Stroke is a syndrome of deficiency in essence and excess in essence, that is, yin and yang prevail in essence and qi is out of balance; In the label, wind and fire incite, phlegm and congestion, blood stasis and internal resistance. Common reasons are anxiety and anger, excessive drinking, or overeating, indulging in fatigue, or careless life. Stroke can be divided into meridians and viscera. In the meridians, there are generally only skin numbness, mouth and eyes? 6? Oblique, poor speech, or hemiplegia, no mental disorder. Common syndrome types are: ① wind evil entering the middle, meridian block type. Both aversion to cold and fever, thin fur and floating pulse. Treatment should dispel wind and dredge collaterals. The prescription is large Gentiana decoction. ② Yin deficiency of liver and kidney and imbalance of wind and yang. Backache and tinnitus, red tongue and thready pulse. Zhengan Xifeng decoction can only be used after nourishing yin and calming wind. ③ Syndrome of phlegm-heat in fu organs, wind-phlegm imbalance. Constipation due to excessive phlegm, greasy fur and slippery pulse. Xiaochengqi decoction can be used to treat phlegm. In addition to midvein symptoms, there are mental symptoms such as drowsiness or ignorance. It can also be divided into two syndromes: ① closed syndrome. The symptoms of clenching teeth, firm hands and strong limb spasm are mostly empirical. Yang-closed patients have red fever, greasy fur and slippery pulse. Treating cold, inducing resuscitation, nourishing yin and calming wind should be treated with Zhi Bao Dan Ling Yang Jiao Tang. Yin-closed person has dark face and lips, cold limbs and slow pulse. Xin Wen kai Qiao, phlegm and wind, appropriate use of Su Hexiang pills, Ditan decoction. ② Disengagement syndrome. The symptoms are closed eyes, open mouth, slight nasal snoring and urine in hands. Most of them belong to deficiency syndrome and should be treated with Shenfu Decoction. Some stroke patients will have sequelae, such as hemiplegia and aphasia, which is related to the severity of the disease, timely treatment and nursing.
concept
Stroke is a disease characterized by sudden fainting and unconsciousness, accompanied by mouth deviation, speech disorder, hemiplegia, or mouth deviation without fainting. Because of the sudden onset, numerous symptoms and rapid changes in the condition, it is similar to the characteristics of good wind and good deeds, so it is named stroke and stroke. The incidence and mortality of this disease are high, and there are often sequelae; In recent years, the incidence rate is on the rise, and the onset age tends to be younger. Therefore, it is a major disease that threatens human life and quality of life.
Acute cerebrovascular diseases in western medicine, such as cerebral infarction, cerebral hemorrhage, cerebral embolism and subarachnoid hemorrhage, all belong to this category. Western medicine mainly divides this disease into hemorrhagic type and ischemic type. Hypertension, arteriosclerosis, cerebrovascular malformation and cerebral aneurysm can often lead to hemorrhagic stroke. Rheumatic heart disease, atrial fibrillation and bacterial endocarditis often form ischemic stroke. In addition, hyperglycemia, hyperlipidemia, abnormal hemorheology and abnormal mood fluctuation are closely related to the occurrence of this disease. Diagnosis can be made by head CT and MRI. Treatment of Diabetes and Stroke With the improvement of living standard and the change of life rhythm, the "three high diseases" (namely hypertension, hyperglycemia and hyperlipidemia) called "the disease of affluence" have passed away like "Xie Wang decoction, flying into the homes of ordinary people", and the incidence and mortality of cardiovascular and cerebrovascular diseases caused by the "three high diseases" have increased year by year.
The use of antihypertensive drugs in elderly hypertensive patients has its particularity and principle. How much do you know about the choice of antihypertensive drugs for the elderly? Different physical conditions, different diseases and the physical conditions of the elderly all affect the choice of drugs. With the increase of age, the prevalence of hypertension gradually increased. 40% ~ 45% of the elderly over 60 suffer from hypertension and hyperglycemia or hyperlipidemia. According to the statistics of the Ministry of Health in 2007, according to foreign data, about 50% of diabetic patients are complicated with senile diseases such as hypertension and hyperlipidemia.
Diabetic patients and non-diabetic patients are only slightly different in the choice of antihypertensive drugs, that is, everyone can lower blood pressure, but diabetic patients pay attention to raising blood sugar while lowering blood pressure, causing metabolism. We do not recommend that patients use a lot of drugs to treat blood pressure, blood lipids and blood sugar. Because of the large amount, although it lowers blood pressure, it will cause changes in blood sugar indexes of diabetic patients. Considering that the disease situation of the elderly is complex and changeable, and there are many complications, we suggest that such patients should be more cautious in using drugs. Comprehensive analysis of hypertension, hyperglycemia and hyperlipidemia in the elderly, in principle, using a variety of antihypertensive, hypoglycemic and lipid-lowering drugs to control, but the effect is not obvious. [Edit this paragraph] Chinese medicine treatment of stroke is a syndrome of "Yin flourishes while Yang declines" caused by deficiency of true yang. Cerebral hemorrhage is a symptom of Yang-qi upwelling caused by "Yin flourishes while Yang declines" and should never be regarded as a symptom of "Yin deficiency and Yang hyperactivity". When the yang goes up and gathers in the brain, the central nervous system will be stimulated several times more than usual. Because the brain is in a state of extreme excitement, is there any reason not to cramp or have a general spasm? Moreover, you will be delirious and delirious, whether it is "yang syndrome" or "yin syndrome", it is the result of gathering elsewhere and not returning to Yuan.
Therefore, the principle of treatment should be to support the true element first, and at the same time give consideration to the pathogenic part. Where the true yang fails, there will be internal evils and external evils. If the true element can be restored, both internal and external evils can be destroyed. This is the truth that "no treatment is actually a cure for evil, and no treatment is actually a cure for wind". This is the key to treating stroke. Only in this way can we not miss the patients. The reason why the therapeutic effect of "dispelling wind and resolving phlegm" is not ideal is because the drugs that dispel wind and resolve phlegm will dissipate their vitality. Among these drugs, there are many drugs that nourish yin and clear heat. Because the patient's yin evil is extremely rich, the use of yin-nourishing drugs will make the yin evil more abundant, leading to the patient's condition turning into syndrome. Moreover, the lack of healthy qi leads to the emergence of evil spirits. Instead of strengthening the body, it drives away evil spirits and even encourages evil spirits, which is the performance of "abandoning the eradication end". In addition, due to the decline of patients' true temperament, the cure rate of nourishing their vitality is still afraid to say 100%, let alone the method of "expelling wind and resolving phlegm"
Treatment: For patients with cerebral hemorrhage, Baitong plus pig bile soup can be used first.
This disease is caused by real yuan loss, excessive yin cold and rejection of yang deficiency. "Fire dominates inflammation", so evil fire is on the top. Therefore, in addition to the heat of dried ginger and aconite, it is also compatible with scallion to help yang. Diseases with excessive yin-cold will definitely exclude yang drugs, so it is necessary to add cold drugs such as human urine and pig bile as guidance to make hot drugs work. When the cold pathogen is dissolved and the true element is stimulated, the deficiency fire in the head will return to the element, and the crisis will be alleviated. Then, with the help of drugs for dredging collaterals and removing blood stasis, the congestion in the brain can be eliminated in a short time. (After taking Baitong plus pig bile decoction, the patient may temporarily feel unwell, open his eyes and have shortness of breath, so the doctor need not panic. This is the manifestation of yang being activated and yin evil going out. At 3 am or 5 pm, the symptoms will be alleviated or eliminated, so it is not suitable for emergency treatment. Moreover, the deficiency fire returns to yuan, the brain is cold, and the convulsion symptoms are naturally eliminated at the same time.
For patients with cerebral thrombosis, first use a large dose of Shenfu decoction (ginseng and aconite root are more than 60g each, and the residue is removed and concentrated), and then use Buyanghuanwu decoction and Sini decoction for treatment. Buyanghuanwu decoction must be used to produce raw astragalus to120g.
More than 30g should be used for the three herbs in Sini decoction, so the dosage will be too little, not too much.
Sini decoction: 30g of aconite, 40g of dried ginger and 50g of roasted licorice.
In addition, a few days after the onset of cerebral thrombosis, patients will have cramps, spasms and other symptoms. This is because there is blood stasis in the brain, and the central nervous system will stimulate some kidney yang to rise to the brain to break the blood stasis. However, due to the decline of the patient's yang, once triggered, most of them will rise to the brain, and the lower coke will be empty, leading to incontinence. Excessive yang stimulates the central nervous system strongly, leading to cramps and spasms. Western medicine will only inject sedatives into patients to inhibit the function of nerves. The function of sedative is to stimulate the true element (extract a certain amount of true yang), so that the "Yin and Yang" can temporarily restore the lifting function, thus achieving the purpose of sedation (taking Sini decoction and Shenfu decoction can make people sleepy, which is the result of the upward lifting of true yang, and the characteristic of true yang is "hiding". And the lack of yang will make people excited.
At this time, it is necessary to use the method of "restoring yang to save inverse" (instead of extracting vitality) to restore the function of vitality, so it is necessary to take a large dose of Shenfu decoction to restore yang to save inverse. After taking it, the patient may temporarily feel unwell, fever, shortness of breath and other symptoms, so doctors do not need to panic. This is the performance of yang medicine running and yin evil going out. By 3 am or 5 am, symptoms will be alleviated or eliminated, and urinary incontinence will be eliminated instead of being treated as an emergency. Moreover, the true yin rises, the deficiency fire falls, the brain naturally cools down, and the convulsion symptoms are naturally eliminated at the same time. Taking Sini decoction will also have the same effect.
The therapeutic principle of stroke Acute cerebrovascular disease, also known as stroke and stroke, is the general term for cerebrovascular diseases. Common in middle-aged and elderly people, the common diseases are hypertension and arteriosclerosis. Due to the rupture of cerebral vessels, blood flows into subarachnoid space, which is called subarachnoid hemorrhage; When blood flows into the brain parenchyma, it is cerebral hemorrhage. Transient ischemic attack (TIA) is caused by cerebral vascular stenosis and occlusion, and the duration of symptoms does not exceed 24 hours. Symptoms lasting more than 24 hours are called cerebral infarction, including cerebral thrombosis and cerebral embolism. Clinical manifestations have some localized neurological symptoms. There is contralateral triple paralysis in one hemisphere, that is, contralateral hemiplegia, mild hemiplegia, hemianopia or aphasia occur at the same time. Occurring in the brain stem and cerebellum are ipsilateral cerebral palsy, contralateral hemiplegia or hemiparalysis, and ipsilateral limb ataxia. Severe cases include headache, vomiting, disturbance of consciousness, and even brain hernia or death.
The incidence and mortality of acute cerebrovascular disease in China are significantly higher than those of coronary heart disease, and the incidence of cerebral hemorrhage is relatively high. On the contrary, the incidence of coronary heart disease in western countries is very high. Besides race, heredity, environment and other factors, differences in diet structure and nutrition are very important reasons. Therefore, correcting nutritional disorders and dietary nutrition therapy are one of the important ways to prevent and treat acute cerebrovascular diseases.
First, the nutritional impact of diet
1. Malnutrition and brain mid-year; Hypertension, atherosclerosis, diabetes and so on are important causes of stroke, so the related dietary and nutritional factors are also closely related to stroke. Epidemiological investigation shows that the incidence of cerebral ischemia and cerebral infarction is high in areas with excessive fat intake, accounting for 40% of the total thermal energy, while the incidence of cerebral hemorrhage is high in areas with low fat, low protein and high salt diet. Experimental studies have confirmed that high serum cholesterol is prone to atherosclerotic thrombosis, while low cholesterol hypertension will make the arterial wall fragile, increase the fragility of red blood cells, and easily lead to bleeding. Nutritional imbalance is not only the imbalance of the quantity of main nutrients, but also the influence of quality is more important than quantity to some extent. For example, polyunsaturated fatty acids and saturated fatty acids in fat can reduce blood cholesterol, but too much will promote lipid peroxidation and destroy cell membranes, while the latter will increase blood cholesterol. Therefore, it is considered that the ratio of polyunsaturated fatty acids to saturated fatty acids is 1: 2, and the best ratio recommended now is p: m: s =1:1. High-quality protein in protein, that is, animal protein with high sulfur amino acid content, such as fish, poultry, lean meat and soybean protein, accounts for less than 50% of the total protein, which is prone to hypertension and stroke. If the diet is high in sodium, low in calcium and low in potassium, it is also prone to hypertension and stroke.
2. Affect the prognosis and rehabilitation of stroke: Because stroke patients have different degrees of brain failure, the course of disease may be accompanied by infection, gastrointestinal bleeding and renal insufficiency; The application of dehydrating agents and hormones can cause water-electrolyte disorder; Light people eat less, heavy people fast, and the dietary nutrition intake is obviously lower than the required amount. Therefore, on the basis of the original malnutrition, stroke patients may be aggravated by reduced intake, leading to more serious malnutrition. If there is not enough heat energy, essential amino acids, phospholipids and vitamins, it will inevitably affect the prognosis and recovery of stroke.
Second, diet nutrition therapy
The purpose of dietary nutrition therapy is to support systemic nutrition, protect brain function and promote the repair and functional recovery of nerve cells. Individualization is required in dietary nutrition supply, that is, different dietary nutrition treatment schemes are put forward according to the patient's condition, complications, normal diet, digestion and absorption function, weight, blood lipid, blood sugar, electrolyte and other factors. In the acute phase, dietotherapy is to help patients get through the critical period and create conditions for recovery. Suggestions on reasonable diet should be put forward in the recovery period to correct malnutrition or malnutrition, promote recovery and prevent recurrence.
1. Diet therapy for severe patients: Severe or coma patients who have vomiting or gastrointestinal bleeding within 2 ~ 3 days after onset should fast and be supplemented with nutrition through veins. Nasal feeding began after 3 days. In order to adapt to the absorption function of digestive tract, rice soup and sucrose were mainly used in the first few days, 200 ~ 250 ml each time, 4 ~ 5 times a day. In the case of tolerance, add heat, protein and fat to the mixed milk, and use milk, rice soup, sucrose, eggs and a small amount of vegetable oil. For those who have been in coma for a long time and have complications, they should be supplied with high-energy and high-fat mixed milk, ensuring that there are 90 ~ 1 100g of protein, 0/00g of fat, 300g of carbohydrate, 0.46mj (2,500kcal) of total heat energy and 2,500 total liquids every day. Nasal feeding speed should be slow to prevent reflux from entering trachea. If necessary, you can choose a homogeneous diet or an elemental diet.
2. Diet therapy for general patients: the heat energy supply can be at125.52 ~167.36 kJ (30 ~ 40 kcal), and the overweight person can reduce it appropriately. Protein takes the ratio of L 5 ~ 2.0g/kg, in which the protein of animals is not less than 20g/d, including fish, poultry and lean meat with low fat and high protein, and beans are not less than 30g per day. Fat should not exceed 30% of total heat energy, cholesterol should be less than 300 mg/d, and viscera with high fat, animal fat and saturated fatty acid should be eaten as little as possible. Overweight people's fat should account for less than 20% of total energy, and cholesterol should be limited to less than 200mg. Carbohydrates are mainly cereals, and the total heat energy is not less than 55%, which needs to be mixed with fine and varied. Limit salt intake to less than 6 grams per day. If dehydrating agent or diuretic is used, it can be increased appropriately. In order to get enough vitamins, more than 400 grams of fresh vegetables should be supplied every day. The dining system should be regular and quantitative, with small meals, four meals a day, and the dinner should be light and digestible. [Edit this paragraph] Stroke complications: After cerebral hemorrhage or massive cerebral infarction, diseases of other organs of the body are often complicated, such as acute gastrointestinal bleeding, brain-heart syndrome, lung infection and acute pulmonary edema, bedsore, central dyspnea, central dyspnea and post-stroke depression, which are described as follows:
( 1); Pulmonary infection: Reports of brain diseases may lead to pulmonary and respiratory vascular dysfunction, pulmonary edema and congestion; If you don't turn over for a long time, it will lead to the accumulation of lung secretions; And the accidental inhalation of vomit into the trachea will all promote the occurrence of pneumonia. Nursing should be strengthened, such as gently changing the patient's position every 3-4 hours and patting his back to prevent lung secretions from accumulating for a long time and being easily discharged. Be especially careful when feeding and try to prevent pneumonia as much as possible.
(2) Bedsore: Due to the limited movement of paralyzed limbs, the bony protuberance is easily compressed, and the blood circulation and nutrition of local skin are damaged, so bedsore is prone to occur, and the prone parts are the lower back, functional tail, femoral trochanter, lateral ankle and heel. In order to avoid bedsore, patients can be helped to change their body position every 2 hours 1 time; Place balloons, sponge pads, etc. In areas prone to bedsores. Keep the skin dry; Local massage can also be performed to improve blood circulation.
(3) Acute gastrointestinal bleeding: Most of the bleeding occurred within 1 week after onset, and more than half of the bleeding came from the stomach, followed by the esophagus, showing hematemesis or melena.
(4) Brain-heart syndrome: Ischemic changes, arrhythmia and even myocardial infarction can be found by ECG examination within 1 week after onset.
(5) Central dyspnea: more common in coma patients. Breathing fast, shallow, weak, irregular, or sigh-like breathing or apnea, because the respiratory center of the brain stem is affected, indicating that the condition is serious.
(6) Central inversion: seen in acute and chronic stages of stroke. In severe cases, intractable seizures are also signs of serious diseases. [Edit this paragraph] Taking care of the elderly with stroke If the elderly have a "stroke", they can't take care of themselves. As the elderly, they have the responsibility and obligation to take care of the seriously ill elderly. So what should they do as children? First of all, we should convince the elderly to build up confidence and exercise their limbs to avoid muscle and nerve atrophy. Massage every joint and muscle regularly is a good way to prevent joint stiffness and muscle atrophy. When the limbs can take the initiative to move, the elderly should be encouraged to sit on the bed or chair, pedal the bed or step on the ground, or turn walnuts by hand (fitness balls can be used for those with mild symptoms). Furthermore, you can help the elderly practice standing and walking.
Some children are afraid that the "stroke" elderly people will fall and have misfortune, so it is not appropriate for them to engage in activities. In fact, the earlier you start exercising, the faster your limb function will recover and the lower your mortality rate will be. According to statistics, the five-year mortality rate of bedridden "stroke" elderly people is 54.7%, while only 12. 1% of active "stroke" elderly people die.
In order to prevent deformity, the limbs of paralyzed old people should be fixed in the "functional position" with bandages, sandbags or pillows. Elbows should be at 90 degrees and wrists should be in pronation position. Old people are prone to drooping feet, so don't press the quilt directly on the instep. It is best to support the quilt with a support and put a pillow under your feet to make your ankle joint at 90 degrees.
It is very important to prevent bedsores. After paralysis, it is inconvenient for the elderly to turn over, often due to the pressure between the protruding part of the bone and the mattress, the skin appears necrotic ulcer, and it is necessary to turn over frequently. Generally, you should turn over every two hours. After turning over, gently massage the protruding parts of the bones with alcohol or talcum powder to facilitate blood circulation. Using an air cushion or foam pad on the bony process can reduce the pressure. In addition, we should always scrub the skin of the elderly and spray some prickly heat powder on the folds, perineum and buttocks to keep them clean and dry. Once bedsore appears, you can dry the affected area with a big light bulb, apply purple liquid medicine, or sprinkle traditional Chinese medicine powder for promoting granulation, and press the pressure sore surface.
Old people who stay in bed for a long time have a bad appetite. They should eat some chewy, digestible and nutritious foods, such as custard, soybean milk, milk, lotus root starch, rice porridge, jiaozi, chicken soup, fine noodles and so on. Be patient when feeding, swallow one mouthful before feeding another, and don't rush to avoid aspiration pneumonia.
If the paralyzed elderly are not used to urinating in the lying position and have difficulty urinating, they can gently massage their lower abdomen with their hands, or apply a hot water bag to their lower abdomen, which will have certain effects.
Elderly people in bed often suffer from constipation due to slow intestinal peristalsis, and constipation is often the cause of recurrence of "stroke", which cannot be taken lightly. If you don't understand the stool for 3 days, you should choose medication under the guidance of a doctor.
For the elderly with paraplegia and hearing impairment on the right side, we should persuade them to speak slowly and listen to the radio more, so that their children and grandchildren can talk to him or her more and rebuild their language functions. Of course, this process is slow and requires great patience.
About 60% of the "stroke" elderly people died of pneumonia during the recovery period. Therefore, we should pay attention to indoor ventilation, increase or decrease clothes in time, keep warm and prevent colds.
Taking care of the elderly with stroke is like taking care of your own children. If the "stroke" elderly people can be carefully taken care of, most of them can recover within one year and half can take care of themselves. [Edit this paragraph] How to prevent the occurrence of stroke 1. To prevent stroke, it is necessary to minimize the risk factors of stroke. Controlling hypertension is the key to prevent stroke. Patients with hypertension should take antihypertensive drugs on time according to the doctor's advice, and if possible, it is best to measure their blood pressure 1 time every day, especially in the stage of adjusting antihypertensive drugs to keep their blood pressure stable. Maintain emotional stability, do or not do things that are easy to cause emotional excitement, such as playing cards, playing mahjong, watching sports games broadcast, etc. The diet must be light and moderate, quit smoking and drinking, and keep the stool unobstructed; Moderate activities, such as walking and playing Tai Ji Chuan.
The key to prevent and treat atherosclerosis is to prevent and treat hyperlipidemia and obesity. Establish healthy eating habits, eat more fresh vegetables and fruits, and eat less fatty foods such as fat meat and animal offal; Moderate exercise increases heat consumption; Take lipid-lowering drugs.
Control diabetes and other diseases such as heart disease and vasculitis.
2. Pay attention to the premonitions of stroke: Some patients often have premonitions such as high blood pressure, fluctuation, headache and dizziness, numbness and weakness of hands and feet before stroke, and take measures to control them as soon as possible after discovery.
3. Effectively control the transient ischemic attack: When patients have the aura of transient ischemic attack, they should rest quietly and actively treat them to prevent them from developing into cerebral thrombosis.
4, pay attention to the influence of meteorological factors: seasonal and climate changes will make hypertensive patients emotionally unstable, blood pressure fluctuations, and induce stroke. At this time, it is even more necessary to prevent the occurrence of stroke.
5, eating more fruits and vegetables is not easy to get a stroke. Why can fruits and vegetables reduce the risk of stroke? First of all, because it contains a lot of vitamin C, according to research, the concentration of vitamin C in blood is closely related to stroke. The higher the concentration, the lower the risk of stroke. In addition, vitamin C is an effective antioxidant, which can scavenge free radicals in the body. The increase of free radicals will increase the risk of heart disease and stroke. Secondly, vegetables and fruits are rich in dietary fiber, which can inhibit the increase of total cholesterol concentration, thus preventing arteriosclerosis, cardiovascular diseases and stroke. A study in the United States shows that taking a certain amount of water-soluble dietary fiber from vegetables and fruits every day can reduce the cholesterol content in blood by 3%-5%. Based on this understanding, people in developed countries quickly adjust their diet structure, eat less meat, sugar and fat and eat more fruits and vegetables. Therefore, in recent years, in Europe and the United States and other countries, the mortality rate of cardiovascular and cerebrovascular diseases has shown a downward trend. Third, fresh vegetables and fruits are rich in nutrients such as potassium, magnesium and folic acid. Potassium can protect blood vessels and lower blood pressure. Magnesium also has the effects of lowering cholesterol, dilating blood vessels and preventing cerebrovascular diseases. Folic acid can convert homocysteine into methionine in stroke patients, and reduce the concentration of cysteine in blood, thus reducing the risk of coronary heart disease and stroke. In addition, many fruits and vegetables contain oligosaccharides, which can reduce blood coagulation and prevent stroke.
The elderly should guard against "heatstroke" in summer.
Now is the hot summer season, and doctors remind the elderly with hypertension, coronary heart disease and hyperlipidemia to abandon the view that "stroke will only happen in cold seasons". When the temperature rises above 32℃, the incidence of stroke will rise sharply, so beware of heatstroke in summer.
In summer, the human body sweats more, while the elderly have less water in their bodies, so it is easy to lack water in summer. Lack of water in the body will thicken the blood. For the elderly with hypertension, hyperlipidemia or cardiovascular and cerebrovascular diseases, this will hinder blood transfusion to the brain and increase the chance of stroke.
Doctors reminded that in order to prevent stroke, we should first pay attention to diseases that are easy to cause stroke, such as hypertension and hyperlipidemia, arrange summer life reasonably, pay attention to the combination of work and rest, eat more foods that can soften blood vessels and lower blood lipids, and use antihypertensive drugs and lipid-lowering drugs under the guidance of doctors.
In summer, the elderly should also avoid overeating. Most of the blood vessels in the elderly are hardened, and the cold and hot temperatures are easy to cause accidents. Therefore, when using air conditioning, the temperature difference between indoor and outdoor should not exceed 8℃. At the same time, replenish water in time to prevent blood thickening from causing thrombosis, stroke, angina pectoris and other diseases. For the elderly who have a history of stroke, once they have symptoms such as dizziness, headache, numbness and frequent yawning, they should go to the hospital in time. [Edit this paragraph] What are the symptoms before the stroke? Although stroke is sudden, there is also a pathological evolution process before the onset. At one stage, the cerebral circulation was slightly unbalanced, but it could be restored. Clinical manifestations are various premonitory symptoms, which often appear within a few minutes to a few days before a stroke. To sum up, there are roughly four kinds:
(1) Headache and dizziness, which may be accompanied by visual rotation, nausea and vomiting. The form and feeling of headache are different from before. Headaches get worse, become persistent, and sometimes become fixed in a certain part. This is the manifestation of blood pressure fluctuation or cerebral vasospasm, which is often a precursor of hemorrhagic stroke.
(2) Various dyskinesia: for example, one limb is weak, or the movement is ineffective, the object is unstable, and sometimes accompanied by muscle spasm. Although I didn't encounter a roadblock when I walked, I was clear-headed, but I suddenly fell to the ground, or I wanted to walk in the middle of the road, but I couldn't help leaning to the side of the road. Suddenly the words are unclear and the words are disordered; Dysphagia and cough; My mouth is crooked and my mouth is watering. There is also a syndrome called "one and a half syndrome", which is also a common symptom in the early stage of stroke. Its performance is that one eye can neither rotate up and down nor spread left and right, and the other eye can not rotate in other directions except moving outward. The mechanism is that the extraocular muscles of one and a half eyes can't move.
(3) Sensory disorders: numbness of lips, face and tongue, numbness of limbs, hearing loss, transient blurred vision or blindness.
(4) personality, behavior and intelligence are suddenly abnormal, such as becoming withdrawn, depressed, anxious or impatient, losing normal understanding and judgment ability, laughing or crying for no reason, and being difficult to control. Sometimes, I suddenly meet an acquaintance, I can't name him, I can't even name my daily necessities, and I feel sleepy all day. The latter three manifestations can be transient, recurrent or gradually aggravated, and are often precursors of ischemic stroke.
Once you find that Zhou people or their families have the same symptoms, you should attach great importance to it and don't be overly nervous and panic. First of all, keep quiet, stay in bed and pay attention to the changes of blood pressure. If it is too high, antihypertensive treatment should be carried out, and if it is too low, antihypertensive measures should be stopped immediately. You'd better call a doctor, or you'll go to the hospital for further examination. It is best to use a stretcher to avoid bumps on the way. Patients should lie flat with their heads tilted to one side to avoid vomit blocking the respiratory tract or causing aspiration pneumonia.
In addition, patients with hypertension have a high recurrence rate after stroke, so monitoring should be strengthened. Once the above situation occurs, it is necessary to step up the hospital. Remember that time is life, the sooner the better.
Language recovery after stroke
More than half of stroke patients can't speak or speak clearly, or they can speak spontaneously, but they don't understand what others are saying. These are all language disorders caused by stroke. Medically, language disorders of stroke patients are divided into aphasia and dysarthria. The former is divided into motor aphasia, sensory aphasia, mixed aphasia and named aphasia.
Motor aphasia is also called expressive aphasia. Although patients can understand other people's languages (spoken and written), they can't express themselves orally or in writing. If the patient can't speak at all, it is called complete motor aphasia; If the patient can only speak simple sentences and can't speak complex sentences, it is called incomplete motor aphasia.
Sensory aphasia is also called receptive aphasia. Patients have the ability to speak, but they can't understand other people's words and their own words. The content of the speech is chaotic or intermittent, and it is often irrelevant to answer questions and use wrong words, which makes it impossible to have a normal conversation.
Mixed aphasia includes both motor aphasia and sensory aphasia. The patient can neither understand what others mean when they speak, nor speak.
Named aphasia patients can say the purpose of the object, but can't say the name of the object. Sometimes you occasionally say the name of an object, but you forget it in an instant, so it is also called amnesia.
The focus of aphasia is in the language center of cerebral cortex. At present, there is no specific drug that specifically acts on the language center. The aphasia of most patients can gradually recover with the improvement of the primary disease. Special functional training is very important for the smooth rehabilitation of aphasia patients. At present, it is believed that the earlier the rehabilitation treatment for language disorders, the better. Recover quickly within 3 months after illness, and it is difficult to recover after one year. Functional rehabilitation training includes pronunciation training, phrase training, conversation training, reading training, sentence retelling training, character recognition, pointing out the name of an article, executing commands, matching pictures with objects, etc.
Rehabilitation training for patients with complete aphasia should start with learning pronunciation, like teaching children to speak, such as making patients pronounce "ah" or whistling with their mouths to induce pronunciation. Then talk about common words, such as eating, drinking, doing, etc. Or show a card and let the patient read the words on it. Then teach disyllabic words, phrases, short sentences and long sentences in turn. During training, speech is combined with visual stimuli, for example, when eating, it is combined with food, or by looking at pictures, speech is combined with pictures. Patients with incomplete motor aphasia can speak some words, phrases, sentences or are not fluent. Patients are often poor in vocabulary, slow in speech and repetitive in language. We should teach these patients patiently, read stories repeatedly, practice flexibility and practice language skills.
The training of patients with sensory aphasia is more difficult than that of patients with motor aphasia. Visual logic method and gesture method can be used for training. For example, give the patient a face plate, put a towel away and tell him to "wash his face". Although the patient doesn't understand the meaning of the word "wash his face", he will logically understand that you are asking him to wash his face. If this is repeated for many days, the language and vision will be combined for a long time, and the language function will be restored. Gesture means that family members or caregivers train patients with gestures and language. If the patient is allowed to "eat" and the trainer demonstrates the action of eating with chopsticks many times, the patient will soon understand and take the initiative to eat with chopsticks.
Functional training for patients with mixed aphasia is more difficult, and it must be repeated by combining speaking, watching and listening. If the patient is asked to wear a sweater, he should not only say "wear a sweater" for the patient to listen to, but also point to the prepared sweater and make a gesture for the patient to see.