Keywords: cerebral infarction
Cerebral infarction, also known as ischemic cerebrovascular disease, cerebrovascular thrombosis, embolism or other causes insufficient blood supply to the brain caused by the disease. Cerebral infarction include common cerebral arteriosclerosis, thrombosis, infarction and cerebral embolism (cerebral thrombosis). In addition to the transient ischemic attack, also known as a transient ischemic attack, also belongs to the ischemic cerebrovascular disease areas, but at the end to the point of cerebral infarction.
TCM type of disease is called a stroke, but a stroke, including cerebral hemorrhage. TCM believes that the wind of good deeds and the number of change “. Of the disease such as Hu Shi Shi Storm moving rapidly “, hence the name" stroke “. The disease may be due to the conditions fail to materialize tone, heart and liver the qi, based fire phlegm; Solid liver and kidney; the liver yang; ferrite obesity, multi wet phlegm, food and wine is not festival, eat more fatty spicy due sputum heat, so the stroke as wind, phlegm, fire can be caused by silt, or mainly standard real or standard real this virtual.
Cause of disease
The cerebral infarction main thrombosis and embolism two categories.
(A) the cause of non-embolic cerebral infarction:
Atherosclerosis in the arterial wall, arterial atherosclerotic plaques based on the formation of blood clots.
2. Arteritis cerebral artery inflammatory changes in the vessel wall can be changed, stenosis and thrombosis.
Hypertension can cause hyaline degeneration of the arterial wall, arterial intimal rupture, platelet easy adhesion and aggregation and thrombosis.
Blood disease polycythemia psychosis prone to blood clots.
The 5. Mechanical pressure and cerebrovascular outside near the tumor and other factors of oppression, occlusion of blood vessels may appear to change.
(B) embolic cerebral infarction is often the cause of the intracranial blood flow into a solid, liquid, or gas emboli a a brain blood vessel blockage. A lot of its etiology, cardiogenic and non-cardiogenic two categories:
1. Of cardiogenic acute or subacute endocarditis generally occurs on the basis of heart disease. Intimal lesions due to inflammation form vegetations, Lu Fasheng after falling with Xuexun into cerebral embolism. Such as rheumatic heart disease, myocardial infarction, congenital heart disease, cardiac tumors, heart surgery and so could easily lead to emboli. Especially heart disease, atrial fibrillation easier to emboli can cause cerebral embolism.
Non-cardiac gas embolism, fat embolism in long bone fractures, pulmonary vein thrombosis, cerebral vein thrombosis Shi Feixin a cerebral embolism reasons. Some can not find out the source of emboli called cerebral infarction of unknown origin.
Cerebral infarction is a common disease common in the elderly, paralyzed limb functional recovery more difficult. Therefore, the prevention of cerebral infarction disease must be given. Cerebral infarction and cerebral hemorrhage pathogenicity factors, they have a common place in the formation of cerebral arteriosclerosis, its has a different predisposing factors. Reference to a cerebral hemorrhage chapter prevention measures in the prevention of pathogenic factors, the prodrome and incentives now only cerebral embolism prevention measures are described below.
A treatment of a variety of heart disease
Cerebral embolism, mainly due to the vegetation on the mitral When the heart beats too fast, bolt easy to fall off, especially in the force of the body, heart contraction force, blood flow faster the emboli in fast blood flow easier to fall off under the impact of shedding embolism vascular incidence of rheumatic heart disease or patients with bacterial endocarditis, in addition to active treatment, not suitable for acute heavy exercise or labor. Is cerebral embolism precautions.
Two smoking cessation
A nicotine substance tobacco on human poison, nicotine inhalation of the human body, stimulate the autonomic, vasospasm, rapid heartbeat, high blood pressure, increased cholesterol in the blood, thus accelerating atherosclerosis.
Three cerebral infarction disease to prevent the onset of pre
Variety of cerebral infarction disease risk factors, such as not serious preventive treatment and allowed to grow unchecked, these factors will be from quantitative to qualitative change, until the outbreak of cerebrovascular disease, prevention of cerebral infarction disease to be caught early, wary of cerebral infarction disease before various signals. Can be divided into five areas.
(A) awareness and change in mental status such as drowsiness, that all day groggy sleep. Anti-normal character, a man of few words, apathy and irritability, some transient loss of consciousness or intelligence decline. Performance and cerebral ischemia.
(B) dyskinesia performance suddenly mouth askew, difficulty speaking, unclear articulation, aphasia or language do not convey. Dysphagia, failure of partial body weakness or activities, hold things lost, ataxia, suddenly fell, some limbs twitching.
(C) sensory dysfunction manifested as the tongue, face, lip and numbness of the limbs. Ear hearing loss, depending on the material sense of rotation.
(D) headache, dizziness, headache with the past in the form of headache was severe long duration.
(E) the autonomic and other obstacles malaise, sweating, fever, chest tightness, palpitations, suddenly hit uh, vomiting and other autonomic symptoms. The small number of patients face with film, retinal hemorrhage and epistaxis. If the above symptoms should seek immediate medical attention, be detailed examination to make a diagnosis, timely treatment to avoid or delay the onset of cerebral infarction.
Treatment and rehabilitation, methods
The treatment of an acute phase
(A) The general treatment should rest in bed, flat head, if necessary, give oxygen. In addition to the extra high blood pressure is generally not buck. Turning frequently, pay attention to airway patency, prevention of respiratory tract and urinary tract infections, and prevention of bedsores.
(B) low molecular weight dextran 500 ml daily intravenous infusion, once every two weeks.
(C) vasodilators intermittently inhaled gas mixture (6-7% carbon dioxide, 50 – 95% oxygen), 5% sodium bicarbonate 250 ml stationary, 1-2 times daily, 100 mg papaverine 250 ml of glucose was slow static point once a day for a total of two weeks. Later the vasodilator used only for 1-2 days early onset disease after three weeks, otherwise the intracerebral steal syndrome can occur, but will increase the damage of brain tissue hypoxia.
(D) anticoagulant therapy treatment method are as follows: 12,500 units of heparin was added 5% glucose, 1000 ml of normal saline or 10% glucose solution was slowly intravenously 24-48 hours (a rate of 20 drops per minute to maintain first days simultaneous oral anticoagulant drugs, such as new dicoumarol 300 mg, 100-200 mg dicoumarol new anticoagulant 4-8 mg).
(E) Traditional Chinese medicine, such as Salvia, Chuanxiong, kudzu root, angelica, safflower. Discretion to choose.
(Vi) the surgical treatment of carotid artery occlusion for thrombus removal surgery. For transient ischemic attack and intracranial arterial system obstruction disease side anastomosis of the superficial temporal artery and middle cerebral artery.
(Vii) The new needle, scalp acupuncture, laser or ultrasonic treatment can be selected.
Two cerebral infarction recovering treatment
Cerebral infarction recovery period should be appropriate to take the peripheral circulation improving agent, reducing platelet aggregation, lowering blood lipids, nutrition nerve, promote nerve cell metabolism, focusing on the treatment of blood pressure and other to pay attention to the primary disease, coronary heart disease, rheumatic heart disease, diabetes, treatment.
(A) traditional Chinese medicine treatment of Chinese medicine in the treatment of cerebral infarction, the basic principle is that the blood stasis.
(1) Gung triazine injection 40-80 mg once added to 500 ml of 5% glucose solution intravenously, once a day, a course of 7-10 times. No significant side effects can be synthetic. Clinical applications: tetramethylpyrazine hydrochloride dihydrate.
Can be used for point injection of convalescent or sequelae, every point injection 10-20 mg daily or every other day.
(2) Salvia Injection usage: Salvia Injection 2 ml plus 40 ml of 5% glucose for intravenous injection, twice a day, 5 Tianyi treatment.
(3) compound Danshen injection usage :2-4 ml intramuscular injection, once a day, or 4-16 ml added to 250 ml of 5% glucose or low molecular weight dextran ester anhydride, intravenous infusion once a day a course of 1-2 weeks.
(4) In the summer, also known as the sessile CORYDALIS Huoxuezhitong. Formulation: INJECTABLE each 2 ml, 0.6 g tablets each. Usage: first intramuscular injection, each time 2-4 ml, once a day, effective change oral. 4-6 tablets each time, 2-3 times a day.
(1) BYHWD to: Huang Qin 16-30 grams, Angelica 9 grams, 9 grams of Radix, Chuanxiong 9 grams, peach kernel 9 grams, 9 grams of saffron, 9 grams of earthworm. Efficacy: qi and blood, the flow of qi. Usage: 1 day, 2 times a decoction.
(2) four rattan soup pink soup components: network Ishido Millettia sea breeze rattan, SFAS 15 grams. Peach kernel, safflower, red peony root, Salvia, Chuanxiong 9 grams each. Efficacy: dispelling, Tongluo, blood circulation, circulation, Usage: 1 day, 2 times decoction.
(3) Tongmai pill formulations: Salvia 30 grams, Guizhi 9 grams, Millettia 30 grams, 9 grams of earthworm, safflower 15 g, Purple Ref 30 g, 9 g Shikonin, Angelica 30 grams, Chuan Shao grams of research to fine, refining dense for the pills, each pill weighs 9 grams. Efficacy: blood circulation, warming yang meridians. Usage: 1 pill each, twice daily.
(B) spa therapy
China’s mineral springs rich in resources. Cerebrovascular accident with Simple Spa, salt spring, sodium bicarbonate spring, sulfate springs, radon springs for spring bath therapy, spring water temperature controlled at 38-40 degrees, one bath for 10-20 minutes, once a day. Yunnan cadre sanatorium spa access to the world-famous “Welcome to the first soup, regardless of water quality, water temperature were significant stroke sequelae, the exact effect.
(3) topical therapy
Stroke coma ramie stump, garlic, the amount used, with smashed Fuyu neck, and can gradually woke up about 20 minutes later, the party only adapted to the stroke autism.
Hemiplegia pangolin, large Aconitum red Hai Ha 60 grams each, with the research to fine, 15 grams each, bipedal heart drug cake paste with onion juice and half an inch size, fixed with gauze, then feet soaked in hot water until the body hemp sweating, immediately remove the drug cake, sheltered treatment. The semimonthly deposited.
(D) The hot iron therapy
. The stroke Kouyanwaixie green papaya with barley flour reconcile into cake, coax hot ironing epigastric cake cooling replacement. Once a day, every 20-30 minutes, which was the problem at source
Stroke hemiplegia late silkworm sand 1000 g fraction into a bag and steam for 20 minutes and serve hot ironing governance affected limb, once a day, one hour at a time.
(E) cerebrovascular accident, physical therapy physical therapy
Allows the brain tissue of patients with vascular expansion, accelerate blood flow, relieve spasm, collateral circulation, improve the status and metabolism of brain tissue hypoxia, accelerated brain cells during regeneration and functional recovery, and to promote the recovery of paralyzed limbs function. The reciprocal inhibition caused by the low-frequency current to stimulate the spastic muscle tendon in synapse shuttle opposing muscle caused by reflex inhibition and stimulation of the skin to achieve the purpose of the spastic muscle relaxation, and recovery of limb function. Commonly used in physical therapy are as follows:
Ultrasonic therapy 1:2 pulsed ultrasound dose by 0.6-1.25 watts / cm: suffering from district head shaved, painted contact with agents of the sound head up and down or left and right-infested areas slow-moving, once a day, every 10 minutes, 20 times a course.
Spasm electrical stimulation therapy 1 Road 2 × 50 square centimeter of electrode put in the limb the forearm tendon at (flexor side), 1-way and 2 × 50 square centimeter of electrode is placed on the forearm skin of the limbs (extensor side) pulse width 0.3 milliseconds, the delay time of 100 milliseconds, current intensity: movement threshold or movement domain, the time of 10 minutes, once a day or every other day, 20 times as a course of treatment.
3 2 × 5 square centimeters of the pulsed intermediate frequency electric therapy electrodes placed on the outside of the limb forearm and set mQ and: 1000 WT: full-wave one-off tune, f1: 50 Hz, t1: 2 seconds; t2: 2 seconds t: 10 minutes, I: wrist dorsal flexor stretch is appropriate. Once a day, 20 times as a course.
4 2 × 2 square centimeter of the low-frequency pulse electric therapy electrode placed on the outside of the limb forearm and set f1: f2: 4 Wt: undulating waves or intermittent wave, t: 4 minutes, I: wrist back flexion, stretching is appropriate. Once a day, 20 times as a course.
5 iontophoresis the eyes – pillow law, double the round pole plus 10% potassium iodide solution, cathode import, import 1-2% potassium iodide solution before the eye, I :1-2 mA, once a day, every 20 -30 minutes, 20 times as a course.
6. Hydrotherapy water temperature is 37-38 degrees, once a day, every 10-20 minutes, 20 times as a course.
7. Magnetic therapy is generally based on the principles of acupuncture treatment acupoints, applicator points to paralyzed limbs floppy diskette the diameter of about 1 cm, the field strength of the diskette general 500-1500 Gaussian. Paralyzed upper limb at the shoulder, Qu pool, foreign relations and Hegu points applicator diskette, lower limb paralysis, can jump in the ring, Wind City, Yanglingquan, Zusanli reconciliation Creek, point application diskette, treatment may be extended, on a regular basis to exchange deposited magnetic acupuncture points; avoid too long tape irritate the skin.