加味三化汤联合常规疗法治疗急性脑出血临床观察  

Clinical Observation of Modified Sanhua Tang Combined with Routine Therapy for Acute Cerebral Hemorrhage

作　　者：袁敏 YUAN Min

机构地区：[1]浙江中医药大学,浙江杭州310053

出　　处：《新中医》2018年第4期59-62,共4页New Chinese Medicine

摘　　要：目的:观察加味三化汤联合常规疗法治疗急性脑出血的疗效及对血清中白细胞介素(IL)-6和肿瘤坏死因子(TNF)-α水平的影响。方法:筛选100例急性脑出血痰热腑实、风痰闭阻证患者,按随机数字表法分成治疗组和对照组,每组50例。2组均予常规对症治疗,治疗组联合加味三化汤治疗,2组疗程均为2周。比较2组治疗前后的格拉斯哥昏迷量表(GCS)评分、美国国立卫生研究院卒中量表(NIHSS)评分、中医症状评分、血清IL-6、TNF-α水平及临床疗效。结果:治疗后,治疗组总有效率为92.00%,高于对照组的74.00%,差异有统计学意义(P<0.05)。2组GCS评分均较治疗前升高,NIHSS评分均较治疗前减少,差异均有统计学意义(P<0.01)。与对照组比较,治疗组NIHSS评分减少更显著,差异均有统计学意义(P<0.01)。2组头痛、目眩、痰多、大便干便秘、舌苔黄腻、舌质暗红评分均较治疗前减少(P<0.01);与对照组比较,治疗组各项症状评分减少更明显(P<0.01)。2组IL-6和TNF-α水平均较治疗前降低(P<0.01);与对照组比较,治疗组IL-6和TNF-α水平降低更明显(P<0.01)。结论:加味三化汤联合常规疗法治疗急性脑出血痰热腑实、风痰闭阻证疗效明显,缓解机体内炎症反应的效果确切,可有效促进神经功能缺损的恢复及意识状态的改善,值得进一步探讨。Objective：To observe the clinical effect of modified Sanhua tang combined with routine therapy for acute cerebral hemorrhage and its effect on the serum levels of interleukins（IL）-6 and tumor necrosis factor（TNF）-α.Methods：Selected 100 cases of patients with acute cerebral hemorrhage along with syndrome of phlegm-heat and fu-organ sthenia,wind-phlegm stagnation,and divided them into the treatment group and the control group randomly,50 cases in both groups.Both groups were given the routine symptomatic treatment,while the observation group additionally received modified Sanhua tang for treatment,and the course of treatment for both groups lasted for 2 weeks.Compared Glasgow Coma Scale（GCS）scores,National Institute of Health Stroke Scale（NIHSS）scores,Chinese medicine syndrome scores,the serum levels of IL-6 and TNF-α and the clinical effect in the two groups before and after treatment.Results：After treatment,the total effective rate was 92.00% in the treatment group,higher than 74.00% in the control group,difference being significant（P 0.05）.GCS scores in both groups were higher than those before treatment,and NIHSS scores were lower than those before treatment,differences being significant（P〈0.01）.Comparing with the control group,GCS scores in NIHSS scores in the treatment group were lower significantly,differences being significant（P〈0.01）.The scores of headaches,dizziness,abundant sputum,dry stool or constipation,yellowish fur and dark red tongue in both groups were lower than those before treatment（P〈0.01）;comparing with the control group,the scores of each symptom in the treatment group were decreased more evidently（P〈0.01）.The serum levels of IL-6 and TNF-α in both groups were lower than those before treatment（P〈0.01）;comparing with the control group,the serum levels of IL-6 and TNF-α in the treatment group were decreased more evidently（P〈0.01）.Conclusion：Modified Sanhua tang combined with routine therapyhas significant clinical effect in tr

关 键 词：急性脑出血 痰热腑实证 风痰闭阻证 中西医结合疗法 三化汤 炎症因子 格拉斯哥昏迷量表(GCS) 美国国立卫生研究院卒中量表(NIHSS) 

分 类 号：R743[医药卫生—神经病学与精神病学]