中西医结合治疗重型颅脑损伤后急性期脑血管痉挛临床观察  

Clinical Observation of Integrated Traditional Chinese and Western Medicine in the Treatment of Acute Cerebral Vasospasm After Severe Craniocerebral Injury

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

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

出　　处：《中国药业》2021年第24期87-89,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：目的探讨中西医结合治疗重型颅脑损伤后急性期脑血管痉挛的临床疗效。方法选取河北省遵化市中医医院2017年3月至2019年6月收治的急性重型颅脑损伤住院患者80例,随机分为观察组和对照组,各40例。两组患者均予常规西医治疗,观察组患者加用活血化瘀汤鼻饲+醒脑静注射液静脉滴注+通腑泻热汤灌肠,均治疗18 d。结果观察组患者治疗第1,3,6,12,18天的脑血管痉挛发生率均显著低于对照组(P<0.05),格拉斯哥昏迷量表评分均显著高于对照组(P<0.05);治疗后,两组患者的日常生活能力评定量表评分、Barthel指数评定量表评分均显著高于治疗前,且观察组显著高于对照组(P<0.05);治疗期间,观察组和对照组不良反应发生率相当(17.50%比10.00%,P>0.05)。结论中西医结合治疗重型颅脑损伤后急性期脑血管痉挛,能降低患者的脑血管痉挛发生率,改善精神状态评分和预后生活质量。Objective To investigate the clinical efficacy of integrated traditional Chinese and Western medicine in the treatment of acute cerebral vasospasm after severe craniocerebral injury.Methods A total of 80 inpatients with acute severe craniocerebral injury admitted to the Zunhua Hospital of Traditional Chinese Medicine from March 2017 to June 2019 were selected and randomly divided into the observation group and the control group,40 cases in each group.The patients in the two groups were treated with conventional Western medicine,and the patients in the observation group were given nasal feeding of Huoxue Huayu Decoction+intravenous drip of Xingnaojing Injection+enema of Tongfu xiere Decoction.Both groups were treated for 18 d.Results After 1,3,6,12 and 18 d of treatment,the incidence of cerebral vasospasm in the observation group was significantly lower than that in the control group(P<0.05),while the Glasgow Coma Scale(GCS)score in the observation group was significantly higher than that in the control group(P<0.05).After treatment,the activities of daily living(ADL)score and Barthel Index score in the two groups were significantly higher than those before treatment,and those in the observation group were significantly higher than those in the control group(P<0.05).During the treatment,the incidence of adverse reactions in the observation group was similar to that in the control group(17.50%vs.10.00%,P>0.05).Conclusion Integrated traditional Chinese and Western medicine in the treatment of acute cerebral vasospasm after severe craniocerebral injury can reduce the incidence of cerebral vasospasm,improve the mental state score and quality of life.

关 键 词：重型颅脑损伤 脑血管痉挛 中西医结合 活血化瘀 豁痰开窍 通腑泻热 

分 类 号：R64[医药卫生—外科学] R25[医药卫生—临床医学]