早期手术结合中医“增水行舟”法治疗高血压脑出血阴虚风动证疗效观察  

Clinical Effect of Early Surgery Combined with Traditional Chinese Medical Method of Increasing Body Fluid for Curing Constipation in Treatment of Hypertensive Cerebral Hemorrhage Patients with Yinxu Fengdong Syndrome

作　　者：吕钊[1] 刘吉祥[1] 张鹏[1] 李建华[1] 刘辉[1] 周涛[1] 

机构地区：[1]邯郸市第一医院神经外科,河北邯郸056002

出　　处：《解放军医药杂志》2015年第3期94-98,共5页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：河北省卫生厅(中医药类)科研立项项目(20122194)

摘　　要：目的观察早期手术结合中医"增水行舟"法治疗高血压脑出血阴虚风动证的临床疗效。方法回顾性分析2011年10月—2014年2月67例高血压脑出血患者。根据治疗方法不同,将67例患者分为西医治疗组和中西医治疗组,所有患者均于发病后24 h内清除血肿,西医治疗组术后给予基础治疗,中西医治疗组在西医治疗组基础上给予口服增液承气汤加减方。观察并比较两组术后不同时期GCS评分变化、神经功能缺损程度评分变化、日常生活活动能力(ADL)评分变化,并比较两组临床疗效。结果两组术后不同时间GCS评分比较差异无统计学意义(P>0.05)。与西医治疗组比较,中西医治疗组术后第21天神经功能缺损程度评分降低(P<0.05),术后第21天日常生活活动能力评分、临床疗效总有效率明显增高(P<0.01,P<0.05)。结论早期手术结合"增水行舟"法治疗高血压脑出血阴虚风动证远期效果优于单纯西医治疗。Objective To observe the clinical effect of early surgery combined with traditional Chinese medicine（ TCM） method of increasing body fluid for curing constipation in treatment of patients with Yinxu Fengdong syndrome.Methods Clinical data of 67 hypertensive cerebral hemorrhage inpatients admitted during October 2011 and February2014 was retrospectively analyzed. The patients were divided into western medicine group（ n = 34） and TCM combined western medicine group（ n = 33） according to the treatment methods. All the patients were treated with hematoma clearance within 24 h,and the western medicine group was given postoperative basic therapy,while the TCM combined western medicine group was given Zengye Chengqi Tang orally based on the basic therapy. The changes in Glasgow Coma Scale（ GCS） scores,degree of neurologic impairment and scores of activities of daily living（ ADL） in different stages in the two groups were observed,and the clinical effect of the two groups was compared. Results The differences of GCS scores in different stages in the two groups were not statistically significant（ P〈0. 05）. Compared with those of western medicine group,in TCM combined western medicine group the score of neurologic impairment on the postoperative 21 std was reduced（ P〈0. 05）,while the ADL score and total effect rate on the postoperative 21 std were significantly increased（ P〈0. 01,P 0. 05）. Conclusion Early surgery combined with TCM method of increasing body fluid for curing constipation in treatment of hypertensive cerebral hemorrhage patients with Yinxu Fengdong syndrome has better long-term effect than that of only western treatment.

关 键 词：中西医结合疗法 神经外科手术 阴虚动风 颅内出血 高血压性 增液承气汤 

分 类 号：R743.34[医药卫生—神经病学与精神病学] R242[医药卫生—临床医学]