活血通腑法对高血压脑出血患者血肿微创清除术后血浆内皮素水平影响的研究  

Influences of expelling blood-stasis and purging fu-organ(活血通腑法) on plasma endothelin of patients with hypertensive intra-cerebral hemorrhage after micro-trauma operation of intra-cerebral hematoma drainage

作　　者：朱文宗[1] 周龙寿[1] 胡万华[1] 范录平[2] 林一均[2] 

机构地区：[1]温州市中医院,浙江温州325000 [2]温州市第三人民医院

出　　处：《中国中西医结合急救杂志》2006年第6期338-341,共4页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：浙江省中医药管理局科研基金(2006Y047)

摘　　要：目的:探讨活血通腑法对高血压脑出血患者血肿清除术后疗效与血浆内皮素(ET)水平的影响。方法:将65例接受血肿微创清除术的患者随机分成两组,均采用内科综合治疗;对照组在综合治疗基础上加用安慰汤剂,治疗组在综合治疗基础上加用活血通腑法方药,每日1剂,均治疗3 d。于治疗后14 d和90 d观察临床综合疗效、日常生活能力和神经功能缺损程度评分的变化,并于治疗后24 h,7、14和21 d检测血浆ET含量的变化。结果:治疗组急性期(14 d)病死率为12.1%(4/33例),对照组急性期病死率为25.0%(8/32例),治疗后14 d和90 d两组存活患者临床综合疗效比较差异均有显著性(P均<0.01)。两组治疗后14 d日常生活能力比较,差异无显著性(P=0.05),治疗后90 d治疗组日常生活能力优于对照组,两组比较差异有显著性(P<0.01);治疗组治疗后90 d神经功能缺损程度评分显著低于对照组(P<0.01)。同时治疗组治疗后24 h,7、14和21 d血浆ET含量均低于对照组(P均<0.01)。结论:高血压脑出血患者血肿清除术合用活血通腑法方药可以降低病死率,降低病残程度,提高生存患者的生活质量,并能降低血浆ET水平,活血通腑法改善病情可能是通过降低患者血浆ET起作用。Objective： To study the influences of expelling blood-stasis and purging fu-organ （活血通腑法） on plasma endothelin （ET） and clinical curative effects on patients with hypertensive intra-cerebral hemorrhage after intra-cerebral hematoma drainage. Methods： Sixty-five patients with hypertensive intra-cerebral hemorrhage were randomly divided into two groups： control and treatment groups. Both groups were treated with mlcro-trauma operation of intra-cerebral hematoma drainage and general treatment of internal medicine. On the basis of the above treatment, the control group was treated with placebo decoction, and the treatment group was treated with expelling blood-stasis and purging fu-organ Chinese herbal drug, one dosage per day for 3 days in the two groups. Changes of clinical curative effects, ability of the daily life （ADL） and neural function deficiency scores were observed on the 14 th and 90 th day after treatment. Plasma ET contents were detected at 24 hours and in 7, 14 and 21 days after treatment. Results： The results showed that the fatality rates were 12.1% （4/33 cases） and 25.0% （8/32 cases） in the treatment group and the control group respectively at acute stage （14 days）, and there were differences of clinical curative effects in survival patients between the two groups on the 14 th and 90 th day after treatment （all P〈0.01）. The difference of the ADL between the two groups was insignificant after 14 -day treatment （P=0.05）, while significant after 3-month treatment, the treatment group being better than that of the control group （P〈0.01）. The neural function deficiency score was significantly lower in the treatment group than that of control group on the 90 th day after treatment （P〈0.01）. Meanwhile, the plasma ET in treatment group were lower obviously than those in control group at 24 hours and in 7, 14 and 2t days after treatment （all P〈0.01）. Conclusion： The treatment of expelling blood-stasis and purging fu-organ Chinese herbal

关 键 词：高血压 脑出血 活血通腑法 中医药 血肿微创清除术 内皮素 

分 类 号：R26[医药卫生—中医外科学]