通窍活血方治疗血瘀型脓毒性脑病患者的临床疗效观察  

Clinical observation on treating the blood stasis type of septic encephalopathy with the Tongqiao Huoxue decoction

作　　者：张云海[1] 邓梦华[1] 马明远[1] Zhang Yunhai

机构地区：[1]佛山市中医院,广东佛山528000

出　　处：《中医临床研究》2021年第7期63-66,共4页Clinical Journal Of Chinese Medicine

基　　金：佛山市卫生和计划生育局医学科研课题(编号:20160036)。

摘　　要：目的:观察中药通窍活血方对血瘀型脓毒性脑病(Septic Encephalopathy,SE)患者的临床疗效。方法:将佛山市中医院重症加强护理病房(Intensive Care Unit,ICU)的SE患者随机分为对照组和观察组,每组40例。对照组患者按照2016年脓毒症指南进行西医常规治疗。观察组患者在对照组的治疗基础上,予服用通窍活血方中药。检测两组患者治疗前后的凝血功能,比较两组患者治疗前后的急性生理与慢性健康(Aaute Physiology and Chronic Health Evaluation II,APACHEII)评分、格拉斯哥昏迷评分(Glasgow Coma Scale,GCS)和临床疗效,统计ICU住院时间和28天病死率。结果:在凝血功能方面,观察组的纤维蛋白原(Fibrinogen,Fg)治疗前后比较无明显差异(P>0.05),对照组治疗后的Fg和血小板计数(Platelet Count,PLT)较前升高(P<0.05)。观察组的活化部分凝血酶原时间(Activated Partial Thromboplastin Time,APTT)、D-二聚体(D-Dimer,DD)和PLT较治疗前及对照组均有明显改善,差异均有统计学意义(P<0.05)。两组患者治疗后的GCS评分和APACHEII评分均有改善(P<0.05),而观察组相比对照组改善更明显(P<0.05)。治疗后的疗效评定,观察组显著优于对照组。观察组的ICU住院时间明显短于对照组(P<0.05),但28天病死率比较无统计学差异(P>0.05)。结论:应用通窍活血方治疗血瘀型SE患者具有良好的临床疗效,且可改善SE患者的凝血功能和缩短ICU住院时间。Objective:To observe the clinical efficacy of the Tongqiao Huoxue decoction(通窍活血方)on the blood stasis type septic encephalopathy.Methods:The patients were randomly divided into the control group and the observation group,with 40 cases in each group.The control group received conventional western medicine treatment.The observation group were prescribed the Tongqiao Huoxue decoction more.Results:In terms of coagulation function,there was no significant difference in FbgC before and after treatment in the observation group(P>0.05),while FbgC and PLT in the control group were increased after treatment(P<0.05).The APTT,DD and PLT in the observation group were significantly better compared with those before treatment and the control group,and the differences were statistically significant(P<0.05).The GCS score and APACHEII score in the groups were improved after treatment(P<0.05),while the improvement in the observation group was more significant than the control group(P<0.05).The clinical effect in the observation group was significantly better than the control group.The length of ICU stay in the observation group was significantly shorter than that in the control group(P<0.05),but there was no statistical difference in the 28-day mortality rate(P>0.05).Conclusion:The Tongqiao Huoxue decoction shows a good clinical effect on the blood stasis type septic encephalopathy,and it can improve the coagulation function of patients and shorten the length of ICU stay.

关 键 词：脓毒性脑病 通窍活血方 凝血功能 临床疗效 

分 类 号：R259[医药卫生—中西医结合]