中西医结合治疗脑卒中后顽固性呃逆临床观察

Clinical observation of integrated traditional Chinese and Western medicine on post-stroke intractable hiccup

目的 探讨中西医结合治疗脑卒中后顽固性呃逆的临床疗效。方法 100例脑卒中后顽固性呃逆患者,应用随机数字表法分为研究组与对照组,各50例。对照组患者采用甲氧氯普胺治疗,研究组患者采用甲氧氯普胺联合中药方剂丁香柿蒂汤治疗。对比两组疗效,不良反应发生率,治疗前后的舒适度评分、心理评分、睡眠状况指标、生活质量评分。结果 研究组治疗总有效率为96.00%,对照组为82.00%,研究组治疗总有效率更高(P<0.05)。研究组中发生2例恶心、1例腹痛,不良反应发生率为6.00%;对照组中发生1例皮疹,不良反应发生率为2.00%。两组不良反应发生率对比,差异无统计学意义(P>0.05)。治疗后,两组舒适度评分、焦虑评分、抑郁评分均较治疗前改善,且研究组舒适度评分(102.80±6.57)分高于对照组的(93.25±6.30)分,焦虑评分(40.90±3.74)分、抑郁评分(41.85±3.81)分低于对照组的(45.61±3.96)、(46.98±4.37)分(P<0.05)。治疗后,两组入睡潜伏期、实际睡眠时长、睡眠质量评分均较治疗前改善,且研究组入睡潜伏期(33.79±7.94)min短于对照组的(42.63±8.75)min,实际睡眠时长(8.04±1.13)h长于对照组的(6.89±1.02)h,睡眠质量评分(10.80±1.31)分低于对照组的(12.56±1.58)分(P<0.05)。治疗后,两组生理、心理、环境、社会关系评分均较治疗前改善,且研究组生理、心理、环境、社会关系评分分别为(89.75±6.48)、(89.07±6.02)、(90.14±6.15)、(89.96±6.27)分,高于对照组的(82.93±6.85)、(82.40±6.13)、(83.27±6.30)、(83.14±6.54)分(P<0.05)。结论 对于脑卒中后顽固性呃逆患者,采用甲氧氯普胺联合中药汤方丁香柿蒂汤的中西医结合疗法可增强治疗效果,提高患者舒适度,有利于改善患者心理、睡眠等状况,提升其生活质量,且不会在用药后增加药物不良反应,安全性良好。

Objective To explore the clinical efficacy of integrated traditional Chinese and Western medicine on post-stroke intractable hiccup.Methods 100 patients with post-stroke intractable hiccup were divided into a study group and a control group by digital random table method,with 50 patients in each group.The patients in the control group were treated with metoclopramide,and the patients in the study group were treated with metoclopramide and traditional Chinese medicine prescription Dingxiang Shidi Decoction.The efficacy,incidence of adverse reactions,comfort score,psychological score,sleep status index and quality of life score before and after treatment were compared between the two groups.Results The total effective rate of the study group was 96.00%,while that of the control group was 82.00%.The total effective rate was higher in the study group(P<0.05).The study group had 2 cases of nausea and 1 case of abdominal pain,with an incidence of adverse reactions of 6.00%;the control group had 1 case of rash,with an incidence of adverse reactions of 2.00%.There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).After treatment,the comfort score,anxiety score and depression score in both groups were improved compared with those before treatment;the comfort score of(102.80±6.57)points in the study group was higher than(93.25±6.30)points in the control group;the study group had anxiety score of(40.90±3.74)points and depression score of(41.85±3.81)points,which were lower than(45.61±3.96)and(46.98±4.37)points in the control group(P<0.05).After treatment,the sleep latency,actual sleep duration and sleep quality score in both groups were improved compared with those before treatment;the study group had shorter sleep latency of(33.79±7.94)min than(42.63±8.75)min in the control group,longer actual sleep duration of(8.04±1.13)h than(6.89±1.02)h in the control group,and lower sleep quality score of(10.80±1.31)points than(12.56±1.58)points in the control group(P<0.05).After treatment,the scores of physiology,psychology,environment and social relations in both groups were improved compared with those before treatment;the scores of physiology,psychology,environment and social relations in the study group were(89.75±6.48),(89.07±6.02),(90.14±6.15)and(89.96±6.27)points,which were higher than(82.93±6.85),(82.40±6.13),(83.27±6.30)and(83.14±6.54)points in the control group(P<0.05).Conclusion For patients with post-stroke intractable hiccup,metoclopramide combined with the traditional Chinese medicine prescription Dingxiang Shidi Decoction can enhance the treatment effect,improve the comfort of patients,which is conductive to improve the psychological and sleep conditions of patients,enhance their quality of life,and will not increase adverse drug reactions after medication,with a high safety profile.