水蛭粉口服对急性期脑出血早中期临床预后的影响  

Effect of Leech Powder on Prognosis of Acute Intracerebral Hemorrhage of Early and Middle Stage

作　　者：王大明[1] 胡浩宇[1] 郑水红[1] 胡娅娜[1] 

机构地区：[1]浙江中医药大学附属金华市中医院,浙江金华321017

出　　处：《中国中医药信息杂志》2007年第7期20-22,共3页Chinese Journal of Information on Traditional Chinese Medicine

摘　　要：目的探讨水蛭粉口服对急性期脑出血早中期临床预后的影响。方法通过59例脑出血患者的病例对照研究,分析治疗组和未治疗组间的差异及对预后的影响。结果约有2/3的患者经水蛭粉口服治疗,平均剂量(2.22±0.42)g/d,平均疗程(10.12±3.39)d。治疗组患者出院时格拉斯哥评分高于未治疗组(P=0.001),早期改良Rankin积分5～6级占43.9%(未治疗组61.1%,P=0.45),病死率2.4%(未治疗组16.7%,P=0.08),中期改良Rankin积分5～6级占17.1%(未治疗组50%,P=0.03),病死率17.1%(未治疗组44.4%,P=0.03)。校正入院时格拉斯哥评分、血糖、肌酐和吸烟史等因素后,Logistic回归分析显示,导致2组间中期预后差异的原因中水蛭治疗起到了一定的作用。结论水蛭粉口服治疗急性期脑出血的疗效,特别是对早中期临床预后的疗效尚不确定,尚需通过较大样本的随机对照试验进行评价。Objective To study the effect of leech powder on mortality and disability of acute intracerebral hemorrhage at 30 days and 1 year. Methods In a Case-control study, we analyzed the 30-day and 1-year mortality and disability with respect to leech powder treatment status in 59 patients consecutively admitted within one week of intracerebral hemorrhage onset. Confounding factors were compared between treated and nontreated patients. Results About two thirds of the patients received oral leech powder as part of their routine treatment, mean dosage was （2.22±0.42）g/d and mean duration was （10.12±3.39）d. The mortality was 2.4% versus 16.7% （P=0.08） at 30 days and 17.1% versus 44.4% （P=0.03） at 1 year in the leech powder treated and nontreated groups, respectively. Modified Rankin score 5-6 was 43.9% （61.1% in nontreated groups, P=0.45） at 30 days and 17.1% （50% in nontreated groups, P=0.03） at 1 year in treated groups, respectively. Leech powder treatment effect was adjusted for Glasgow Coma Scale, hyperglycemia, creatinine and smoker in logistic regression models. Depending on the factors entered into the model, either no effect or harm could be attributed to leech powder. Conclusions Based on the results of this study, no recommendations can be made on the use of leech powder in acute intracerebral hemorrhage. And properly randomized, controlled trials should be performed to come to a final conclusion.

关 键 词：水蛭 脑出血 预后 病死率 残障率 

分 类 号：R743.34[医药卫生—神经病学与精神病学]