活血利水通腑方辅助治疗在自发性脑出血灶周水肿中的应用效果及对相关因子的影响  

Efficacy of Huoxue Lishui Tongfu Recipe in Adjunctive Treatment of Edema around Spontaneous Intracerebral Hemorrhage Focuses and Its Effects on Related Factors

作　　者：刘冰 石铁 李占成 LIU Bing;SHI Tie;LI Zhan-cheng(Department of Encephalopathy,Chengde Hospital of Traditional Chinese Medicine,Chengde,Hebei 067000,China)

机构地区：[1]承德市中医院脑病科,河北承德067000

出　　处：《临床误诊误治》2022年第5期23-26,共4页Clinical Misdiagnosis & Mistherapy

基　　金：河北省承德市科学技术局立项课题(201801A018)。

摘　　要：目的探究活血利水通腑方辅助治疗自发性脑出血(SICH)灶周水肿的效果及对相关因子的影响。方法选取2018年1月—2020年9月收治的SICH灶周水肿86例,按治疗方法分为观察组和对照组各43例。对照组采取常规治疗,在此基础上观察组辅助活血利水通腑方治疗。比较2组治疗效果,观察治疗前后水肿情况、血清水肿标志物、脑脊液蛋白酶激活受体-1(PAR-1)、水通道蛋白-4(AQP-4)、美国国立卫生研究院卒中量表(NIHSS)评分、格拉斯哥昏迷量表(GCS)评分变化情况,统计应激性溃疡发生情况。结果观察组总有效率高于对照组(P<0.05)。治疗7 d后,2组血肿体积、水肿体积、脑水肿扰动系数及血清血红素氧合酶-1(HO-1)、基质金属蛋白酶-3(MMP-3)、MMP-9、脑脊液PAR-1、AQP-4水平较治疗前显著下降,且观察组低于对照组(P<0.05,P<0.01)。治疗7 d后,2组NIHSS评分较治疗前下降,GCS评分较治疗前升高,且观察组改善情况优于对照组(P<0.05,P<0.01)。观察组应激性溃疡发生率低于对照组(P<0.05)。结论活血利水通腑方辅助治疗SICH灶周水肿能显著提高治疗效果,促进水肿消退,加快神经功能恢复与疾病转归,且应激性溃疡发生率低。Objective To explore efficacy of Huoxue Lishui Tongfu Recipe in adjuvant treatment of edema around spontaneous intracerebral hemorrhage(SICH) focuses and its effects on related factors.Methods A total of 86 patients with edema around SICH admitted between January 2018 and September 2020 were selected and divided into observation group(n=43) and control group(n=43) according to therapeutic methods. Control group was treated with routine treatment, while observation group was treated with Huoxue Lishui Tongfu Recipe on the basis of treatment for control group. The therapeutic efficacy was compared between two groups. Changes of edema condition, serum edema markers, cerebrospinal fluid protease activated receptor-1(PAR-1), aquaporin-4(AQP-4), scores of National Institute of Health Stroke Scale(NIHSS) and Glasgow Coma Scale(GCS) were observed before and after treatment, and the incidence rates of stress ulcer were calculated. Results The total effective rate in observation group was significantly higher than that in control group(P<0.05). After treatment for 7 d, values of hematoma volume, edema volume, brain edema disturbance coefficient and serum levels of heme oxygenase-1(HO-1), matrix metalloproteinase-3(MMP-3), matrix metalloproteinase-9(MMP-9), cerebrospinal fluid PAR-1 and AQP-4 were significantly lower than those before treatment in two groups, and the values in observation group were significantly lower than those in control group(P<0.05, P<0.01). After treatment for 7 d, NIHSS scores were significantly decreased, while GCS scores were significantly increased compared with those before treatment in two groups, and the improvement conditions in observation group were better than those in control group(P<0.05, P<0.01). Incidence rate of stress ulcer in observation group was significantly lower than that in control group(P<0.05). Conclusion Huoxue Lishui Tongfu Recipe in adjuvant treatment of edema around SICH focuses may significantly improve the therapeutic efficacy, promote regression of edema, accelerate re

关 键 词：自发性脑出血 灶周水肿 活血利水通腑方 血红素氧合酶-1 基质金属蛋白酶 蛋白酶激活受体-1 

分 类 号：R743.34[医药卫生—神经病学与精神病学]