓前体蛋白(TpP)指标明显低于治疗前，凝血四项中Fib指标治疗7d后明显低于治疗前，故治疗组治疗前后血浆TpP，Fib水平具有统计学意义(P0. 05)。治疗前、7d后两组神经功能缺损程度评分均有显著降低，与治疗前比拟，差异均有显著性意义(P0.05)，治疗后比拟，治疗组评分降低优于对照组，差异有显著性意义(P0. 05)。结论：加味补阳还五汤联合依达拉奉治疗急性脑堵塞临床疗效显著，血浆中血栓前体蛋白(TpP)可用于治疗效果的评价，疗效确切，值得临床推广应用。关键词：急性脑堵塞；加味补阳还五汤；血栓前体蛋白；依达拉奉THE EXPRESSION OF HIF-1，VEGF AND UPA INGLIOMASANDTHE RELATION WITH ANGIOGENESISPostgraduateSpecialitySupervisor Professor Professor ABSTRACTClinical observation of Bu Yang Huan Five Decoction Combined with edaravone in treatment of acute cerebral infarctionAbstractObjective:Change before and after the observation of Bu Yang Huan Five Decoction Combined with edaravone in treatment of acute cerebral infarction clinical curative effect and the thrombus precursor protein, and provide clinical evidence for traditional Chinese medicine and Western medicine in treatment of acutecerebral infarction.Method：Selection in August 2021 to December 2021, the hospital treated 64 cases with acute cerebral infarction in conform to the standards of the patients were randomly divided into two groups. 32 cases in each group, the treatment group and 32 cases (20 male and female 12 cases, age 47-78, the average age (60.82 + 12.05); The control group, 32 cases (21 male female 11 cases, aged 48 to 80 years old, average (61.26-11.87). Both groups are to worship the aspirin 100 mg, 20 mg simvastatin butyl capsule, each 1 times a day, 1 time 1 piece, oral, dredge cycle, nutrient nerve, acupuncture and limb function rehabilitation exercise, etc. The control group on the basis of routine therapy used in accordance with the adr injection (kunming big pharmaceutical co., LTD., batch number 111201) 30 mg + 0. 9% sodium chloride injection 100 ml intravenous drip, 2 times/d, 30 min drip off. Treatment group in the control group on the basis of the treatment, to make up for Yang also five tonga scorpion, centipede, basis. The mulberry parasitism on flavored Yang also five soup, then Fried water decoction, twice a day, each 200 ml, oral. Observing two groups of patients into groups and treatment of 7 days after each group of thrombus precursor protein (TpP) and the change of the blood coagulation four, two groups of patients before treatment and weekly symptoms and curative effect of traditional Chinese medicine, limb nerve function defect changes, etc., to fill system evaluation flavored Yang also five soup clinical curative effect for the treatment of acute cerebral infarction. All data input SPSS18.0 software package for statistical analysis, the result expressed with mean + standard deviation, mean differences between groups compared with t test, P 0.05). The treatment group total effective rate of treatment group was 93.75% (30/32), the control group was 81.25% (26/32), the two groups, there was significant difference (P0. 05), the treatment group than the control group. 7d in the plasma of patients with thrombus precursor protein (TpP) index was obviously lower than that before treatment, coagulation index of Fib four in 7d after treatment was obviously lower than that before treatment, the treatment groupbefore and after treatment of plasma TpP, Fib with statistical significance level(P0. 05).Before treatment, 7d two group defect degree of neurological function scoredecre