通窍活血汤治疗重度颅脑损伤42例  

42 Cases of Severe Traumatic Brain Injury Treated by Tongqiao Huoxue Tang

作　　者：宋彦彬[1] 郝东宁[1] 马瑞[1] 车震[1] 周峰[1] 刘琦[1] 马肃[1] 杨建龙[1] 李乔[1] 

机构地区：[1]榆林市第一医院,陕西榆林718000

出　　处：《河南中医》2015年第2期275-277,共3页Henan Traditional Chinese Medicine

摘　　要：目的:观察通窍活血汤治疗重度颅脑损伤的临床疗效。方法:将84例重度颅脑损伤患者随机分为对照组和观察组患者各42例。两组患者均给予抗感染、呼吸机辅助通气、吸氧、低温处理、降颅内压、纠正水及电解质紊乱等西医常规基础治疗,必要时行手术治疗。对照组患者在此常规治疗的基础上给予乙酰谷酰胺、依达拉奉注射液静脉注射治疗,连续治疗2周;观察组患者则在对照组治疗基础上给予通窍活血汤内服或鼻饲治疗,连续治疗2周。比较两组患者意识恢复时间、觉醒人数;对患者的精神状态、神经功能、昏迷程度进行评估,并对预后情况进行统计。结果:观察组患者经治疗后意识恢复时间更快,觉醒人数更多,与对照组比较,差异具有统计学意义(P<0.05);患者经治疗后精神状态评分MMSE、神经功能缺损程度评分NIHSS有所下降,昏迷GCS评分有所上升,与对照组比较,差异具有统计学意义(P<0.05);观察组患者的预后程度明显优于对照组,差异具有统计学意义(P<0.05)。结论:通窍活血汤联合乙酰谷酰胺、依达拉奉静脉注射治疗利于促进重度颅脑损伤患者的意识恢复、改善其精神状态及神经功能,预后良好。Objective： To observe the clinical effect of Tongqiao Huoxue Tang for treating severe traumatic brain injury. Methods： 84 cases with severe traumatic brain injury were randomized into control group and observation group,with 42 cases in each group.Both groups were given the western routine treatments of anti-inflammation,mechanical ventilation,oxygen uptake,low temperature treatment,intracranial pressure reduction,regulating water and electrolyte disorder,and surgery can be performed if necessary.Control group were additionally given intravenous injection of aceglutamide and edaravone for successive 2 weeks; based on the treatment of control group,treatment group were additionally given internal administration of Tongqiao Huoxue Tang or nasogastric treatment for successive 2 weeks. The consciousness recovery time,number of awakening patients in two groups were compared;the patients＇ mental state,nervous function,degree of coma were assessed; and the conditions of prognosis were recorded. Results：Compared with control group,in treatment group,the consciousness recovery was earlier,the number of awakening patients were more; the difference had statistical significance（ P〈0. 05）. After the treatment,the scores of MMSE and NIHSS declined,while the score of GCS rose; compared with control group,the difference had statistical significance（ P〈0. 05）. Conclusion： Tongqiao Huoxue Tang combined with intravenous injection of aceglutamide and edaravone is favorable for consciousness recovery and improvement of the mental state and nervous function and the prognosis of the patients with severe traumatic brain injury.

关 键 词：重度颅脑损伤 通窍活血汤 乙酰谷酰胺 依达拉奉 

分 类 号：R259.491.2[医药卫生—中西医结合]