参附注射液对重型颅脑损伤亚低温治疗患者颅内压、血生化指标及神经功能的影响  

Investigation of Shenfu injection on ICP,blood test index and neurofunction of patients with severe traumatic brain injury treated by mild hypothermia

作　　者：王冠[1] 曹德晨[2] 张国斌[2] 杜斌[1] 董琨[1] 

机构地区：[1]天津中医药大学第二附属医院神经外科脑病中心,天津300150 [2]天津市环湖医院神经外科,天津300060

出　　处：《河北中医》2013年第5期737-740,共4页Hebei Journal of Traditional Chinese Medicine

基　　金：天津市卫生局科技基金项目(编号:2011KZ122)

摘　　要：目的观察参附注射液对接受亚低温治疗的重型颅脑损伤患者的辅助治疗作用。方法将61例接受亚低温治疗的重型颅脑损伤患者随机分为2组。对照组30例单用亚低温治疗,治疗组31例接受亚低温治疗同时用参附注射液。2组均治疗7 d,对2组治疗后颅内压(ICP)、血生化指标、神经功能、并发症及死亡率进行评价,对C反应蛋白(CRP)、血糖、乳酸、格拉斯哥昏迷量表(GCS)评分、并发症及死亡率进行统计。结果 2组ICP均在发病后第4 d达到峰值,随后2组ICP均进行性下降,从第5 d后治疗组ICP低于对照组(P<0.05)。2组CRP均于伤后前5 d进行性升高而后逐渐呈下降趋势,从第3 d开始治疗组低于对照组(P<0.05);2组血糖在第3 d达到最高值,并于第5 d开始下降,治疗组血糖下降较对照组快,于第5、7 d 2组比较差异有统计学意义(P<0.05);2组乳酸数值均先开始呈现增高,并于第3 d到达最高值,随后开始下降,治疗组乳酸值下降较对照组快,于第5、7 d 2组比较差异有统计学意义P<0.05)。2组治疗前GCS评分比较差异无统计学意义(P>0.05),治疗后2组神经功能均进行性好转,于第7 d开始治疗组GCS评分较对照组升高(P<0.05)。治疗组肺感染、心律失常、休克、应激性溃疡并发症发生率较对照组低(P<0.05);2组死亡率比较差异无统计学意义(P>0.05)。结论参附注射液对重型颅脑损伤接受亚低温治疗患者可通过多种途径达到神经保护及整体调节作用,可以降低亚低温治疗相关并发症发生。Objective To investigate the adjuvant therapeutic effect of Shenfu injection on patients with severe traumatic brain injury treated by mild hypothermia.Methods 61 patients with severe traumatic brain injury treated by mild hypothermia were randomly divided into control and treatment groups.30 cases in control group received only mild hypothermia therapy.31 cases in treatment group received the adjuvant therapeutic effect of Shenfu injection on the basis of mild hypothermia therapy.The therapeutic course was 7 days in two groups.Intracranial pressure（ICP）,C reactive protein（CRP）,blood glucoses,blood lactate,Glasgow Coma Scale（GCS）,blood biochemical index,neural function,complications and death rates were counted at the end of therapy.Result ICP in treatment group was lower than that in control group in the 5th day after treatment（P0.05）.CRP in treatment group was lower than that in control group in the 3rd day after treatment（P0.05）.Decrease of blood glucose in treatment group was faster than that in the control group,there was significant difference between two groups in the 5th,7th day（P0.05）.Decrease of lactate in treatment group was faster than that in the control group,there was significant difference between two groups in the first,7th day（P0.05）.GSC in treatment group was higher than that in control group from 7th day after treatment（P0.05）.The incidence of complications including lung infection,arrhythmia,shock,stress ulcer in treatment group was lower than that in control group（P0.05）.However,the death rates have not showed significant different between two groups.Conclusion Shenfu injection can achieve neuroprotective and overall regulation effect for the patients with severe traumatic brain injury treated by mild hypothermia through a variety of channels,moreover it may assist to reduce the complications related mild hypothermia therapy.

关 键 词：低温 脑损伤 颅内压 参附汤 注射剂 

分 类 号：R651.150.5[医药卫生—外科学] R651.1[医药卫生—临床医学]