加用中医分期序贯疗法在高血压脑出血中的疗效观察  

Clinical observation on the combined treatment of hypertensive intracerebral hemorrhage with TCM sequential therapy by stages

作　　者：邵波 陈钰 侯正军 陈慧慧 杨鹏翔 滕灵方 SHAO Bo;CHEN Yu;HOU Zhengjun;CHEN Huihui;YANG Pengxiang;TENG Lingfang(Department of Neurosurgery,the First People's Hospital of Wenling in Zhejiang Province,Wenling 317500,China;Department of Traditional Chinese Medicine,the First People's Hospital of Wenling in Zhejiang Province,Wenling317500,China)

机构地区：[1]浙江省温岭市第一人民医院神经外科,浙江温岭317500 [2]浙江省温岭市第一人民医院中医科,浙江温岭317500

出　　处：《中国现代医生》2020年第31期142-145,154,共5页China Modern Doctor

基　　金：浙江省中医药科技计划项目(2018ZB139)。

摘　　要：目的探讨在高血压脑出血不同病期辨证加用中医序贯疗法的疗效。方法选择2018年1月~2019年12月温岭市第一人民医院收治的60例高血压脑出血患者,分为对照组和观察组,每组各30例,对照组予常规西医治疗,观察组加用中医序贯疗法,即出血水肿期采用泻火解毒涤痰通腑法,血肿吸收期采用平肝潜阳化痰醒脑法,功能恢复期采用益气养血化瘀通络法,日一剂,口服或鼻饲。通过中医症状量化评分、NIHSS量表和Barthel指数比较对照组和观察组治疗前后指标变化。结果治疗前两组患者的中医症状量化评分、NIHSS评分和Barthel指数比较,差异无统计学意义(P>0.05)。治疗后两组患者的中医症状量化评分和NIHSS评分均较治疗前明显下降,Barthel指数较治疗前明显上升(P<0.05)。分期辨证加用中医序贯疗法后,观察组中医症状量化评分为(6.98±2.13)分,低于对照组的(10.87±3.58)分,观察组NIHSS评分为(6.28±1.64)分,低于对照组的(7.38±1.93)分,观察组Barthel指数为(64.78±20.15)分,高于对照组的(53.92±16.48)分,差异有统计学意义(P<0.05)。结论在高血压脑出血不同病期辨证加用中医序贯疗法疗效确切,符合中医的辨证施治理论,在临床上具有可操作性,值得临床应用。Objective To investigate the therapeutic efficacy of Traditional Chinese Medicine(TCM)sequential therapy combined with syndrome differentiation in different stages of hypertensive intracerebral hemorrhage.Methods A total of 60 patients with hypertensive intracerebral hemorrhage admitted to the First People's Hospital of Wenling from January 2018 to December 2019 were divided into the control group(n=30)and the observation group(n=30)according to the random parallel control principle.The control group was treated with conventional western medicine,while the observation group was treated with sequential therapy of traditional Chinese medicine.That is to say,the methods of purging fire,detoxicating,eliminating phlegm and dredging fu-organs were adopted in the stage of hemorrhage and edema.The methods of calming liver,suppressing yang,resolving phlegm and refreshing brain were adopted in the period of hematoma and absorption qi,nourishing blood,removing blood stasis and dredging collaterals in functional recovery period.The methods of invigorating qi,nourishing blood,removing blood stasis and dredging collaterals were adopted in the period of functional recovery.According to the dosage of one dose per day,oral or nasal feeding was carried out.The changes of indexes before and after treatment were compared between the control group and the observation group by TCM symptom quantitative score,NIHSS scale and Barthel index.Results Before treatment,there were no significant differences in TCM symptom quantitative score,NIHSS score and Barthel index between the two groups(P>0.05).After treatment,the TCM symptom quantitative scores and NIHSS scales of the two groups decreased significantly,while Barthel index increased significantly(P<0.05).The quantitative score of TCM symptoms in the observation group was(6.98±2.13)score,which was lower than(10.87±3.58)score in the control group.The NIHSS score in the observation group was(6.28±1.64)score,which was lower than(7.38±1.93)score in the control group.And the Barthel index

关 键 词：脑出血 序贯疗法 高血压 中医药治疗 

分 类 号：R743.34[医药卫生—神经病学与精神病学]