基于治未病理论探讨改良中药湿热敷预防脑梗死急性期偏瘫患者发生下肢深静脉血栓的临床研究  

Clinical study on the treatment of improved Chinese medicine wet hot application to prevent lower extremities deep vein thrombosis in patients in acute stage of cerebral infarction in based on the prevention of disease

作　　者：黄雯 葛芳[2] 冯敏萍 徐梦成 Huang Wen;Ge Fang;Feng Minping;Xu Mengcheng(Department of Emergency,Hangzhou Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University,Hangzhou 310007,China;Department of Nursing,Hangzhou Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University,Hangzhou 310007,China;Department of Brain Disease,Hangzhou Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University,Hangzhou 310007,China)

机构地区：[1]浙江中医药大学附属杭州市中医院急诊科,杭州310007 [2]浙江中医药大学附属杭州市中医院护理部,杭州310007 [3]浙江中医药大学附属杭州市中医院脑病科,杭州310007

出　　处：《中国实用护理杂志》2025年第11期801-807,共7页Chinese Journal of Practical Nursing

基　　金：浙江省中医药科技计划项目(2022ZB255)。

摘　　要：目的基于治未病理论探讨改良中药湿热敷预防脑梗死急性期偏瘫后下肢深静脉血栓形成(LEDVT)的临床效果,为改良中药湿热敷在预防脑梗死急性期偏瘫后LEDVT提供理论依据。方法采用随机对照试验,便利抽样法选取2022年1月至2024年1月浙江中医药大学附属杭州市中医院收治的脑梗死急性期偏瘫患者62例,根据随机数字表法分为对照组和观察组各31例。对照组实施常规康复护理,观察组在对照组的基础上采用改良中药湿热敷技术。分别在干预前和干预14d后观察2组患者D-二聚体、股静脉和肌间静脉血流速度的指标变化情况,以及干预14d后2组患者LEDVT发生情况。结果对照组年龄为(68.90±6.30)岁,男19例,女12例。观察组年龄为(70.52±8.69)岁,男18例,女13例。干预前,2组的D-二聚体水平、股静脉和肌间静脉的血流速度比较,差异均无统计学意义(均P>0.05);干预14d后,观察组D-二聚体水平为0.56(0.44,0.73)mg/L,低于对照组的0.68(0.54,0.84)mg/L,差异有统计学意义(Z=-2.12,P<0.05);观察组股静脉、肌间静脉的血流速度分别为(24.48±9.25)、(14.08±3.59)cm/s,优于对照组的(16.64±4.70)、(12.32±2.61)cm/s,差异均有统计学意义(t=-4.21、-2.21,均P<0.05);观察组LEDVT发生率为3.23%(1/31),低于对照组的25.81%(8/31),差异有统计学意义(χ^(2)=4.68,P<0.05)。结论基于治未病理论运用改良中药湿热敷能显著改善脑梗死急性期偏瘫患者D-二聚体水平,提高偏瘫侧下肢股静脉、肌间静脉血流速度,可有效预防LEDVT,值得临床推广应用。Objective To discuss the clinical effect of improved traditional Chinese medicine wet hot application to prevent the formation of lower extremities deep venous thrombosis(LEDVT)after acute stage hemiplegia of cerebral infarction based on the prevention of disease,so as to provid a theoretical basis for the formation of wet heat application of improved traditional Chinese medicine to prevent LEDVT of hemiplegia after acute stage of cerebral infarction.Methods A total of 62 patients with cerebral infarction acute hemiplegia were admitted to Hangzhou Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medicine University from January 2022 to January 2024,which were divided into control group(n=31)and observation group(n=31)according to the random number table method.The control group implemented routine rehabilitation nursing,and the observation group adopted the improved traditional Chinese medicine wet-heat application technology on the basis of the control group.Compared the change of blood flow velocity of D-dimer,femoral vein and inter muscle vein before and after 14 days of intervention,and the occurrence of LEDVT after 14 days of intervention.Results The age of the control group was(68.90±6.30)years,19 males and 12 females.The age of the observation group was(70.52±8.69)years,18 males and 13 females.Before intervention,the D-dimer index,femoral vein and intermuscular vein blood flow velocities of the 2 groups were compared,and the differences were not statistically significant(all P>0.05).After 14 days of intervention,the D-dimer index of the observation group was 0.56(0.44,0.73)mg/L,which was statistically lower than 0.68(0.54,0.84)mg/L of the control group(Z=-2.12,P<0.05).The blood flow velocities of femoral vein and intermuscular vein in the observation group were(24.48±9.25)and(14.08±3.59)cm/s,respectively,which were better than those of(16.64±4.70)and(12.32±2.61)cm/s in the control group,and the differences were statistically significant in all of these cases(t=-4.21,-2.21,both

关 键 词：脑梗死 偏瘫 治未病 中药湿热敷 下肢深静脉血栓 

分 类 号：R47[医药卫生—护理学] R743.3[医药卫生—临床医学]