益气化瘀方联合阿托伐他汀钙片对慢性硬膜下血肿气虚血瘀证术后患者血液流变学指标及血肿吸收的影响  

Effect of Yiqi Huayu recipe on hemorheology and hematoma absorption in postoperative patients with chronic subdural hematoma concurrent with hematoma Qi deficiency and blood stasis syndrome

作　　者：顾九馥 王永谦[1] GU Jiufu;WANG Yongqian(Department of Neurosurgery,Longhua Hospital Shanghai University of Traditional Chinese Medicine,Shanghai 200032)

机构地区：[1]上海中医药大学附属龙华医院神经外科,上海200032

出　　处：《河北中医》2021年第2期242-246,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：上海市卫生和计划生育委员会卫生行业临床研究专项计划(编号:201840029)。

摘　　要：目的观察益气化瘀方对慢性硬膜下血肿(CSDH)气虚血瘀证术后患者血液流变学指标及血肿吸收的影响。方法将68例CSDH气虚血瘀证患者按照随机数字表法分为2组。2组均行微创钻孔引流术治疗,对照组34例术后予阿托伐他汀钙片,治疗组34例在对照组治疗基础上予益气化瘀方治疗。2组均连续治疗8周。比较2组治疗前后蒙特利尔认知评估量表(MoCA)评分、日常生活活动能力量表(ADL)评分、血液流变学指标及CT血肿量,分析2组治疗方案的安全性,并统计疗效。结果治疗组总有效率82.3%(28/34),对照组总有效率58.8%(20/34),治疗组疗效优于对照组(P<0.05)。治疗后2组MoCA、ADL评分均较本组治疗前升高(P<0.05),且治疗后治疗组均高于对照组(P<0.05)。治疗后2组全血黏度(高切)、全血黏度(低切)、血浆黏度、红细胞比容、红细胞聚集指数均较本组治疗前降低(P<0.05),且治疗后治疗组均低于对照组(P<0.05)。治疗2、4周后2组颅脑CT血肿量均较本组治疗前降低(P<0.05),且治疗2、4周后治疗组低于对照组(P<0.05)。2组治疗前后生化全项、血、尿常规及凝血象均未出现明显异常。结论益气化瘀方能够调节CSDH气虚血瘀证术后患者血液流变学指标,促进硬膜下血肿吸收,有助于促进患者认知功能和日常生活能力的恢复,疗效确切。Objective To observe the effect of Yiqi Huayu recipe on hemorheology and hematoma absorption in patients with chronic subdural hematoma(CSDH)concurrent with hematoma Qi deficiency and blood stasis syndrome.Methods A total of 68 patients with CSDH were randomly divided into two groups,34 cases per group.Both groups were treated with micro-invasive drainage(MID).The control group was treated with atorvastatin calcium tablet after surgery,and the treatment group was treated with Yiqi Huayu recipe on the basis of the control group.Both groups were treated continuously for 8 weeks.The Montreal Cognitive Assessment Scale(MoCA)scores,Activities of Daily Living Scale(ADL)scores,hemorheology indexes,and CT hematoma volume were compared before and after treatment between the two groups;the safety of the two treatment plans was analyzed and the efficacy was calculated.Results The total effective rate in the treatment group was better than that in the control group[82.3%(28/34)vs 58.8%(20/34),(P<0.05),respectively].After treatment,the scores of MoCA and ADL in the both groups were significantly increased than those in this group before treatment(P<0.05),and which in treatment group were significantly higher than in the control group(P<0.05);the index of the whole bloodviscosity(high shear,low shear),the plasma viscosity,the hematocrit and erythrocyte aggregation in two groups were significantly decreased than those in this group before treatment(P<0.05),and which in the treatment group were significantly lower than in the control group(P<0.05).After 2 weeks and 4 weeks of treatment,the CT hematoma volume in the two groups was significantly lower than that in this group before treatment(P<0.05),and which in the treatment group was significantly lower than in the control group(P<0.05);there was no obvious abnormality in biochemical test,blood routine test,urine routine test and coagulation test between the two groups compared before treatmeat.Conclusion Yiqi Huayu Recipe can adjust hemorheology indexes of postoperative patient

关 键 词：血肿 硬膜下 慢性 益气 中药疗法 血液流变学 

分 类 号：R651.155[医药卫生—外科学]