五苓散联合脑室腹腔分流术治疗特发性正常颅压脑积水疗效观察  

Treatment of Idiopathic Normal-Pressure Hydrocephalus by Wuling Powder Combined Ventriculoperitoneal Shunt Surgery: an Efficacy Observation

作　　者：陈祖鹏[1] 张昕[1] 黄李法[1] 李徐[1] 徐震[1] 竺国充[1] 

机构地区：[1]浙江中医药大学附属第一医院神经外科,杭州310006

出　　处：《中国中西医结合杂志》2016年第11期1312-1315,共4页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：浙江省中医药科技计划(No.2014ZB040)

摘　　要：目的观察五苓散联合脑室腹腔分流术治疗特发性正常颅压脑积水(idiopathic normal-pressure hydrocephalus,INPH)的临床疗效。方法 56例患者随机分为对照组及治疗组,每组28例,两组均予以脑室腹腔分流术;术后3天治疗组加服五苓散,对照组加服安慰剂,每天1剂,分早、晚口服,7天为1个疗程,共6个疗程。治疗前及术后3个月检测两组简易精神状态检查量表(Mini-Mental State Examination,MMSE)评分、转向步数、Evan’s指数,记录两组不良反应,术后3个月评价临床疗效。结果治疗组治愈21例(80.8%),好转3例(11.5%);对照组治愈14例(51.9%),好转11例(40.7%)。治疗组治愈率高于对照组(P<0.05)。与本组术前比较,两组术后3个月MMSE评分升高(P<0.05),转向步数及Evan's指数降低(P<0.05)。与对照组同期比较,治疗组术后3个月MMSE评分升高(P<0.05),180°转向步数降低(P<0.05)。结论五苓散联合脑室腹腔分流术治疗INPH疗效优于单用分流术。Objective To observe the clinical efficacy of Wuling Powder （WP） combined ventricu- Ioperitoneal shunt surgery in patients with idiopathic normal-pressure hydrocephalus （INPH）. Methods Totally 56 INPH patients were randomly assigned to the control group and the treatment group, 28 in each group, All patients received ventriculoperitoneal shunt surgery. Three days after surgery patients in the treatment group took WP, while those in the control group took placebo decoction （one dose per day, once in the morning and once in the evening, 7 days as one course, a total of 6 courses after surgery）. Mini- Mental State Examination （MMSE） score, the steps to turn around 180°, and Evan＇s index were tested be- fore surgery and 3 months after surgery. Adverse reactions were recorded in the two groups. Clinical effica- cy was assessed after 3 months of surgery. Results At month 3 after surgery 21 patients （80.8%） were cured and 3 patients （11.5%） were improved in the treatment group, with statistical difference when com- pared with the control group [14 cured （51.9%） and 11 improved （40.7%） ; P 〈0.05]. Compared with be- fore surgery in the same group, levels of MMSE score increased and the steps to turn around 180° were obviously reduced in the two groups at month 3 after surgery （both P 〈0.05）. Compared with the control group at month 3 after surgery, levels of MMSE score increased and the steps to turn around 180° were ob- viously reduced in the treatment group （both P 〈0.05）. Conclusion In treating INPH patients, WP combined ventriculoperitoneal shunt surgery was superior to the effect of using ventriculoperitoneal shunt surgery alone.

关 键 词：五苓散 特发性正常颅压脑积水 脑室腹腔分流术 

分 类 号：R651.1[医药卫生—外科学]