本文關鍵詞：補陽還五湯對急性脊髓損傷患者血清MBP含量影響的臨床研究　出處：《福建中醫(yī)藥大學》2017年碩士論文　論文類型：學位論文

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【摘要】：目的:應用補陽還五湯于急性脊髓損傷患者術后,通過探究補陽還五湯對急性脊髓損傷患者術后血清中MBP含量影響,并結合對比患者ASIA感覺、運動評分及等級同步變化,進一步探討補陽還五湯在血清中MBP含量與神經(jīng)功能改善狀況的關系,為急性脊髓損傷患者術后功能恢復尋找新的治療方案與臨床參考指標。方法:將2015年3月至2016年5月期間河南省洛陽正骨醫(yī)院醫(yī)院脊柱外科收治的60例急性脊髓損傷患者以入院時間為序隨機分為試驗組和對照組,所有納入研究對象入院后均在創(chuàng)傷72h內于急診或亞急診下行切開復位減壓內固定手術。術后所有受試者均給予脫水、激素、抗炎和神經(jīng)營養(yǎng)類藥物常規(guī)治療。試驗組在上述常規(guī)治療基礎上自術后第一天起開始服用補陽還五湯,每日一劑,持續(xù)服用12周。所有受試者在院期間均進行常規(guī)康復訓練,術后4*5周出院后繼續(xù)堅持相關康復治療。采用ASIA評分量表分別于術前、術后4周、術后12周對所有受試者的感覺運動功能及生活自理能力進行評估,同期運用酶聯(lián)免疫吸附法對受試者血清中MBP含量進行測定。數(shù)據(jù)分析采用SPSS20.0統(tǒng)計數(shù)據(jù)軟件進行,全部測定數(shù)據(jù)以均數(shù)±標準差(X±S)格式記錄;兩組的性別、年齡、損傷節(jié)段、病程、損傷程度均進行差異性分析,采用t檢驗和方差分析計量資料,采用秩和檢驗對不符合正態(tài)分布的計量資料分析;采用X2檢驗分析計數(shù)資料。P0.05示差異有統(tǒng)計學意義。結果:組內比較:術后12與術前、術后4周ASIA感覺評分比較:實驗組有統(tǒng)計學意義(P0.05),對照組無統(tǒng)計學意義(P0.05);術后12與術前、術后4周ASIA運動評分及血清中MBP含量比較:兩組均有統(tǒng)計學意義(P0.05)。術后4周與術前ASIA感覺評分比較:兩組均無統(tǒng)計學意義(P0.05);術后4周與術前ASIA運動評分及血清中MBP含量比較:兩組均有統(tǒng)計學意義(P0.05)。組間比較:術前的ASIA感覺運動評分及血清中MBP含量比較:兩組差異無統(tǒng)計學意義(P0.05),具有可比性。術后4周及術后12周患者ASIA感覺評分比較:兩組差異無統(tǒng)計學意義(P0.05),ASIA運動評分比較差異有統(tǒng)計學意義(P0.05);血清中MBP含量比較:術后4周兩組差異有統(tǒng)計學意義(P0.05),術后12周兩組差異性比較無統(tǒng)計學意義(P0.05)。兩組治療前與術后12周ASIA分級比較:兩組差異有統(tǒng)計學意義(P0.05)。結論:1.補陽還五湯對急性脊髓損傷術后患者的感覺運動功能評分以及ASIA等級有改善作用。2.補陽還五湯的應用可以在早期明顯降低患者血清中的MBP含量。3.早期血清中MBP含量的變化程度與急性脊髓損傷患者術后功能恢復程度有相關性。
[Abstract]:Objective: to investigate the effect of Buyang Huanwu decoction (BHD) on serum MBP content in patients with acute spinal cord injury (sci) after operation, and to compare patients' ASIA sensation. To explore the relationship between the content of MBP in serum and the improvement of nerve function in the serum of Buyang Huanwu decoction. To find a new treatment plan and clinical reference index for postoperative functional recovery of patients with acute spinal cord injury (Asci). Methods:. From March 2015 to May 2016, 60 patients with acute spinal cord injury admitted in Department of Spine surgery, Luoyang Zhenggu Hospital, Henan Province, were randomly divided into experimental group and control group. All subjects were treated with open reduction and decompression and internal fixation within 72 hours of trauma. All subjects were given dehydration and hormone after operation. Routine treatment of anti-inflammatory and neurotrophic drugs. On the basis of the above routine treatment, the experimental group began to take Buyang Huanwu decoction once a day from the first day after operation. All subjects received routine rehabilitation training during the hospital and continued to adhere to the related rehabilitation treatment after 4 weeks of discharge. The ASIA scale was used before operation and 4 weeks after the operation. Sensory motor function and self-care ability of all subjects were evaluated 12 weeks after operation. At the same time, the content of MBP in serum was determined by enzyme-linked immunosorbent assay (Elisa). The data were analyzed by SPSS20.0 statistical data software. All the measured data were recorded in the format of mean 鹵standard deviation X 鹵S; Sex, age, injury segment, course of disease and degree of injury were all analyzed. T test and variance analysis were used to measure the data, and rank sum test was used to analyze the non-normal distribution data. X2 test was used to analyze the counting data. P0.05 showed statistical significance. Results: intragroup comparison: postoperative 12 and preoperative. Comparison of ASIA sensory scores at 4 weeks after operation: the experimental group had statistical significance (P 0.05), while the control group had no statistical significance (P 0.05). Postoperative 12 and preoperative. Comparison of ASIA motor score and serum MBP content at 4 weeks after operation: there was significant difference between the two groups (P 0.05), and ASIA sensory score at 4 weeks after operation was not statistically significant in both groups (P < 0.05). P0.05; 4 weeks after operation compared with preoperative ASIA motor score and serum MBP content: there was significant difference between the two groups (P 0.05). Group comparison: preoperative ASIA sensory motor score and serum MBP content comparison: there was no significant difference between the two groups (P 0.05). Comparison of ASIA sensory scores at 4 weeks and 12 weeks after operation: there was no significant difference between the two groups (P 0.05). The difference of ASIA motor score was statistically significant (P 0.05). Comparison of serum MBP levels: there was a significant difference between the two groups at 4 weeks after operation (P 0.05). There was no significant difference between the two groups at 12 weeks after operation (P 0.05). Comparison of ASIA grading before treatment and 12 weeks after operation: the difference between the two groups was statistically significant (P 0.05). ... conclusion:. 1. Buyang Huanwu decoction can improve the sensory and motor function score and ASIA grade of patients after acute spinal cord injury .2.The application of Buyang Huanwu decoction can obviously reduce the MBP content in patients' serum at the early stage. The level of serum MBP was correlated with the degree of postoperative functional recovery in patients with acute spinal cord injury (Asci).
【學位授予單位】：福建中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R651.2

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