不同中医治法对脑出血患者日常生活能力的影响  

Effects of Various TCM Decoctions on Daily Life Activities of Patients With Cerebral Hemorrhage

作　　者：赵艳[1] 梁清华[1] 熊新贵[1] 陈疆[1] 范荣[1] 谭勇 

机构地区：[1]中南大学湘雅医院,湖南长沙410008 [2]湘潭市中心医院

出　　处：《实用预防医学》2007年第5期1390-1392,共3页Practical Preventive Medicine

基　　金：湖南省科技基金(1013-50);湖南省自然科学基金(01JJY2024)

摘　　要：目的观察不同中医治法对急性脑出血患者日常生活能力的影响,比较不同中医治法的远期疗效。方法选择2002年8月-2007年1月湘雅医院收治的90例脑出血患者,将符合条件的病例随机分为西医对照组1组,结合中医辨证标准分为中药治疗5组,共6组。各组均为15例。各中药组分别采用镇肝熄风汤、血府逐瘀汤、涤痰汤、大承气汤、平肝熄风汤治疗,西药组采用甘露醇降颅压,调控血压,对症支持治疗,疗程均为30d。采用Barthe1指数记分法评定患者日常生活能力,满分100分。结果各组治疗后Barthe1指数评分均较治疗前显著改善(P<0.01);平肝熄风汤组、血府逐瘀汤组、涤痰汤组,镇肝熄风汤组均较西药组有显著改善(P<0.05或P<0.01);比较后发现,平肝熄风汤组Barthe1指数评分增加值优于大承气汤组、血府逐瘀汤组、镇肝熄风汤组(P<0.05或P<0.01),但与涤痰汤组相比,仅有增高趋势,无统计学意义。结论根据急性脑出血中风"风、火、痰、瘀"的病理特点,分别从"风、火、痰、瘀"论治均具有一定疗效,但采用平肝熄风汤"风、火、痰、瘀"同治能显著提高患者日常生活能力,提示"风、火、痰、瘀"同治(平肝熄风汤)对急性期脑出血疗效最佳。Objective To study the efficacy of various TOM therapies on the daily living activities in patients with cerebral hemorrhage. Methods This clinical trial was conducted in Xiangya Hospital from August, 2002 to January, 2007. Ninety cases corresponding to diagnosis criteria of cerebral hemorrhage were randomly divided into 6 groups, 15 cases in each group received 5 different TCM decoction therapies and the other one group received conventional western medical therapy of mannitol for reducing intracranial pressure and controlling blood pressure for 30 days. The other 5 groups were randomly assigned to receive 4 types of TCM decoctions for 30 days, including Zhenganxifeng tang, Xuefuzhuyu tang, Ditan tang, Dachengqi tang, and Pingganxifeng tang. At the end of the 30 - day therapy, all patients＇ activities of daily living （ADL） before and after treatment were assessed by Barthel index（0-- 100 points）and performed statistical analysis. Results Scores of Barthel index were increased significantly in each group after treatment（ P〈 0.01）. Compared with the control group, the scores of Barthel index were improved significantly in the groups of Zhenganxifeng tang, Xuefuzhuyu tang, Ditan tang, and Pingganxifeng tang（ P〈 0.05 or P〈 0.01 ）. The score of Pingganxifeng tang was exceeded the scores of Zhenganxifeng tang, Xuefuzhuyu tang and Dachengqi tang（ P〈 0.05 or P〈 0.01 ）. The scores of Barthel of Pingganxifeng tang were better than those of Ditan tang but showed no statistical significance. Conclusions Every TCM decoction can improve ADL in patients with cerebral hemorrhage, but the efficacy of Pingganxifeng tang is the best. The results suggest that the treatment method with wind, fire, phlegm and blood stasis resolved simultaneously is better than those resolved separately.

关 键 词：脑出血 日常生活能力 不同中医治法 平肝熄风汤 

分 类 号：R189[医药卫生—流行病学]