CN110478401A - A kind of thickening Chinese medicine improving therapy of dysphagia following stroke - Google Patents

A kind of thickening Chinese medicine improving therapy of dysphagia following stroke Download PDF

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CN110478401A
CN110478401A CN201910907577.3A CN201910907577A CN110478401A CN 110478401 A CN110478401 A CN 110478401A CN 201910907577 A CN201910907577 A CN 201910907577A CN 110478401 A CN110478401 A CN 110478401A
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chinese medicine
thickening
minutes
cooked
slow fire
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CN110478401B (en
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程红
马希佳
李彦杰
程芳
许彦超
李吉磊
马纯政
任锟
吉鸿涛
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Henan Hospital Traditional Chinese Medicine Second Affiliated Hospital of Henan University of Traditional Chinese Medicine TCM
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Henan Hospital Traditional Chinese Medicine Second Affiliated Hospital of Henan University of Traditional Chinese Medicine TCM
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Abstract

The present invention relates to the thickening Chinese medicines for improving therapy of dysphagia following stroke, the prior art, which can effectively be solved, causes patient to choke cough, even accidentally swallow, the problem of accidentally inhaling, its solve technical solution be, the thickening Chinese medicine is made of the material medicine of following poidometer: Radix Astragali 25-35g, Radix Angelicae Sinensis 25-35g, peach kernel 12-18g, safflower 12-18g, Rhizoma Chuanxiong 8-12g, scorpio 8-12g, centipede 1-3 item and peppermint 25-35g, the present invention is conducive to the swallowing function training of patient, be effectively improved patient swallows symptom, the intake having additional nutrients, to preferably reach therapeutic effect, it is worth clinical application, it is the innovation improved on therapy of dysphagia following stroke drug.

Description

A kind of thickening Chinese medicine improving therapy of dysphagia following stroke
Technical field
The present invention relates to field of medicaments, especially a kind of thickening Chinese medicine for improving therapy of dysphagia following stroke.
Background technique
Apoplectic dysphagia is in the disease categories such as traditional Chinese medicine category " sore throat ", " tongue is strong ", " silent miliaria ", and sick position is in brain, mark In glossopharyngeal part, patient is in disorder of limb's activity, hemiplegia because kidney deficiency and liver, qi and blood thanks to cause hematogenous blockage less；Brain inanition, tongue Pharynx, which is lost, moistens and causes throat opening and closing mistake department, dispute skew.The purpose of rehabilitation of cerebral apoplexy merging aphetite disorder is to rebuild function of deglutition, ice Irritation therapy is the primary treatments of dysphagia after current treatment apoplexy, is the principle contracted on cooling using muscle, Soft palate and pharyngeal sensibility are improved, enhancing body swallows the incoming of presensation impulsion, rebuilds function of deglutition access；It can be with Swashed by ice-spur, improves the attention that patient swallows feed.The disadvantage is that the liquid that ice-cream stick generates after melting can be anti-due to swallowing Penetrate delay time difference it is out of control cause patient choke cough, even accidentally pharynx, accidentally inhale the phenomenon that, so as to cause complication such as pulmonary infections Occur.Therefore, inventing a kind of prevents patient from choking cough, even accidentally pharynx, the drug the problem of being current urgent need to resolve accidentally inhaled.
Summary of the invention
For above situation, for the defect for solving the prior art, the purpose of the present invention is just to provide a kind of improvement cerebral apoplexy The thickening Chinese medicine of aphetite disorder, can effectively solve the problems, such as the prior art cause patient choke cough, even accidentally pharynx, accidentally inhale.
The technical solution that the present invention solves is that the thickening Chinese medicine is made of the material medicine of following poidometer: Radix Astragali 25- 35g, Radix Angelicae Sinensis 25-35g, peach kernel 12-18g, safflower 12-18g, Rhizoma Chuanxiong 8-12g, scorpio 8-12g, centipede 1-3 item and peppermint 25- Above-mentioned raw materials drug is added clear water 2000ml to impregnate 30 minutes, is then cooked by slow fire 45 minutes, filtered juice adds water by 35g 1000ml will be pressed every 200ml liquid 6g on the rocks, honey 30ml after decoction merges twice, and be used xanthan with being cooked by slow fire 30 minutes Glue (thickener) 4g stirring thickening is fitted into ice lolly mould, a Chinese medicine ice lolly 19-21g, freezing 2 is small not flow thick paste When to get.
Honey is added in the Chinese medicine of activating microcirculation and removing stasis medicinal, promoting menstruation benefit key by the present invention, xanthan gum thickens to change the physics of Chinese medicine Character, make it have certain viscosity one can avoid accidentally inhaling, and two combine pharyngeal ice irritation therapy improving pharyngeal sensitivity While property, Chinese medicine is gradually locally fully absorbed, and the swallowing function training of patient is conducive to, and be effectively improved patient swallows disease Shape, the intake having additional nutrients are worth clinical application to preferably reach therapeutic effect, are to improve cerebral apoplexy to swallow barrier Hinder the innovation on drug.
Specific embodiment
Specific embodiments of the present invention will be described in further detail with reference to embodiments.
Embodiment 1
The present invention in the specific implementation, can be made of the material medicine of following poidometer: Radix Astragali 26g, Radix Angelicae Sinensis 34g, peach kernel Above-mentioned raw materials drug is added clear water 2000ml to impregnate 30 by 13g, safflower 17g, Rhizoma Chuanxiong 9g, scorpio 11g, centipede 1 and peppermint 34g Minute, it is then cooked by slow fire 45 minutes, filtered juice adds water 1000ml, with being cooked by slow fire 30 minutes, will press after merging decoction twice Every 200ml liquid 6g on the rocks, honey 30ml do not flow thick paste with xanthan gum (thickener) 4g stirring thickening, are packed into ice In stick mold, a Chinese medicine ice lolly 19g, freeze 2 hours to get.
Embodiment 2
The present invention in the specific implementation, can also be made of the material medicine of following poidometer: Radix Astragali 30g, Radix Angelicae Sinensis 30g, peach Above-mentioned raw materials drug is added clear water 2000ml to impregnate by benevolence 15g, safflower 15g, Rhizoma Chuanxiong 10g, scorpio 10g, centipede 2 and peppermint 30g It 30 minutes, is then cooked by slow fire 45 minutes, filtered juice adds water 1000ml, will be after decoction merges twice with being cooked by slow fire 30 minutes By every 200ml liquid 6g on the rocks, honey 30ml, thick paste is not flowed with xanthan gum (thickener) 4g stirring thickening, is packed into In ice lolly mould, a Chinese medicine ice lolly 20g, freeze 2 hours to get.
Embodiment 3
The present invention in the specific implementation, can also be made of the material medicine of following poidometer: Radix Astragali 34g, Radix Angelicae Sinensis 26g, peach Above-mentioned raw materials drug is added clear water 2000ml to impregnate by benevolence 17g, safflower 13g, Rhizoma Chuanxiong 11g, scorpio 9g, centipede 3 and peppermint 26g It 30 minutes, is then cooked by slow fire 45 minutes, filtered juice adds water 1000ml, will be after decoction merges twice with being cooked by slow fire 30 minutes By every 200ml liquid 6g on the rocks, honey 30ml, thick paste is not flowed with xanthan gum (thickener) 4g stirring thickening, is packed into In ice lolly mould, a Chinese medicine ice lolly 21g, freeze 2 hours to get.
The sweet temperature of Radix Astragali used in side can reduce platelet adhesion reaction power, reduce thrombosis, be the key medicine of tonifying middle-Jiao and Qi therefore be Monarch drug in a prescription；Radix Angelicae Sinensis, Gan Xinwen are longer than and enrich blood, and have apparent anti thrombotic action, can remarkably promote to Mouse oral Radix Angelicae Sinensis infusion The generation of hemoglobin and red blood cell is ministerial drug.Peach kernel, safflower promoting blood circulation, dredging channels, removing blood stasis and relieving pain, it is kind to control all cards of congestion blood block, peach Benevolence extracting solution can obviously increase cerebral blood flow (CBF), reduce vascular resistence, improve hemodynamic situation, and decoction has suppression to external thrombus Production is used, and is adjutant；Rhizoma Chuanxiong pungent-warm, which rises, to be dissipated, and energy " the uplink head " is kind to control stagnation of QI and blood pain, is " the gas medicine in blood "；Scorpio, Centipede property is apt to walk to alter, and the two is with not only calming down liver wind, but also searches wind and removing obstruction in channels, for the key medicine for the treatment of spasm twitch.All medicines share is played altogether The function of promoting blood circulation.Peppermint, lightly floating, it is floating to rise, awakening consciousness, Compendium of Materia Medica cloud: " throat, all diseases of ability to speak ".Borneol, acrid flavour gas Perfume (or spice), irritation is strong, consciousness regaining, the kind disease for controlling ability to speak, throat, knowledge, and the two has the function of priming up to disease is to make medicine, Honey is the medicine of invigorating the spleen and benefiting qi rich in nutritional ingredient, and honey is added in ice-cream stick can be increased mouthfeel, and can tonifying middle-Jiao and Qi, analgesic solution Poison and xanthan gum are used as excipient to have the function of thickening simultaneously.
Clinical trial discovery of the present invention oral cavity is apparently higher than general liquid to the control ability with viscous thickening liquid, Can slow down its by oral stage and swallow the phase transport process, when food slowly enters it is pharyngeal after, delay swallowing reflex starting, larynx Pharynx, nasopharynx, oral pharynx passageway are closed, and air flue protection is completed, and esophagus cricopharyngeus is open at this time, and thickening liquid can smoothly enter into esophagus, very Avoid the time difference of swallowing reflex delay, air flue guard delay well, while lowering and swallowing difficulty, hence it is evident that reduce accidentally inhale and The risk of pulmonary infection, and pass through clinical experiments have proved that achieving significant clinical effectiveness, related experiment data is as follows:
1. data and method
1.1 general information
With in May, 2016 to the apoplectic patients suffering from dysphagia of in May, 2019 institute of traditional Chinese medicine, Henan Province rehabilitation department hospitalization 64 are research object, cerebral infarction are diagnosed as through CT or MRI, and be First episode, through 3~5 grades of hollow field water drinking test, the course of disease Within 4 months.It is randomly divided into conventional function of deglutition rehabilitation group and Chinese medicine function of deglutition rehabilitation group, each 32.Wherein, often Function of deglutition rehabilitation group male 17 is advised, it is female 15, the age 48~80 years old, 63.24 ± 8.78 years old average；Chinese medicine function of deglutition rehabilitation Group male 15, it is female 17, the age 49~80 years old, 63.41 ± 8.92 years old average.Two groups of patient's general information compare, and difference is without system Meter learns meaning (P > 0.05).
1.2 are included in standard
" the Stroke Chinese Medicine diagnosis treatment that tcm diagnosis is worked out referring to State Administration of Traditional Chinese Medicine's encephalopathy acute disease scientific research cooperative groups Imitate evaluation criteria ", Syndrome Diagnostic is syndrome of blood stasis due to qi deficiency: hemiplegia, and dispute skew, speech is stuttering puckery or in silence, brothers' swelling, tongue Matter is dim, and white and greasy fur has indentation, small and wiry pulse.
Doctor trained in Western medicine diagnoses " the Chinese cerebrovascular disease guideline of prevention and treatment " write referring to neurology branch, Chinese Medical Association, meets brain Infarct or the diagnostic criteria of cerebral hemorrhage convalescence.
Aphetite disorder evaluation criteria: patient takes end sitting position, drinks warm water 30mL water, and required time and cough feelings of choking are swallowed in observation As a result condition divides five grades, the higher dysphagia that scores is more serious, chooses III grade~IV grade patient, hollow field water drinking test Scoring: V grade: it is difficult to swallow comparison for full dose in 10s, with cough of repeatedly choking, remembers 8 points；IV grade: 5~10s point swallows for 2 times or 2 times or more, With cough of choking, 6 points are remembered；III grade: 5~10s is disposably swallowed, but with cough of choking, remembers 4 points；II grade: 5~10s point 2 times or 2 times with epipharynx Under, without cough of choking, remember 2 points；15ml warm water is disposably smoothly swallowed in I grade: 5s, remembers 0 point.
1.3 exclusion criteria
Severe psychiatric diseases or cognitive disorder；Receptive aphasia；Unconsciousness；Previously there are oral cavity, pharynx and oesophagus structure different Often；Larynx neck has metallic in-laid object；Pacemaker implantation；Acute myocardial infarction AMI；Malignant tumour；Serious hepatic and kidney function obstacle； Severe infection person.
1.4 therapeutic scheme
1.4.1 conventional function of deglutition rehabilitation group (control group) gives conventional function of deglutition rehabilitation training: 1. with self-control length 10cm rubs the positions such as root of the tongue anterior palatal arch, soft palate and tonsillotome 10~20 times of patient repeatedly with cotton ice lolly, and then guidance is suffered from Person is unfolded swallowing act 20 times；2. instructing patient that tongue operation training is unfolded, that is, instruct patient by tongue repeatedly to the left side, it is right Side, front stretching, extension, repeatedly tightly against maxilla, upper and lower gum and left and right bicker etc., daily practice 30 times；3. carrying out feed Training instructs patient in feed, and trunk is adjusted to ground and, at 45 jiaos, while allowing patient by head toward anteflexion, is used Smaller superficial spoon carries out feeding, and during feeding, spoon should be pressed the surface of patient's tongue body by nursing staff, with Stimulate the starting of its swallowing reflex.
1.4.2 Chinese medicine function of deglutition rehabilitation group (treatment group) conventional function of deglutition rehabilitation training 1. 2. 3. when will be in ice lolly Clear water change into the present invention thickening Chinese medicine freezing it is laggard assassinate swash intervene.In use, patient is advised to take semireclining position, taken out from refrigerator One Chinese medicine ice lolly, the positions such as root of the tongue anterior palatal arch, soft palate and the tonsillotome of the patient that rubbed repeatedly with ice lolly 10~20 times, then Patient is instructed to be unfolded swallowing act 20 times, other treatment is the same as conventional function of deglutition rehabilitation group.
1.5 curative effect determinate standard
All selected cases are by fixed evaluation teacher (after being admitted to hospital the 1st day) and 30 days, 60 days carry out scales before the treatment Evaluation blind method, fixed estimator are taken in scoring, and estimator is unaware of specific grouping, to exclude disturbing factor when evaluation.
1.5.1 hollow field water drinking test criterion: 1. effective: dysphagia symptom disappears, and hollow field water drinking test is rated I Grade；2. effectively: dysphagia symptom disappears substantially, and hollow field water drinking test is rated II grade；3. invalid: aphetite disorder symptom does not disappear It loses and even aggravates, hollow field water drinking test is rated III grade or more.Overall efficiency=1.+2./(1.+2.+3. × 100%).
1.5.2 swallow curative effect determinate standard: 1. fully recover: aphetite disorder is increased to 7 grades or more, ingests to swallow and have no problem； 2. effective: aphetite disorder improves 3~5 grades, but not to 7 grades；3. effectively: aphetite disorder improves 1~2 grade, but not to 7 grades；4. nothing Effect: aphetite disorder is unchanged.
1.6 statistical method
Data are handled using 19.0 statistics software of SPSS, measurement data is indicated with " x ± s ", is examined using t； Enumeration data is indicated with percentage (%), using x2It examines, is that difference is statistically significant with P < 0.05.
2 results
1 two groups of patients of table treat total effective rate comparative example (%)
2 two groups of table before and after treatment compare by hollow field water drinking test scoring
Note: two groups are compared, and after treatment 30 days, 60 days, Chinese medicine function of deglutition rehabilitation group (treatment group) is significantly better than that pair According to group, P < 0.01.
Pretherapy and post-treatment one youth's swallow of the rattan island scoring of 3 two groups of patients of table is compared
Note: two groups are compared, and after treatment 30 days, 60 days, Chinese medicine function of deglutition rehabilitation group (treatment group) is significantly better than that pair According to group, P < 0.01.
3 conclusions
Honey is added in the Chinese medicine of activating microcirculation and removing stasis medicinal, promoting menstruation benefit key by the present invention, xanthan gum thickens to change the physics of Chinese medicine Character, make it have certain viscosity one can avoid accidentally inhaling, and two combine pharyngeal ice irritation therapy improving pharyngeal sensitivity While property, Chinese medicine is gradually locally fully absorbed, and the swallowing function training of patient is conducive to, and be effectively improved patient swallows disease Shape, the intake having additional nutrients are worth clinical application to preferably reach therapeutic effect.

Claims (4)

1. a kind of thickening Chinese medicine for improving therapy of dysphagia following stroke, which is characterized in that the thickening Chinese medicine is by following poidometer Material medicine is made: Radix Astragali 25-35g, Radix Angelicae Sinensis 25-35g, peach kernel 12-18g, safflower 12-18g, Rhizoma Chuanxiong 8-12g, scorpio 8-12g, Above-mentioned raw materials drug is added clear water 2000ml to impregnate 30 minutes, is then cooked by slow fire 45 points by centipede 1-3 item and peppermint 25-35g Clock, filtered juice add water 1000ml, with being cooked by slow fire 30 minutes, will after decoction merges twice by every 200ml liquid 6g on the rocks, Honey 30ml does not flow thick paste with xanthan gum 4g stirring thickening, is fitted into ice lolly mould, a Chinese medicine ice lolly 19-21g, Freezing 2 hours to get.
2. the thickening Chinese medicine according to claim 1 for improving therapy of dysphagia following stroke, which is characterized in that by following poidometer Material medicine be made: Radix Astragali 26g, Radix Angelicae Sinensis 34g, peach kernel 13g, safflower 17g, Rhizoma Chuanxiong 9g, scorpio 11g, centipede 1 and peppermint Above-mentioned raw materials drug is added clear water 2000ml to impregnate 30 minutes, is then cooked by slow fire 45 minutes, filtered juice adds water by 34g 1000ml will be pressed every 200ml liquid 6g on the rocks, honey 30ml after decoction merges twice, and be used xanthan with being cooked by slow fire 30 minutes Glue 4g stirring thickening is fitted into ice lolly mould, a Chinese medicine ice lolly 19g not flow thick paste, freezing 2 hours to get.
3. the thickening Chinese medicine according to claim 1 for improving therapy of dysphagia following stroke, which is characterized in that by following poidometer Material medicine be made: Radix Astragali 30g, Radix Angelicae Sinensis 30g, peach kernel 15g, safflower 15g, Rhizoma Chuanxiong 10g, scorpio 10g, centipede 2 and peppermint Above-mentioned raw materials drug is added clear water 2000ml to impregnate 30 minutes, is then cooked by slow fire 45 minutes, filtered juice adds water by 30g 1000ml will press every 200ml liquid 6 g on the rocks, honey 30ml after decoction merges twice, with Huang with being cooked by slow fire 30 minutes Virgin rubber 4g stirring thickening is fitted into ice lolly mould, a Chinese medicine ice lolly 20g not flow thick paste, freezing 2 hours to get.
4. the thickening Chinese medicine according to claim 1 for improving therapy of dysphagia following stroke, which is characterized in that by following poidometer Material medicine be made: Radix Astragali 34g, Radix Angelicae Sinensis 26g, peach kernel 17g, safflower 13g, Rhizoma Chuanxiong 11g, scorpio 9g, centipede 3 and peppermint Above-mentioned raw materials drug is added clear water 2000ml to impregnate 30 minutes, is then cooked by slow fire 45 minutes, filtered juice adds water by 26g 1000ml will be pressed every 200ml liquid 6g on the rocks, honey 30ml after decoction merges twice, and be used xanthan with being cooked by slow fire 30 minutes Glue 4g stirring thickening is fitted into ice lolly mould, a Chinese medicine ice lolly 21g not flow thick paste, freezing 2 hours to get.
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