中西医结合治疗急性重型颅脑损伤临床研究  

Clinical Study of Integrated Traditional Chinese and Western Medicine in the Treatment of Acute Severe Craniocerebral Injury

作　　者：赵建阳 张民 薄红梅 李辉 孙强 ZHAO Jianyang;ZHANG Min;BO Hongmei;LI Hui;SUN Qiang(Zunhua People's Hospital,Tangshan,Hebei,China 064200;Zunhua Hospital of Traditional Chinese Medicine,Tangshan,Hebei,China 064200)

机构地区：[1]河北省遵化市人民医院,河北唐山064200 [2]河北省遵化市中医医院,河北唐山064200

出　　处：《中国药业》2021年第20期96-98,共3页China Pharmaceuticals

基　　金：河北省中医药管理局科研计划项目[2020409]。

摘　　要：目的探讨活血化瘀汤鼻饲、醒脑静注射液静脉滴注、通腑泻热汤灌肠联合西医治疗急性重型颅脑损伤的临床疗效。方法选取遵化市人民医院2017年3月至2019年6月收治的急性重型颅脑损伤患者80例,按随机数字表法分为观察组和对照组,各40例。两组患者均予常规西医治疗,包括甘露醇注射液、氨甲苯酸注射液、依达拉奉注射液静脉滴注;观察组患者加用活血化瘀汤鼻饲、醒脑静注射液静脉滴注及通腑泻热汤灌肠。两组均连续治疗18 d。结果治疗期间,观察组脑血管痉挛及脑梗死发生率均明显低于对照组(P<0.05);治疗后,观察组患者的格拉斯哥昏迷指数评分、日常生活活动能力量表评分及超氧化物歧化酶(SOD)水平均明显高于对照组(P<0.05),大脑前、中、后动脉和椎动脉血流速率,以及丙二醛、内皮素-1水平均明显低于对照组(P<0.05);观察组与对照组不良反应发生率差异不显著(15.00%比7.50%,P>0.05)。结论上述中西医结合方案治疗急性重型颅脑损伤,能进一步改善患者的昏迷状态、预后和生活质量,降低脑血管痉挛和脑梗死的发生率,其机制可能与改善颅内血流速率及减轻机体的氧化应激反应等有关。Objective To investigate the clinical efficacy of nasal feeding of Huoxue Huayu Decoction,intravenous drip of Xingnaojing Injection,enema with Tongfu Xiere Decoction combined with Western medicine in the treatment of acute severe craniocerebral injury.Methods A total of 80 patients with acute severe craniocerebral injury admitted to the Zunhua People’s Hospital from March 2017 to June 2019 were selected and divided into the observation group and the control group according to the random number table method,40 cases in each group.Both groups were treated with conventional Western medicine,including intravenous drip of Mannitol Injection,Aminotoluene Acid Injection and Edaravone Injection,on this basis,the patients in the observation group were treated with nasal feeding of Huoxue Huayu Decoction,intravenous drip of Xingnaojing Injection and enema with Tongfu Xiere Decoction.Both groups were continuously treated for 18 d.Results During the treatment,the incidence of cerebral vasospasm and cerebral infarction in the observation group was significantly lower than that in the control group(P<0.05).After treatment,the Glasgow Coma Scale(GCS)score,activities of daily living(ADL)score and the level of superoxide dismutase(SOD)in the observation group were significantly higher than those in the control group(P<0.05),and the blood flow velocity of anterior cerebral artery,middle cerebral artery,posterior cerebral artery and vertebral artery,as well as the levels of malondialdehyde(MDA)and endostatin-1(ET-1)in the observation group were significantly lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the observation group and the control group(15.00%vs.7.50%,P>0.05).Conclusion The above scheme of integrated traditional Chinese and Western medicine in the treatment of acute severe craniocerebral injury can further improve the coma state,prognosis and quality of life,and reduce the incidence of cerebral vasospasm and cerebral infarction.Its mechani

关 键 词：急性重型颅脑损伤 活血化瘀汤 醒脑静注射液 通腑泻热汤 格拉斯哥昏迷指数 生活质量 颅内血流速率 氧化应激反应 

分 类 号：R969.4[医药卫生—药理学] R2-031[医药卫生—药学]