应用无创脑水肿动态监护仪观察血府逐瘀汤治疗急性脑出血后脑水肿的临床研究  

Clinical Application Research of Non-invasive Dynamic Brain Edema Monitor in Xuefu Zhuyu Decoction on Brain Edema after Acute Intracerebral Hemorrhage

作　　者：熊震[1] 黄宇星[1] 李成勋[1] 姚源[1] 袁苹[1] 刘颖[1] 邓莉莎[1] XIONG Zhen HUA NG Yuxing LI Chengxun et al(Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Sichuan, Chengdu 610000, China.)

机构地区：[1]成都中医药大学附属医院,四川成都610000

出　　处：《中国中医急症》2017年第7期1292-1295,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：成都中医药大学附属医院基金项目(2010-D-YY-27)

摘　　要：目的观察血府逐瘀汤对急性脑出血的治疗价值及无创脑水肿动态监护仪对其治疗及指导的作用。方法 40例急性脑出血患者按随机数字表法分为治疗组和对照组,各20例。其中对照组患者仅采用常规西药治疗,治疗组患者在其基础上再加用血府逐瘀汤予以治疗。所有病例均于入院后第1、3、5、8天观察以下项目:采用无创脑水肿动态监护仪动态检测综合扰动系数、行颅脑CT检查分别计算两组患者的脑血肿量以及其周围的低密度容积的大小、行美国国立卫生研究院卒中量表(NIHSS)评分,并比较两组患者双侧大脑半球扰动系数与血肿周围低密度容积的变化。结果随着治疗的进展,治疗组与对照组患者在扰动系数、水肿程度以及神经功能评分方面在第3、5、8天均有差异,治疗组优于对照组(P<0.05或P<0.01)。两组患者血肿周围低密度容积的变化与其扰动系数及评分的变化一致。在第3、5、8天,治疗组NIHSS评分明显低于对照组(P<0.05或P<0.01)。结论血府逐瘀汤联合常规西医治疗可明显减轻患者继发脑水肿,改善其神经功能。使用无创脑水肿动态监护仪可真实定性的观察脑出血后脑水肿的动态发展演变过程,其综合扰动系数的变化反应了水肿的形成过程,实现动态监测和评估,具有实用、无创、准确、灵敏的特点,对临床的诊断及治疗具有一定的指导意义。Objective： To investi gate the value of Xuefu Zhuyu Decoction in the treatment of acute cerebral hemorrhage and the effect of non-invasive brain edema dynamic monitor on its treatment and guidance. Methods： 40 patients with acute cerebral hemorrhage were randomly divided into treatment group and control group,20 cases in each group. The patients in the control group were treated only with conventional Western medicine,and the treatment group was treated with Xuefu Zhuyu Decoction on the basis of it. The following items were observed on 1st,3rd,5th and 8th days after admission： dynamic detection of synthetic disturbance coefficients with noninvasive brain edema dynamic monitor,the volume of brain hematoma and the size of the low-density volume by CT examination,NIHSS scores. The perturbation coefficients of bilateral cerebral hemisphere and the volume of low density around hematoma were compared between the two groups. Results： With the progress of treatment,the difference was statistically significant in the disturbance coefficient,edema degree and neurological function score between the treatment group and the control group on the third,fifth and eighth days;the treatment group was better than the control group. The change of the low-density volume around the hematoma was consistent with the change of the coefficient of disturbance and the score of the two groups. On the third,fifth and eighth days,the NIHSS score in the treatment group was significantly lower than that in the control group. Conclusions： Xuefu Zhuyu Decoction combined with routine Western medicine treatment can obviously reduce the secondary brain edema and improve the nerve function of the patients. The noninvasive dynamic monitoring of cerebral edema can be used to observe the dynamic evolution of brain edema after intracerebral hemorrhage. The change of comprehensive perturbation coefficient reflects the formation process of edema and realizes dynamic monitoring and evaluation. It is practical,noninvasive,accurate and sensitive,and

关 键 词：急性脑出血 血府逐瘀汤 脑水肿 脑水肿无创监护 

分 类 号：R743.34[医药卫生—神经病学与精神病学]